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JAKi for nonradiographic axSpA
One area of continued interest for many rheumatologists is the field of non-radiographic axial spondyloarthritis. Furthermore, the question of the utility of JAK inhibitors for the treatment of axial spondyloarthritis has been on the rise.
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The PROOF study showed the predictors of radiographic progression included male gender HR 3.16, good response to NSAIDs HR 4.66, fulfillment of the imaging arm HR 6.64 and HLA-B27+ HR 3.99 by Poddubnyy et al #EULAR2022 @RheumNow OP0149
Dr. Antoni Chan synovialjoints ( View Tweet)
The GESPIC cohort reports in Axial PsA, 75% had inflammatory back pain, 45% met NY criteria for AS, 55% with active inflammatory change in SI joint and 60% in the spine. This is where the overlap between Axial PsA and Axial SpA happens, Kading et al #EULAR2022 @RheumNow OP0026
Dr. Antoni Chan synovialjoints ( View Tweet)
Pregnancy outcomes in SpA
Increased risk of
❗️gestational diabetes aRR 1.88
❗️Cesarean delivery aRR 1.54 & 1.23
❗️preterm birth aRR 1.52
❗️trend for increased infection
in 1st year of life in newborns aRR 1.23.
#EULAR2022 @RheumNow OP0126 https://t.co/jMryB5UXQr
Aurelie Najm AurelieRheumo ( View Tweet)
Hamroun S et al for the GR2 Cohort showed that age HR 1.22 and use of NSAIDs HR 3.01 in the pre-conception period was associated with a longer time to conception in women with SpA. Research is needed on continuous NSAID use in the preconception period #EULAR2022 @RheumNow OP0153 https://t.co/hl6jUlK5PN
Dr. Antoni Chan synovialjoints ( View Tweet)
How many and quickly does nr-AxSpA progress to r-AxSpA? Poddubnyy et al for the PROOF study showed that 16% of nr-AxSpA pts progressed to r-AxSpA within 5 years, mean time to radiographic progression was 2.4 years #EULAR2022 @RheumNow OP0149 https://t.co/KTC8Xkt4ey
Dr. Antoni Chan synovialjoints ( View Tweet)
Good morning from Copenhagen. Starting the day with looking at imaging in SpA, review of posters, vaccination, lupus nephritis and auto inflammatory disease #EULAR2022 @RheumNow https://t.co/aPEkLjDaK7
Dr. Antoni Chan synovialjoints ( View Tweet)
ASRI @Gillianfitzger1 @bososhea @Sineadm15 Current smoking is associated with lower risk of uveitis and arthritis in males with axSpA. I wonder why this would be? @RheumNow #EULAR2022 POS1001 https://t.co/3bKmyvI606
Richard Conway RichardPAConway ( View Tweet)
Sex differences may affect the response to first line TNFi in AxSpA. Hellamund et al EuroSpA study showed the TNFi 6/12/24 month retention rate was lower in females (58%) compared to males (72%). Females had lower CRP level and higher PROs at baseline #EULAR2022 @RheumNow OP0020 https://t.co/ANgRYMxpat
Dr. Antoni Chan synovialjoints ( View Tweet)
Upadacitinib shows promising response in the treatment of nr-AxSpA in the SELECT-AXIS 2 study. Deodhar et al showed the ASAS40 response rate for UPA was twice vs placebo (45% vs 23%). 12/14 of the secondary endpoints were also met #EULAR2022 @RheumNow OP0016 https://t.co/dOWVJdLRtG
Dr. Antoni Chan synovialjoints ( View Tweet)
Updated #EULAR2022 AxSpa Recc: The Algorithm @rheumnow https://t.co/fu46QJ3jmQ
TheDaoIndex KDAO2011 ( View Tweet)
GR2 cohort prospective study of pregnancies in 126 pts w/ SpA over 15 years
-Rx exposure 23% steroids, 11% NSAIDS, 55% biologics
- 116 live births, 7 miscarriages, 3 stillbirths
- 36.5% had unfavorable pregnancy outcomes
- 19% SGA
- 4.8% preterm birth
#EULAR2022 @rheumnow POS1000
TheDaoIndex KDAO2011 ( View Tweet)
SELECT-AXIS 2: RCT UPA 15 mgQD vs. PBO in NRAxSpA
as expected:
↘️disease activity
↘️pain and function
↘️QoL
at 14 wks
no new safety alerts https://t.co/2efpx7Mi6i
Aurelie Najm AurelieRheumo ( View Tweet)
AxSpA and AxPsA 2 sides of the same coin or 2 different diseases? Divergent IL-23i efficacy data seem to suggest the latest.
German GESPIC AxPsA cohort:
*More frequently 🚺
*Less frequently B27+
*20% isolated Ax involvement
@Rheumnow OP0026 #EULAR2022 https://t.co/FZP9nEyG7J
Aurelie Najm AurelieRheumo ( View Tweet)
Phase 3 RCT upadacitinib in nrAxSpA. Clinical (ASAS40), PRO, and radiologic response seen at week 14 vs placebo @RheumNow #EULAR2022 OP0016 https://t.co/s3Vf4QiiAD https://t.co/gzlxZ3sxHF
Links:
Richard Conway RichardPAConway ( View Tweet)
#EULAR2022 OP0073: Gender-specific assessment for MRI imaging criteria
⭐️Sex differences in axSpA - disease presentations, jt biomechanics, diagnostic delay in ♀️
⭐️Higher fat metaplasia in ♂️, Sclerosis in ♀️
⭐️Ankylosis much higher in ♂️ (DOR 40!)
@Rheumnow
Eric Dein ericdeinmd ( View Tweet)
Hellamand et al. Sex differences in first TNFi response in AxSpA. Treatment efficacy (RR 0.85) and retention (58% vs 72% month 24) rates lower in females. @RheumNow #EULAR2022 OP0020 https://t.co/2IL88K7q40 https://t.co/hSJds5EJFK
Links:
Richard Conway RichardPAConway ( View Tweet)
Bimekizumab (dual 17A/17F inhibitor) RCT in AS. ASAS40 45% vs 23% at week 16. All secondary clinical and imaging endpoints also + @RheumNow #EULAR2022 OP0019 https://t.co/RiZ7Divap3 https://t.co/ushogL5TaX
Links:
Richard Conway RichardPAConway ( View Tweet)
Dr Fabian Proft @ProftDr present CONSUL open label RCT of effect of adding NSAIDS to TNFi on structural outcomes. Bottom line, no significant difference in mSASSS. However new syndesmophytes in 11% vs 25%. @RheumNow #EULAR2022 OP0018 https://t.co/OcYH6oKbJQ https://t.co/kxH5vUdibe
Links:
Richard Conway RichardPAConway ( View Tweet)
Bimekizumab (dual IL-17F and IL-17A inhibitor) phase 3 study for treatment of active ankylosing spondylitis demonstrated ASAS40 improvement at wk 14 (44% vs. 25%).
#EULAR2022 @RheumNow #ABSTOP0019 https://t.co/eohvNFG3GS
Robert B Chao, MD doctorRBC ( View Tweet)
