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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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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)
10 year study showed NSAIDs associated with slowing radiographic progression in axSpA patients. mSASSS progression numerically lower in COX2i pts compared to non-selective NSAIDs.
@RheumNow #EULAR2022 #ABSTOP0021 https://t.co/dfz3rseikl
Robert B Chao, MD doctorRBC ( View Tweet)
Secukinumab 300mg at week 52 in ankylosing spondylitis patients (who did not achieve inactive disease with SEC 150mg at week 16) experienced similar clinical response and safety profile regardless of dose escalation.
#EULAR2022 @RheumNow #ABSTOP0023 https://t.co/7LeZMMWeRC
Robert B Chao, MD doctorRBC ( View Tweet)
SELECT-AXIS 2 trial demonstrated efficacy and safety of upadacitinib in treatment of non-radiographic axSpA. ASAS40 at week 14 (45% vs. 23% placebo). No MACE, VTEs, IBD, death.
@RheumNow #EULAR2022 ABST#OP0016 https://t.co/vyky0JJJjS
Robert B Chao, MD doctorRBC ( View Tweet)
Combination tx of NSAIDs and TNFi (celecoxib and golimumab) did not show significant superiority compared to TNFi alone in slowing radiographic progression for treatment of radiographic axSpA. There was a numerical reduction however.
#EULAR2022 @RheumNow #ABSTOP0018 https://t.co/gUZAwd92dK
Robert B Chao, MD doctorRBC ( View Tweet)
