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Drug retention of TNFi vs. secukinumab in AxSpA pts
Abs#911
⭐️46% discontinued either treatment
⭐️TNFi with slightly better drug retention
⭐️Age, BASDAI, BMI did not favor any group
⭐️inefficacy - main reason
#ACR21 @RheumNow https://t.co/ynoomYrTvX
Robert B Chao, MD doctorRBC ( View Tweet)
Dr. R Thomas: current studies on prevention of RA:
👉oral DMARDS (MTX, HCQ)
👉biologics (RTX, abatacept)
👉 studies regulating T cells to restore tolerance
👉biomarkers of tolerant state & look at people who don't develop RA
👉 imaging as window of subclin dz. #ACR21 @rheumnow https://t.co/5bsu5459az
TheDaoIndex KDAO2011 ( View Tweet)
#ACR21 Abs#0818: Starting biologics in moderate vs severe RA activity:
▶️ Moderate disease activity: more likely to reach LDA, remission
▶️ Severe disease: greater overall improvements, but less likely to reach remission
https://t.co/9jBtN9wUGF @Rheumnow
Links:
Eric Dein ericdeinmd ( View Tweet)
Tocilizumab biosimilar study. Pharmacokinetic and pharmacodynamic bioequivalence. Delighted to see this, we really need a toc biosimilar after the negative impact of supply shortages of Actemra/Roactemra this year on patients. Abstr#0823 #ACR21 @RheumNow https://t.co/MMVCwaar3r
Richard Conway RichardPAConway ( View Tweet)
#ACR21 Abst#0793. Japanese multicenter US cohort (KUDOS) study, looked at difficult to treat (D2T) RA pts
▶️ 1/5 pts are D2T (fail 2+ b/tsDMARD, mod disease or GCs)
⭐️ Contributors of good outcomes: IL-6i (OR 9.6), concomitant MTX (OR 7.1)
@Rheumnow https://t.co/9YSa4ebQlR
Links:
Eric Dein ericdeinmd ( View Tweet)
Novel treatment options for Giant Cell Arteritis
Giant cell arteritis is associated with significant treatment related morbidity due to the dependence on glucocorticoids as a treatment option. After sixty years of therapeutic stagnation, these are exciting times in the management of GCA. At this year's ACR Convergence meeting, encouraging data will be presented on options for GCA.
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@benjaminsutu @RheumNow Always steroids first, we learned that the hard way in GUSTO - but yeah, probably something after that, and TCZ is our only b/tsDMARD choice... for the time being
(at #ACR21 - mavrilimumab, baricitinib, secukinumab...)
David Liew drdavidliew ( View Tweet)
Blurred line btwn RA, preRA & RA prevention which makes interpretation of RCTs problematic. I’ve learned that if pt has RA not meeting criteria, some Rx ⬇️chance of RA over time-MTX, now #Abatacept but was it RA anyway AND what happens when you stop Rx? #ACR21 @RheumNow abst#0505 https://t.co/HwivsITvCQ
Janet Pope Janetbirdope ( View Tweet)
#ACR21 #Abstr0437 OK, so RTX affects #COVID vaccine but some pts need RTX. Factors predicting response to vaccine:
RA vs AAV/IIM
Higher IgG
Longer time-to-RTX
Lower RTX courses Number.
Prediction Calculator is developed but need ext. validation #RheumNow https://t.co/iXSaGQ76hS https://t.co/WQAV3GRPBz
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Role of anti-CK antibodies:
👉⬆️susceptibility to severe mycobacterial dz & opportunistic infx (similar to HIV)
👉causes an indeterminate quantiferon (no response to mitogen)
👉initiated by infx➡️anti-Noc2 Ab➡️cross react with IFN➡️IFN-Ab
👉⬆️severity of #COVID19 #ACR21 1/2 https://t.co/5NHQpwQw6X
TheDaoIndex KDAO2011 ( View Tweet)
#GreatDebate: add belimumab (BLMB) vs. voclosporin (VCS) to MMF for lupus nephritis (LN)
Dr. Petri argues for BLMB b/c: (1/2)
👉improvement in LN
👉improvement in non-renal lupus
👉decrease lupus renal mortality
👉**prevent GFR reduction **
👉long term efficacy
#ACR21 @rheumnow
TheDaoIndex KDAO2011 ( View Tweet)
#ACR2021 Dr. L Sammaritano shows evidence for using belimumab during breastfeeding @RheumNow https://t.co/kDXXauoOZQ
Donald Thomas, MD lupuscyclopedia ( View Tweet)
IL-22 as a potential biomarker of AxSpA from non-inflammatory mimickers?
⬆️IL-22 in AxSpA vs. controls
⭐️IL-22 did not correlate w/ mSASSS, BASADI, ASDAS, CRP
Abs#385
#ACR21
@RheumNow https://t.co/hNtStAluJH
Robert B Chao, MD doctorRBC ( View Tweet)
Biologic dose tapering in #axialspondyloarthritis in 52% of patients if criteria are met (BASDAI)< 40, physician global score< 40 and no signs of disease activity the previous year, escalation to previous dose if there is a flare @RheumNow #ACR21 Abst#0364 https://t.co/4GntJ6jS11
Dr. Antoni Chan synovialjoints ( View Tweet)
KEEPsAKE trial 1 (DMARD-IR) and 2 (DMARD/biologic-IR) on risankizumab (IL23i) for PsA:
👉phase 3 DBRPCT 24 weeks
👉150 mg week 0,4, 16 weeks
👉improved ACR20,ACR50,ACR70
👉improved PASI90
👉improved HAQ-DI
👉no increased safety signals
#ACR21 Abstr#0438 #Plenary @rheumnow https://t.co/ioIBXgV4Hi
TheDaoIndex KDAO2011 ( View Tweet)
Prevention study using Abatacept in 100 patients with arthralgia is superior (61%) to placebo (31%) in improving subclinical inflammation in RA at-risk patients (ACPA+, MRI+, Arthralgia+) at 6 months. No new safety issue emerged @RheumNow #ACR21 Abst#0455 https://t.co/DoRItcHfBE
Dr. Antoni Chan synovialjoints ( View Tweet)
#ClinicalPearl What lasts longer/⬆️retention in sero+ RA: Abatacept or TNFi or JAKi? #ACR21 abst#0463 @RheumNow Adjusting for confounding incl line of Rx / past bio Rx, #abatacept wins. But data not stratified for bio naive or exposed. Not sure if that would alter results https://t.co/1dEQncwPQF
Janet Pope Janetbirdope ( View Tweet)
Retrospective study of FAERS database: 186 irAE w/rheum manifestation
👉4.7% of all AEs
👉Arthritis, myositis, Sjogren, sarcoidosis were frequent
👉myositis assc w/ durvalumab, avelumab, atezolimumab and cemiplimab
#ACR21 Abstr#0438 #Plenary @rheumnow https://t.co/t8UQWQicFc https://t.co/FGo6WCDQTp
TheDaoIndex KDAO2011 ( View Tweet)
How can we tell whether a patient already on rituximab will have an immunogenic response to Pfizer COVID-19 vaccination?
Better chance of response if:
- RA or SLE, not AAV or IIM
- high serum IgG pre-last RTX
- longer time since last RTX
Israeli data #ACR21 ABST0437 @RheumNow https://t.co/yyuFd0eDH6
David Liew drdavidliew ( View Tweet)
Phase 2 German study demonstrates superiority of TCZ vs PBO in FMF. SAA levels only normalized in TCZ treated patients. Interesting concept that needs to be replicated in larger trials. Abs 0193 #ACR21 #RheumNow @RheumNow https://t.co/awqOpwg3gH https://t.co/lGzYglnkyM
Dr. Rachel Tate uptoTate ( View Tweet)