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Don’t be ‘ticked’: TYK2 is not a JAK!

Janet Pope, MD, MPH, FRCPC Nov 12, 2022

Recently the FDA approved deucravacitinib, a highly selective TYK2 inhibitor for psoriasis. Trials are positive in psoriatic arthritis and a phase II study in SLE. What about the effects? Presentations from the ACR22 meeting may provide answers.

Keynote lecture from Abraham Varghese at #ACR22 @RheumNow Opening Session Physicians and Patients ◦ Physical examination is meaningful and cannot be replaced by technology ◦ Don’t treat the EHR, treat the patient ◦ Acknowledge how much goes into patient care by our nurses https://t.co/piV0O8O7Hw

@MayoClinic data for bari in relapsing GCA caused waves at #ACR21 Spanish data looking at real-world practice: slightly longer, slower GCA, but equally encouraging outcomes waiting for SELECT-GCA with interest! @EBRheum ABST0464 #ACR22 @RheumNow https://t.co/pVRPXAohhc https://t.co/FgNNfPSWk3

https://twitter.com/drdavidliew/status/1457688108338606083

Ab0349 #ACR22 BEL vs AZA ifn risks in non-renal SLE BEL: lower risk of severe ifn (HR 0.81) and hospitalization for ifn (HR 0.73) through 5 yrs Challenge to interpret data as 56% of patients were on glucocorticoids and other anti-rheumatic meds @RheumNow https://t.co/a0tNFn5Wqr

⬆️ correlation between BASDAI + ASQoL in 🙋‍♂️ vs 🙋‍♀️ What does this mean? ❓low disease activity in 🙋‍♀️ resulting in more marked ⬇️ in QoL❓ OR ❓Is there a need for gender stratified tools of disease activity❓ Abst#0406 #ACR22 @RheumNow @Sineadm15

A #myositis discussion will not be complete without a slide on myositis antibodies - @JuliePaikMD Great review slide for trainees! #ACR22 @Rheumnow #RheumTwitter @rheumarhyme @PhRheumaJr @doktora_ging https://t.co/e6cB344vH8

MIRROR results showed 12-month safety/efficacy support MTX co-therapy w/ pegloticase. No IRs after 6mo of tx and increased resolution of tophi at wk 52. I use MTX in my gout pts on Pegloticase. Are you #rheumtwitter? Abs 0001 #ACR22 @RheumNow https://t.co/FLwOmAYrS4

12-month Findings of the Randomized, Double-Blind, Placebo-Controlled, Multicen…

🔸DM pts who are anti-TIF-1 Ab+ have higher risk of malignancy 🔸Ovarian cancer - most common Really important to do cancer screening in #dermatomyositis #ACR22 @RheumNow https://t.co/jErqcR0Gyr

Study of IV tocilizumab for GCA that led to FDA approval of intravenous TCZ this year (2/2022) -one of Dr. C Langford's pick for #YearinReview @rheumnow #ACR22 https://t.co/luxDDluddM

Effect of Tocilizumab on Disease Activity in Patients With Active Polymyalgia R…

Is it the medication or behaviour that increases mortality? #SLICC grp showed in #SLE severe non-adherence to #HCQ in Yr 1 of #lupus = 3 poor outcomes -more 1 flares, 2 damage, 3 5yr-death. Surrogate of other poor health behaviours and/or HCQ? abst#0343 #ACR22 #ACRBest @RheumNow https://t.co/tTRdyti0sf

OPAL dataset 🇦🇺: 55000+ RA pts, 1/10 first line JAKi. Persistence > if 1st line,< x2 if 3rd line. 1/2 switch JAKi->TNFi 1/3 switch JAKi ->JAKi Why high proportion of JAKi cycling, when AE reason for switch low? https://t.co/APdWW7fzJE Abst #0274 #ACR22 @Rheumnow @ClaireDeakin10 https://t.co/3xM3lQO1wI

Temporal Trends and Risk of Rheumatoid Arthritis in Celiac Disease Patients: A …

Ab#0348 #ACR22: Meta-analysis of Belimumab for CLE w or w/o SLE 13 studies included: 70% with low risk of bias BEL improved clinical response at W52 vs non-users OR 1.44 Decrease risk of severe cutaneous flare OR 0.51 Most studies against placebo group @RheumNow https://t.co/2bSwNKRHZZ

TCZ in GCA: what does it mean for diabetes? post-hoc GiACTA: HbA1c obvs better with TCZ (PNL dosing) but then: even after adjusting for PNL dose, apparent benefit Is there protective effect? Interesting observation worth investigating ABST0461 @MGHrheumatology #ACR22 @RheumNow https://t.co/CF1as5y7Yy

#ACR22 Year in Review. Dr Varga highlighted work by @Kahlenberglab. Non-lesional skin in patients with #lupus is not normal and is IFN-riched. Also implication for future therapy development to target organ/tissues vs circulation @RheumNow https://t.co/rSnLYrZoMO

#ACR22 Yr in Review. John Varga says novel vaccination immune therapy may reverse #fibrosis - at least in mice. Hope for #scleroderma & other fibrotic diseases. Data need to be transferred into human experiments @RheumNow https://t.co/ybFRXheQq3

Ab0343. #ACR22 Severe non-adherence of HCQ associated with FLARES, DAMAGE and DEATH 7.3% had "severe non-adherence" by HCQ levels Hazard ratio of flare 3.3, damage 4.26, and death 5.4 Not surprising, but very useful for pt discussion Checking HCQ levels are helpful! @Rheumnow https://t.co/S7P9oTPRGJ

Study showing Evusheld can protect our patients who are immunosuppressed; it saved alot of live. One of Dr. C Langford's pick for #YearinReview @rheumnow #ACR22 https://t.co/6ekWvA6Ruw

https://www.nejm.org/doi/full/10.1056/NEJMoa2116620

ACR Year in review J. Varga What drives TNF superproduction in RA? Study mice 🐁 model grafted w/ human synovial tissue suggests important role of mitochondrial stress through aspartate deficiency A potential new therapeutic target 🎯 RA? @RheumNow #ACR22 #ACRyearinreview https://t.co/lKrOn05sFp

Was delighted to be a (very) small part of the fantastic work by the covid GRA getting a special mention by Dr Langford at yr in review #ACR22 @RheumNow Congrats @RichardPAConway @EBRheum @jeffsparks @SattuiSEMD @rheum_cat 🎉 https://t.co/W0n7rW9pma

Dr. C Langford's pick for #YearinReview; she is impressed with the novel mechanistic approaches to #SLE @rheumnow #ACR22. https://t.co/5GrtMYYZSv

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Don’t be ‘ticked’: TYK2 is not a JAK!

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