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Promising new therapies in SLE
The pharmacology treatment in SLE is a rapidly expanding field of research that provides excitement and optimism to both the patients and the clinicians. We now have three licensed targeted therapies (belimumab and voclosporin in active lupus nephritis and anifrolumab in non-renal SLE) over the last 3 years compared to one therapy (belimumab in non-renal SLE) in the previous 50 years. What are other promising therapies on the horizon?
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#EULAR2023 #POS0116 How does Voclosporin fare in #lupus pts with heavy proteinuria (=>2g/day)? Pooled Analyses from Phase 2&3 RCTs showed consistent improvement in renal response regardless of demographics or clinical characteristics. An option this resistant group @RheumNow https://t.co/AmZ0fStJrW
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2023 #POS0115 Can we minimise placebo response in #lupus trials? Post-hoc analysis of Phase 2 RCT Dapirolizumab (CD40-CD40L-i) showed greater response in acute flare with Normal Complement levels in the PBO group. Could Low Complement be used for trial entry? @RheumNow https://t.co/8aRq5tWi97
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2023 #OP0142 From #Lupus to #Sjogren. A phase 2 RCT in China showed more patients on Telitacicept (BAFF/APRIL-i) achieved significant reduction in ESSDAI at Wk24 vs PBO. Trend to improvement in glandular function. Intriguing option & will await Phase 3 global RCT @RheumNow https://t.co/BCiohuAfP3
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2023 #OP0141 CAR T cell therapy to treat refractory #lupus took centre stage in 2022. Up to 2yrs data on 7 patients showed continued drug-free remission despite repopulation of naive B cells. No safety concerns. Intriguing to learn even longer-term follow-up @RheumNow https://t.co/lINDT32VBj
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2023 #OP0139 Should we aim for dual blockade in #lupus? A Phase 2 RCT showed more patients on ABBV-599 HD (elsubrutinib (BTK-i) + Upadacitinib (JAK-i)) and UPA monotherapy met primary & secondary endpoints vs Placebo at 48Wks. No major malignancy or VTE concerns @RheumNow https://t.co/HEUbkzZwyl
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2023 #OP0137 Most impressive Delta difference vs Control in #lupus! In Phase 3 RCT in China, more patients in Telitacicept, BAFF/APRIL-i met SRI-4 (delta 44% if data imputed; 34% without) vs placebo. No major safety. Global Phase 3 RCT is in progress @RheumNow https://t.co/DUFRQ7pNUA
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2023 #OP0136 New Biomarkers in #lupus nephritis? Indoxyl sulfate and cytosine metabolite serum levels were associated with kidney damage but not SLEDAI and reduced following therapy with anifrolumab in Phase 2 RCT @RheumNow https://t.co/URiKx9rmmU
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2023 #OP0046 With more effective therapies in #lupus, we should aim for bare minimum/cessation of steroid. A study using French database showed:
>12% were on =>5mg Pred/d, this associated with comorbidities & increased costs
14% on high dose Pred weren’t on HCQ
@RheumNow https://t.co/x99Jt9yf1g
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2023 #OP0007 What are the recent trends of autoimmune disease (AID)? A database study (22m) in UK showed:
- 1 in 10 people had AID in the last 20yrs
- socioeconomic, seasonal & regional disparities cd influence pathogenesis
- CTD (SLE,pSS,SSc) tended to co-occur @RheumNow https://t.co/3DDPR2K5NC
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Medication adherence in #lupus - assessed using Optum administrative database 14 yrs. 12510 pts. Median copays were less than $ 10. Black and hispanics had significantly lower odds of adherence after adjusting for several SDOH! @rheumnow #EULAR2023 abst#AB0579 https://t.co/pO5tjzTPbz
Bella Mehta bella_mehta ( View Tweet)
Recruitment in clinical trials is tough in #lupus and #CTD. A #EULAR2023 study of 49 trials, 1909 records- in an unselected, real world cohort of #CTD pts, upto 50% would be excluded due to classification criteria or overlapping features etc! Abst#op0013 @RheumNow https://t.co/X3YuvgSVzo
Bella Mehta bella_mehta ( View Tweet)
#EULAR2023 #OP0052 Could we predict renal flares in #lupus patients treated with Belimumab for non-renal purpose? Post-hoc analyses of 3 x RCTs showed predictors were:
- Current/former renal involvement
- high baseline proteinuria
- hypoalbuminaemia
- low C3
@RheumNow https://t.co/vylWCf0XNy
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
RheumNow’s expanded coverage of the #EULAR2023 annual meeting is sponsored in part by Bristol Myers Squibb. All content is chosen by RheumNow and its faculty.
Dr. John Cush RheumNow ( View Tweet)
#EULAR2023 #OP0053 Baricitinib in non-renal #lupus were inconclusive. How about Renal #SLE?An RCT showed primary endpoint (=>50% reduction in proteinuria) was met more in Bari vs Cyclo at Wks12 & 24. Intriguing but need longer-term, composite endpoint and larger size! @RheumNow https://t.co/z3YJog6gTy
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2023 Could we predict renal flares in #lupus patients treated with Belimumab for non-renal purpose? Post-hoc analyses of 3 x RCTs showed predictors were:
- Current/former renal involvement
- high baseline proteinuria
- hypoalbuminaemia
- low C3
@RheumNow https://t.co/bBtBm1olcr
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Nathalie Conrad, Abstr#OP0007 @RheumNow presenting on the incidence, prevalence and co-occurrence of autoimmune disease - no evidence of overall increase in conditions. Environmental and socioeconomic factors involved in the presentation of the conditions https://t.co/3jy9NoltkG
Dr. Antoni Chan synovialjoints ( View Tweet)
#EULAR2023 #OP0051 4-year Pooled Analyses of 3 x Anifrolumab RCTs in #lupus (inc. LTE) showed:
- LLDAS was attained earlier & more cumulative time was spent in LLDAS in anifrolumab compared to placebo groups
Assuring longer-term data
*sorry photos weren’t permitted @RheumNow
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Autoimmune disease diagnoses slowly on the rise, despite reduced smoking - but that’s now 10% of the population, & many patients have more than one. Most are lifelong.
Surely this needs more investment??
CPRD data from the UK #EULAR2023 OP0007 @RheumNow https://t.co/7NGF5YaE9z https://t.co/m6SaibqmEq
David Liew drdavidliew ( View Tweet)
#EULAR2023 Abstr #OP0048 What happened if we taper steroid in #lupus patients who are Serologically Active Clinically Quiescent? A cohort study in Asia showed:
- Tapering was NOT associated with subsequent flare
- Tapering reduced damage in those on =>5mg/day
@RheumNow https://t.co/Q6GiaSCgV6
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
