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TYK2/JAK1 in Dermato? Interesting pre-clinical study of brepocitinib... but we really just need clinical data
Glad to see this is headed straight to a Phase 3! Hoping they allow IVIG: has been a problem with many/most/all? recent dermato studies
#ACR24 @RheumNow Abstr#0882 https://t.co/KS8fTMBpPR
Mike Putman EBRheum ( View Tweet)
Which RA patients are at increased risk of JAKi adverse events? Does disease activity matter?
in the upadacitinib ph3 trials, high disease activity pts had more:
serious infections
HZ
MACE
VTE
Active RA is a massive contributor to many AEs in JAKi pts
#ACR24 ABST1393 @RheumNow https://t.co/DlFf9Sfbja
David Liew drdavidliew ( View Tweet)
Zhang @jeffsparks et al. Even more evidence that MTX does not cause ILD, and in fact prevents ILD, in RA, OR 0.48 in meta-analysis. @RheumNow #ACR24 Abstr#1384 https://t.co/YvQnmmvNjF https://t.co/crYUwHahDb
Links:
Richard Conway RichardPAConway ( View Tweet)
STAR trial of GC w/d in RA LDA
SEMIRA of GC w/d controlled RA on Toci
Very slight disease activity increase, but higher flares
No symptomatic adrenal insufficiency, but data of abnormal ACTH stim
No good evidence of steroid w/d symptoms
Beth Wallace
@RheumNow #ACR24 https://t.co/j6UPWlVNIu
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Eric Dein ericdeinmd ( View Tweet)
Slick poster, but must be careful w/real world data. Big risk of confounding/channeling bias
Pts with MACE risk (not always well-characterized by ICD codes) also less likely to receive JAK & therefore less liekly to have subsequent MACE
#ACR24 @RheumNow Abstr#1394 https://t.co/lilU0byJ1s
Mike Putman EBRheum ( View Tweet)
Getting more data on using deucravacitinib for PsO/PsA manifestations
Impressive effect on scalp psoriasis (which often means a lot to patients)
Given how safe it is, it's increasingly tempting to use more of it in mild-mod PsA
#ACR24 PSORIATYK SCALP trial ABST1137 @RheumNow https://t.co/vxS3RSlIN0
David Liew drdavidliew ( View Tweet)
What do current national/international rheumatology association guidelines say about perioperative discontinuation of biologics?
it's highly, highly variable
no wonder people get confused!
#ACR24 ABST1037 @CatherineL_Hill @RheumNow https://t.co/cmJ3qKU1QT
David Liew drdavidliew ( View Tweet)
Serrano-Combarro et al. Case series of upadacitinib in RA-ILD. 18 patients. Report stable/improved dyspnoea and HRCT over 12 months. PFTs shown, relatively stable @RheumNow #ACR24 Abstr#1372 https://t.co/yncy0lPq60 https://t.co/mrDMtEDwUt
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Richard Conway RichardPAConway ( View Tweet)
Great table re:side effects of even low dose steroids in RA
Likely generalizes to other diseases ie PMR, SLE
P in prednisone stands for poison!
#ACR24 @RheumNow https://t.co/0opDEtzm9E
Mike Putman EBRheum ( View Tweet)
Petri recommends IM triamcinolone as safer than prednisone dosing per FLOAT trial, decreased risk of fx
@RheumNow #ACR24
@jhrheumatology https://t.co/vhMRdSkBAA https://t.co/novlGcss6x
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Eric Dein ericdeinmd ( View Tweet)
Late-onset asthma but earlier EGPA diagnosis?
Abstract 1604 used IQVIA data to develop a machine learning model for better EGPA dx. Key predictors included eosinophilia, asthma, chronic sinusitis, multiple CXRs, skin biopsies, and GC prescriptions. @RheumNow #ACR24
Akhil Sood MD AkhilSoodMD ( View Tweet)
Sukumaran et al. Does does of IA steroid matter in knee injection? RCT 30 patients. Triamcinolone. 6-week WOMAC decrease 6% in 10mg, 10% in 20mg , 29% in 40mg @RheumNow #ACR24 Abstr#1186 https://t.co/WUYiEP5dSo
Richard Conway RichardPAConway ( View Tweet)
Exciting early data for new highly selective TYK2i zasocitinib
Improved PASI skin scores (though not as much as IL23i...)
Funky skin-related adverse events at higher doses, not sure what to make of that?
#ACR24 @rheumnow Abstr#1477 https://t.co/CtOFsoHdBh
Links:
Mike Putman EBRheum ( View Tweet)
Reset the bar for remission (off steroids)!! Session #17S19
3% higher risk of organ damage for each 1mg of pred
Remission possible in rheum with lower dose GC regimen and faster taper #GCStewardship
#ACR24 @RheumNow @BethIWallace
Jiha Lee JihaRheum ( View Tweet)
In case you needed more encouragement for recombinant zoster vaccination in RA patients:
it prevents herpes zoster episodes, in the real world.
RA pts in KP system
n=1926 vaccinated matched 1:3 with non-vaccinated
- HZ reduced 60%
- PHN reduced 88%
#ACR24 ABST0977 @RheumNow https://t.co/BryBrlv9K5
David Liew drdavidliew ( View Tweet)
Petri on Steroids in SLE
Steroid-related organ damage presents later
- organ damage is higher in African-Americans
Dose response for prednisone and CVD risk
Each 1 mg prednisone = 3% increase risk in organ damage!
#ACR24 @jhrheumatology
@RheumNow https://t.co/00S1mxrXJp
Links:
Eric Dein ericdeinmd ( View Tweet)
John Stone
Steroid-free AAV
CYCLOPS: steroid tox like “wallpaper on room”
WGET (ETN for GCA) - taper off by 6 mos - neg trial but started tapers
RAVE - low doses 8-9 mg/d over 18 mos
LoVAS - low dose steroid equally eff
ADVOCATE - AVA one month taper, tox score
#ACR24 @RheumNow https://t.co/C7eLK5UNPM
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Eric Dein ericdeinmd ( View Tweet)
Biosimilar changes
ASP outpacing reimbursement making not affordable to use
Working with CMS but needs further legislation to fix this
FDA may change interchangeability status for medications to no longer require switching studies
@ACRheumDC @RheumNow #ACR24 https://t.co/daYQJvsHRG
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Eric Dein ericdeinmd ( View Tweet)
Regulatory update @ACRheumDC
Inflation Reduction
Planned decrease in 10 drug prices including ETN
Expect this may be gutted by new administration. Will follow and advocate for drug pricing
@RheumNow #ACR24 https://t.co/ZrcMaLD6tu
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Eric Dein ericdeinmd ( View Tweet)
@LennMcD @ACRheumDC
Do policies affect medication access, costs, reimbursements, telehealth, or your life as a rheumatology provider or patients?
Contact - quick and easy!
https://t.co/TvMlXiIZQR
@RheumNow #ACR24 https://t.co/plnUtl7Kml https://t.co/lFGx7hzlKy
Links:
Eric Dein ericdeinmd ( View Tweet)
