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TNF inhibitors and radiographic progression in axSpA

Aurelie Najm, MD, PhD Nov 07, 2021

A remaining challenge for clinicians is the ability to delay, if not completely stop, structural progression in patients with axSpA, whether they are diagnosed with radiographic (r-axSpa) or non-radiographic (nr-axSpA) disease.

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Bridging the gap in the delayed diagnosis of axSpA

Swetha Ann Alexander, MD Nov 07, 2021

Delay in the diagnosis of axial spondyloarthritis (axSpA) has been a huge challenge and is associated with poor outcomes.

⭐️C-OPTIMISE: Early, active AxSpA on certilozumab (CZP) 200mg q2w x 48w. Then, if remission, randomized to CZP q2w vs q4w vs PBO x 48w ➡️No flare in PBO BUT w/ ↑: *️⃣ASDAS + BASDAI *️⃣CRP + fecal calprotectin Thus, keep some dose of CZP on! Abst#0916 #ACR21 @RheumNow https://t.co/DT8FKHAhr0

⭐️Imaging of the SIJ in psoriatic axSpA is similar to axSpA associated with iritis or colitis! Abst#0902 (https://t.co/f55Vfi1LSS) #ACR21 @RheumNow https://t.co/UCXrwPiyhh

Does Imaging of the Sacroiliac Joint and Spine Differ in Patients Presenting wi…

Real-world data shows no difference between genders in effectiveness of secukinumab in #AnkylosingSpondylitis, for disease activity, global functioning and severity of depression. #Abs0909 #ACR21 @RheumNow https://t.co/2n6Y5ZB1Ot https://t.co/zIMEzHBUrh

How Does Gender Affect Secukinumab Treatment Outcomes and Retention Rates in Pa…

Predictors of clinical remission in AS patients Rx with TNFi ⭐️Age and 3-mo BASDAI improvement➡️ predictor of clinical remission criteria ⭐️Normalized ESR and CRP at month 3 were predictors of achievement of BASDAI-CRP Abst#0931 #ACR21 @RheumNow https://t.co/Ot1ypgNg3A

Baseline/ Clinical /Imaging predictors of flare when tapering TNFI in axSpA in remission: ⭐️🔼Baseline physician global VAS 🔼flare in 16 weeks after tapering to 2/3 of standard dose. ⭐️🔼Age 🔼flare within 16 weeks after tapering to 1/2 dose Abst #0929 #ACR21 @RheumNow https://t.co/EFiwKA8z99

AxSpA pts who achieve ASDAS low disease activity (LDA) 6 mo after bDMARD initiation ⭐️ 25% achieved ASDAS LDA ⭐️ASDAS LDA achievers were ♂️ + naïve to c/b DMARDs + with PROM / Clinical improvement ⭐️ASDAS LDA non-achievers=depression, uveitis, IBD Abst# 0925 #ACR21 @RheumNow

Turkish study finds that ETN may be negatively associated w/ the development of ADA in AS pts. Abs 0936 #ACR21 #RheumNow @RheumNow https://t.co/z3pYDpp1NN https://t.co/MR1R41rCHV

Factors Associated with the Development of Anti-drug Antibodies to Tumour Necro…

Evaluate effectiveness and Rx survival of different TNFI in cohort of axSpA ⭐️No difference among different TNFI ⭐️No difference between nr-axSpA and AS ⭐️Failure to initial TNFI did not diminish effectiveness or drug survival of subsequent TNFi Rx Abst#0938 #ACR21 @RheumNow

Abst0897 #ACR21 @RheumNow radiographic progression in AS accelerates w/age, highest at age 30–39 (mean mSASSS change per year 1.148), followed by 40–49 , 20–29,≥50 & least < 20 (0.643). radiographic damage rapidly ⬆️ among 20s w/risk factors:⬆️ CRP &preexisting syndesmophytes https://t.co/tiAgKUyjJq

SELECT-AXIS 1: UPA 15 mg QD consistently efficacious over 2 years for ASAS40. Low radiographic progression rates in AS pts. No new safety findings were observed. Abs 0924 #ACR21 #RheumNow @RheumNow https://t.co/CWvH1OPGyR https://t.co/uC67fJZDCE

Efficacy and Safety of Upadacitinib in Patients with Active Ankylosing Spondyli…

SELECT-AXIS 1 Post Hoc Analysis results showed improvement in PROs & reduction in back pain score at 12 weeks predicted clinical outcomes at 1 year in AS pts. Abs 0926 #ACR21 #RheumNow @RheumNow https://t.co/vRVpv1O6YS https://t.co/wjafMf1UPY

Predictors of 1-Year Treatment Response Among Upadacitinib-Treated Patients wit…

SEC reduced SIJ bone marrow edema in active nr-axSpA pts. Majority of pts both in SEC and PBO arms showed no radiographic progression through 2 years. Abs 0921 #ACR21 #RheumNow @RheumNow https://t.co/yC2AZoacxF https://t.co/pjCL8HCanR

Effect of Secukinumab on Radiographic Progression and Inflammation in Sacroilia…

Googling rheumatic diseases. On average google search lacked essential information to guide patient decisions. Websites on AS scored the highest on the DISCERN and RA scored the highest on JAMA @RheumNow #ACR21 Abst#0742 https://t.co/k2o2AqYEeh https://t.co/ZKljvA2f4O

Googling Rheumatic Diseases: Evaluating the Reliability of Information Found on…

Factors associated with Anti Drug Ab against TNFi over 2-y in axSpA pts are: ⭐️ 🔼 Disease activity ⭐️Development of adverse events ⭐️Treatment discontinuation Abst #0936 #ACR21 @RheumNow

Physician global score was the strongest predictor of future flares in AS patients with TNFi dose tapering. 29 (27%) flared at 2/3 of standard dose, 21 (20%) at 1/2 dose, 29 (27%) at 1/3 dose and 27 (25%) after discontinuation @RheumNow #ACR21 Abst#0929 https://t.co/pIzLgexe3k https://t.co/UM9cGLiYl7

Tapering of TNF Inhibitors in Patients with Axial Spondyloartritis – Can Flare …

SKIPPAIN results: Spinal pain response after 8 weeks of SEC showed notable differences between HLA-B27 subgroups. Can subtype pre-determine tx efficacy/response? Abs 0917 #ACR21 #RheumNow @RheumNow https://t.co/FKpCqXpobM https://t.co/WbjjyTIaiG

Efficacy of Secukinumab and HLA-B27 Subtypes: Results from a Phase IIIb Randomi…

GO-ALIVE study by Prof ADeodhar & grp 🔘IV GOL was shown to be effective across all efficacy outcomes in AS pts w/ early & late dse 🔘⬆proportions of pts w/ early dse achieved BASDAI50 and ASDAS inactive dse Early dx and tx 👉better outcomes @RheumNow #ACR21 #ACRBest abs0912 https://t.co/jwvEn5LdDB

Physician global score only predictor of axSpA flares when tapering TNFi ⭐️Changes in imaging did not predict flare Abs#929 #ACR21 @RheumNow https://t.co/vVn6ARKJu0 https://t.co/FlVtlLmTfl

Tapering of TNF Inhibitors in Patients with Axial Spondyloartritis – Can Flare …

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TNF inhibitors and radiographic progression in axSpA

Bridging the gap in the delayed diagnosis of axSpA

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