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JAK inhibitors in GCA?
The SELECT-GCA study, looking at upadacitinib in GCA, anchored the ACR 2024 opening plenary for a reason - it is highly notable and badly needed.
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ACR 2024 - Day 1 Report
ACR Convergence 2024 opened today with a full slate of presentations, posters and specialty meetings. The meeting began with a flip: the plenary sessions started at 9AM and the poster session began at 1030 AM. Below are some of the highlights from day one in Washington, DC.
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SELECT-GCA suggests JAKis may be the new kid on the block
Clinicians treating giant cell arteritis (GCA) have long had to contend with a disappointingly limited selection of drugs from which to select. A new group of drugs is finally showing promise in the treatment of GCA.
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@LennMcD @ACRheumDC
Current congress (118th) - very tight margins, paralyzed by the ‘24 elections. Now in lame duck
Many ACR policies made into bills - PA, step rx, copay accumulator, workforce, loan repayment, incr Rx transparency
Needs to be passed into law
@RheumNow #ACR24 https://t.co/1elEUiUAmh
Eric Dein ericdeinmd ( View Tweet)
Managing DMARDs in pregnancy. Curbside consults by Lisa Sammaritano @RheumNow #ACR24 https://t.co/FQrLNz4yCz
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Phase 2 DBRCT of daxdilimab, an immunoglobulin-like transcript 7 to target plasmacytoid dendritic cells
No difference in primary outcome... but kiiiinda looks like something there?
I dislike Phase 2's; should go straight to Phase 3 if able
#ACR24 @rheumnow Abstr#1542 https://t.co/osDWDskfnA
Links:
Mike Putman EBRheum ( View Tweet)
@KDAO2011 help me out here; what is the point of analyses like this?
NO difference in PROs comparing voclo vs plbo...
...but if you split by responder status its different
Prescribing the drug doesn't help PROs, but when it works it works? 🤔
#ACR @RheumNow Abstr#1538 https://t.co/339drHwUuK
Mike Putman EBRheum ( View Tweet)
This is very true. We showed a number of years ago that patients with gout have increased platelet activation at baseline, which then dramatically increases during flare. Treating gout properly may ameliorate this. #ACR24 @RheumNow https://t.co/VL8fy3ezjx https://t.co/9XdrG1NG9c
Links:
Richard Conway RichardPAConway ( View Tweet)
Factors associated w/ secukinumab response in PsA?
Analysis of 2.7k pt in EuroSpA
Associated w/ favorable response
❗️elevated CRP >10 mg/L
❗️fewer prev tx
Associated w/ lower response:
❗️smoking
❗️higher patient global score / HAQ
@RheumNow #ACR24 Abstr 2325
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
New data to guide role of long-term, low dose GC in GPA
Active GPA s/p tx -> randomized to d/c pred within 1 mo or stay on 5mg daily
Fewer relapses on 5mg pred but w/qualifications:
👉 most flares = minor
👉 no difference in flares if RTX on board
@RheumNow #ACR24 Abst 0774 https://t.co/Jvc40QWLqM
Links:
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Challener et al. TriNetX study. 32,000 patients. SGLT2i reduce need for gout visits (HR 0.94) ULT initiation (HR 0.69) and colchicine (HR 0.82). I worry about the discordant rates, ULT initiation much lower. @RheumNow #ACR24 Abstr#0848 https://t.co/VTKHMmDEKV https://t.co/C2opiDmBXx
Links:
Richard Conway RichardPAConway ( View Tweet)
🤵♂️Results from BACHELOR
➡️34 PMR pts
➡️18 BARI, 16 PBO
➡️Primary endpoint: CRP PMR-AS≤10 w/o oral GC rescue from W0 to 12
78% BARI pts reached primary endpoint vs 13% PBO
No new safety signals
BARI 4mg 12W, then 2mg 12W➡️36W low disease activity in PMR
Ab0858 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
How does #cardiovascular risk vary with #ACPA & #biologics in #RA?
⬆️BMI assoc with ⬆️MACE risk in ACPA+ pts
In ACPA- pts, BMI inversely assoc with MACE risk among pts on biologics
Further evidence to consider ACPA, BMI & MACE as part of RA management
Ab0870 #ACR24 @RheumNow https://t.co/UkkC146DWS
Mrinalini Dey DrMiniDey ( View Tweet)
Hamroun et al. Meta-analysis of glucocorticoids in pregnancy and breast-feeding. Increase pre-term birth with GCs, adjusted OR 2.24. Dose-dependent effect. Minimal breastmilk transfer. @RheumNow #ACR24 Abstr#0810 https://t.co/H0o9ElsHmc https://t.co/uciFP6UOhF
Links:
Richard Conway RichardPAConway ( View Tweet)
Cannabis in Pain:
CBD can help with nociceptive pain
THC better for neuropathic, centralized pain
Perhaps a role in helping decrease other medications like opiates
Clauw 16S18
#ACR24 @RheumNow https://t.co/kaQXrD4GAn
Links:
Eric Dein ericdeinmd ( View Tweet)
Abstract #0805
Data from OTIS Registry shows Certolizumab pegol (Cimzia) exposure during pregnancy was not associated with increased risk of major birth defects, structural defects, or adverse pregnancy outcomes. #ACR24 @RheumNow
Akhil Sood MD AkhilSoodMD ( View Tweet)
Is it safe to administer rotavirus vaccine to infants exposed in utero to TNFi?
Abstract#0806 shows no significant ↑ in the risk of diarrhea-related healthcare events among TNFi-exposed infants who received the vaccine compared to those who did not
@RheumNow #ACR24 https://t.co/HpTCgywE4H
Akhil Sood MD AkhilSoodMD ( View Tweet)
Langford et al. Abatacept NOT effective in GPA in ABROGATE RCT. 65 patients. Relapse/worsening in 62% vs 68%. No difference in any secondary end-point. @RheumNow #ACR24 Abstr#0823 https://t.co/yRFZ2diJFF https://t.co/LgXkPnDArE
Links:
Richard Conway RichardPAConway ( View Tweet)
A systematic review highlights the impact of glucocorticoids (GC) during pregnancy and lactation. Increased risks of preterm birth were noted with GC exposure, advocating for minimized doses and pregnancy-compatible treatments. Encouragingly, low levels of GC found in breast milk… https://t.co/7CnJUBrUDQ https://t.co/ZeGHFHNT13
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Data from the study by Dr. Aguilar et al showed that high dose NSAID use was not assoc'd with incident HTN in their cohort of early axSpA patients.
Shows important role of NSAIDs in #axSpA but still should be used judiciously
@RheumNow #ACR24 abs540
@rheum_cat @rheumarhyme https://t.co/LK5yFZynu4
sheila RHEUMarampa ( View Tweet)
