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#ACR 2024 BEST Abstracts from Day 2
Here’s a collection of some of the best abstracts presented on day 2 of ACR 2024 as selected by the RheumNow faculty.
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ACR 2024 - Day 2 Report
Plenary sessions began the day, followed by thousands on the abstract floor. Here are a few of my favorite presentations from day 2 at ACR 2024.
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Instead of just JAKi, why don't we look at all our RA meds and MACE risk
FAERS data & reporting odds ratios here: all the caveats of voluntary reporting, so don't put too much weight, but...
prednisone. Don't forget pred is really not great for MACE!
#ACR24 ABST1981 @RheumNow https://t.co/L9SlPZF2Jd
David Liew drdavidliew ( View Tweet)
Always looking for cancer/CV signals from JAKi in big observational datasets w extensive JAKi use nationwide 🇯🇵 claims data RA pts n=52k (JAKi n=4.3k) Cancer with JAKi vs TNFi: aHR 2.2 (esp lung, lymphoma) This is a problem. Watch these data. #ACR24 ABST1336 @RheumNow #ACRBest https://t.co/vsnT46De6T
David Liew drdavidliew ( View Tweet)
ANA neg, but ENA pos
should we care about that result?
PPV 5.5% here
(similar to 6% prev @EricFMorand: https://t.co/Hyaued3rw2)
and how many really needed the serology? Anxiety?
Surely pos ENA w neg ANA might be more hassle than help. So what to do?⬇️
#ACR24 ABST1930 @RheumNow https://t.co/rE7RmgOGey
Links:
David Liew drdavidliew ( View Tweet)
Should you worry about giving TNFi to RA pts after a cancer diagnosis?
Medicare data with colorectal, lung, prostate Ca:
TNFi pts survival no worse (numerically better) than csDMARDs
Cancer pts deserve good RA treatment!
#ACR24 ABST0202 Suarez-Almazor @MDAndersonNews @RheumNow https://t.co/w58MNqRt1T
David Liew drdavidliew ( View Tweet)
Upadacitinib in Behcet's disease - would be very much welcomed, and this open label 8 patient pilot from China is encouraging.
We saw similar data for tofacitinib before @ARD_BMJ: https://t.co/YlAQVXpnTY
JAKi (?generic) could be a fantastic option!
#ACR24 ABST2515 @RheumNow https://t.co/65friNLUOK
Links:
David Liew drdavidliew ( View Tweet)
Steroids in checkpoint inhibitor rheumatic irAEs need to be approached with caution.
Persistent higher doses earlier on might dampen ICI response.
@HSpecialSurgery ICI-IA (inflamm arthritis) cohort
big diff in survival based on early steroid exposure
#ACR24 ABST1989 @RheumNow https://t.co/3WAZ3ZLbFw
David Liew drdavidliew ( View Tweet)
Rheumatic irAEs can get on the CAR-T bandwagon, too!
CAR-T can invoke new rheumatological issues (not just cytokine release) - see @DrGomezPuerta's experience.
Infrequent, but if CAR-T in general becomes common, yet another job for us to attend to...
#ACR24 ABST2004 @RheumNow https://t.co/xBSlhUdkNr
David Liew drdavidliew ( View Tweet)
Now that nipocalimab is approved for Sjogren's Disease, what about vaccination response whilst on this FcRn inhibitor (inherently lowers IgG)?
Actually, not bad: takes a little longer to get there, but reassuring!
(always fun to get to know a new med)
#ACR24 ABST1988 @RheumNow https://t.co/IYqIGo5xVP
David Liew drdavidliew ( View Tweet)
Here's a meta-analysis of MACE/malignancy in JAKi vs TNFi in observational cohort studies.
All the epidemiological challenges here aside, it's a good reminder that with ORAL Surveillance it's *cardiovascular risk enriched pts* we're concerned about.
#ACR24 ABST2264 @RheumNow https://t.co/vIXlrI3V2d
David Liew drdavidliew ( View Tweet)
We saw evidence for JAK use in GCA this conference... what about IL-1 inhibition?
Double-blind RCT: Anakinra vs. PBO w/ similar GC taper in GCA pt
NO difference in relapse rate at 26, 52 wks despite addition of Anakinra
@RheumNow #ACR24 Abst1699 https://t.co/gUb0gGJjTG
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Super helpful results from COVER study, holding JAK or IL17 for COVID boosters Antibody titers went up regardless of holding Holding caused flares (14-25% increase!) Pretty clear message; continue JAK / IL17 #ACR24 @RheumNow Abstr#1718 #ACRbest https://t.co/Mf89dWrRWz
Mike Putman EBRheum ( View Tweet)
Would be helpful for us (and pts) to better understand rimmunotherapy agent specific risk on subsequent GCA/PMR
AFTRER propensity matching of >7k pt on combo nivolumab/ipilimumab compared to pembrolizumab:
- PMR RR 3.8x N/I vs. P
- no diff in GCA risk
@RheumNow #ACR24 https://t.co/IF4Gh7Cumd
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Phase 2 RCT of MK2 inhibitor did not show clinical efficacy at week 12 in active AS pts compared to PBO.
There are still unmet needs for additional therapeutics in pts with AS that not respond to current therapies.
Abst#1760 #ACR24 @RheumNow https://t.co/cXv8HYr0Xr
Links:
Adela Castro AdelaCastro222 ( View Tweet)
Comparison of infection risk across b/tsDMARDs in IA in real-world study
Treatment with
➡️Rituximab
➡️JAKi
➡️Anti-IL6
assoc with ⬆️⬆️ risk of severe infection compared to TNFi
A reminder to consider comorbidities & infection risk in selecting b/tsDMARDs
Ab1716 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
RCTs are the gold standard in drug research, but rising placebo (PBO) response rates with global recruitment could distort treatment effects. Limited access to care in less affluent countries may be a factor.
#ACR24 @RheumNow ABST#1746 https://t.co/fVeNcw5qwO
Jiha Lee JihaRheum ( View Tweet)
In this systematic review & metaanalyis by Dr. RFarhat et al, tacrolimus whole blood levels decrease in the 1st & 2nd trimesters then increase back to pre-pregnancy levels postpartum.
Needs further studies to guide dose adjustment.
@RheumNow #ACR24 abs1535 https://t.co/5MovzPJoFc
sheila RHEUMarampa ( View Tweet)
Dr. BDinneen et al reported predictors that can help screen axSpA pts w/o traditional CV RFs for carotid doppler utz:
- shorter dse duration
- no family hx of IHD
- HLAB27+
- ⬆️ dBP, WHratio, ferritin, TC, LDL and TC:HDL ratio
Small size, more data reqd
@RheumNow #ACR24 abs1440 https://t.co/3pZxFmutJz
Links:
sheila RHEUMarampa ( View Tweet)
Ab1676 discussed an intervention to change patient mindsets about side-effects of #methotrexate. Watch my video for @RheumNow on this abstract here:
https://t.co/NxuxQ5wYda
#ACR24
Mrinalini Dey DrMiniDey ( View Tweet)
