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Drs. Jack Cush and Arthur Kavanaugh discuss highlights and key takeaways from ACR 23.
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While there wasn’t much original new programming and research presented on the final day, that didn’t slow the RheumNow faculty from tweeting the noteworthy “Best of ACR” abstracts. Enjoy these below.
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Since chronic kidney disease is one of the strongest CV risk factors, any new strategy to reduce proteinuria and avoid a decline in renal function may likely improve patient outcomes. In large cardiovascular outcome trials, the use of a fairly new-kid-on-the-block therapy, sodium–glucose cotransporter-2 inhibitors (SGLT2i) appear to be both cardio and renal-protective. Would the use of SGLT2i have the same impact in SLE?
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The last day at ACR23 was a ghost town as most left, largely because there was limited programming on the fourth and final day. The main attraction on Day 4 was the late-breaking abstract – oral presentations. Here’s a list of the late breakers; below, I provide commentary on the ones that caught my attention.
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Should rheumatologists be counseling patients on cervical cancer prevention and screening?
Janet Pope
Tweet
#Yr in #Preview #ACR2023 J Buyon
Pregnancies in #SLE have high #VTE risk - look at Ob/Gyn guidelines for prophylaxis of LMW #heparin - all SLE pregnancies recommend #ASA & #HCQ
biomarkers for #renal #lupus, #HCQ levels ?aid #Rx
-#SLE nephritis low prednisone
2 IS>1
@RheumNow
Janet Pope
Tweet
#Hope for people with #SLE
Insights from #ACR23
#Lupus #nephritis - half the oral #prednisone is = to 1 mg/kg induction after IV #solumedrol LESS PRED
#Anifrolimumab reduces similarly skin, jts, other common organs in #SLE RCTS APPROX 2X improvement vs PBO
@RheumNow @ACRheum https://t.co/OtdfTxZxr4
sheila
Tweet
Frail pts with SLE is associated with 🔸prolonged hospitalizations (28.89%), 🔸significantly higher in-pt mortality (2.88%)
🔸fewer days-to-readmission (59.8%)
vs. non-frail pts with SLE
(CLeung et al)
Screen your SLE pts for frailty too.
#ACR23 ABST2590 @RheumNow https://t.co/c4YP5h2ypn
Md Yuzaiful Md Yusof
Tweet
#ACR23 Abstr#2587 Can we agree on how to measure frailty in #SLE? A cohort study: moderate agreement at best among SLICC-FI, SPPB, FRAIL=>2 & PROMIS PF=<40. SLICC-FI was robust predictor of all outcomes except for cognitive impairment. FRAIL & PROMIS not far behind @RheumNow https://t.co/qWjM4crPvg
Dr. John Cush
Tweet
The Heart of Lupus
During ACR 2023 Convergence, several abstracts were presented evaluating the prevalence of CV disease and exploring new tools to predict CV disease. The ones that caught my eye included...
https://t.co/5Qk2fF3nlA #ACR23 https://t.co/Rja7K44BUf
sheila
Tweet
COVAD2 data:
⬆️proportion of SLE pts from lmHDI countries were on CS(73% vs 59% p=0.0002), antimalarials(81% vs 68% p=0.0002) & IS(66% vs 53%p=0.0009) vs pts from hvhHDI countries
Comorbids more in younger pts from lmHDI (prob from CS use)
#ACR23 ABST2269 @RheumNow @rheumarhyme https://t.co/4CLGFYG1d0
Eric Dein
Tweet
L17 #ACR23 @RheumNow
Afimetoran TLR7/8 inhib for cutaneous lupus
Safety: No SAEs, mild-mod AEs, lower than PBO
Nasopharyngitis & bronchitis
Trough concentration consistent from D8 to 113, support 30 mg qd
CLASI change; MCDI 50% Afim v 0% PB, CLASI-50 Afim 50% v 0%
Inhib of IFNGS https://t.co/cKYY6rmIWE
Meral K. El Ramahi, MD
Tweet
L17 @ #ACR23
New therapy on horizon for cutaneous LE (CLE)?
⭐️AFIMETORAN
➡️ TLR7/8 inhibitor
➡️1st-in-class orally bioavailable, potent
⭐️Phase Ib trial
➡️Criteria:
👉18-65 yo SLE vs biopsy proven CLE
👉CLE Dz Area & Severity Index (CLASI-A) at least 6
👉ANA… https://t.co/HPqw4d0AHl https://t.co/5u9aEvzdMb
David Liew
Tweet
Telitacicept (BlyS/APRIL inhibitor) ph3 in RA
wholly in China, after SLE approval there (SLE trial now w global sites)
Efficacy okay, no better than other b/tsDMARDs
What's the hook here, in a crowded RA market incl biosimilars?
Safety does look good though
#ACR23 L20 @RheumNow https://t.co/UzQ0f18E2A
sheila
Tweet
ICYMI
Interesting study by Dr LWGarcia et al:
👉IFN-a serum levels predicted failure to respond to tx 2 years after a flare in pts w/ LN
👉Pts w/⬆️BL IFN-a levels had greater risk of having 2 or more subsequent flares
#ACR23 ABST2297 @RheumNow @ZahiTouma https://t.co/WJZnNUPUbT
Eric Dein
Tweet
Q for Rheumatologists:
How often do you counsel appropriate SLE patients about cervical ca screening and/or vaccination?
Re: PAPILUP Study A#1479 #ACR23 - shows PAP findings of HR-HPV+abnml cytology comparable to HIV+ pts
@RheumNow
Janet Pope
Tweet
Agimeteran a TLR7/8i 30 mg in #cutaneous #lupus which differentiated from placebo. Small single site #RCT. Far more pts improved #CLASI by 50% vs PBO #ACR23 #ACRbest @RheumNow @ACRheum L15 In larger RCT now! https://t.co/zssjgpydVY
sheila
Tweet
Burden of flare & organ damage of SLE pts from the Asia Pacific cohort:
Prevalence of organ damage at BL - 39%
Incidence of damage accrual: ~58 per 1000PY
Pts w/ >=2 flares accrued damage
Flares independently⬆️risk of damage accrual
#ACR23 ABST2261 @RheumNow @rheumarhyme https://t.co/nW34sI9FdP
Md Yuzaiful Md Yusof
Tweet
#ACR23 Abstr#2332 We need to compliment the Complement #SLE. Post-hoc analysis of SOC + PBO from Dapirolizumab Phase 2 RCT showed reduced response in patients who flared with low complement levels vs normal or persistent activity. To consider as a stratifier @RheumNow https://t.co/BcN6ExLD0s
Dr. Antoni Chan
Tweet
Treatment of lupus nephritis #ACR23
Dall’Era M, Furie R, Mosca M
@RheumNow https://t.co/Md2DsOrY5F
