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Avoid Abatacept in RA patients with a history of cancer?

Richard Conway, MBBChBAO, PhD

The management of RA patients with a history of cancer continues to be an area of concern. General recommendations are to treat patients with a history of solid organ cancer as no different to any other RA patient. Recently, the ORAL-Surveillance study demonstrated evidence of a greater risk of cancer with tofacitinib than with TNF inhibitors. In this setting, two posters both reassure and raise a new cause for concern.

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Do biologics help taper steroids in Adult Still’s Disease?

Bella Mehta, MBBS, MS

A Japanese large scale claims data study was able to collect 5-year data to study the treatment patterns in Still’s. In May 2019, intravenous tocilizumab was approved in Japan for Still’s disease. The study was designed to see patterns of steroid exposure before and after the approval of this therapy.

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Anifrolumab shows long-term promise in patients with lupus

EurekAlert!

Type I interferon (IFN) is a powerful immune activator that is present at high levels in the majority of patients with lupus, an autoimmune disease.

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Emerging and exciting treatments in RA: ACR22 preview

Julian Segan, MBBS, BMedSc, FRACP

Rheumatoid arthritis treatment has come leaps and bounds in recent decades. Gone are the days of gold injections, chemical synovectomies, and physician-mandated bedrest (heaven forbid). Though the marketplace for RA treatments is becoming ever more crowded, there are still unmet needs.

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New 2022 EULAR Recommendations for the Management of Rheumatoid Arthritis

Jack Cush, MD

The updated 2022 EULAR recommendations for the management of rheumatoid arthritis (RA) were initially presented by Dr. Josef Smolen at EULAR 2022, and are now in press delineating the most recent developments and perspectives in RA treatment.

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AS, Lupus and Subclinical RA: What I'm looking forward to at ACR22

Robert Chao, MD

As we approach ACR22, there are many things to be excited about, especially with the reintroduction of in-person attendance. My attention this year is in research being presented in these three areas: ankylosing spondylitis; lupus management and treatment; and, subclinical RA.

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Update: axSpA Recommendations

EurekaAlert!

Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic musculoskeletal disease which can be managed with both pharmacological and non-pharmacological options. The joint ASAS-EULAR recommendations for axSpA were first developed in 2006, and last updated in 2016.

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Interesting findings from Abs 0417 - when early axSpA is defined by duration of symptoms, only nr-axSpA tx w/ bDMARDs may lead to better outcomes vs early or established axSpA. #ACR22 @RheumNow https://t.co/8aGdyJRvv1 https://t.co/chAEGPicPd

Links:

Dr. Rachel Tate uptoTate ( View Tweet)
2022 ASAS-EULAR Recommendations of AxSpA management 1) NSAIDs still first line 2) Analgesics/opioids contraindicated 3) TNFi, IL-17i first line bDMARDs, followed by JAKinibs 4) Tapering but not discontinuation of bDMARDs in sustained remission Abs#0542 @RheumNow #ACR22 https://t.co/ffaN2fMc3v
Robert B Chao, MD doctorRBC ( View Tweet)
Terrier @TerrierBen . Pooled analysis of MAINRITSAN trials. For major relapse at 84 months RTX>AZA HR 2.5. RTX fixed-dose>tailored HR 3. RTX 18 vs 36 months equal HR 1.2 (although 78% vs 70% relapse free). @RheumNow #ACR22 Abstr#0527 https://t.co/IWQmcGeRiW

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Richard Conway RichardPAConway ( View Tweet)

Vikse et al. Norwegian case series of 40 patients treated with RTX for IgG4-RD. Efficacy across phenotypes 80-100% for improvement but only 45-78% for remission. @rheumnow #ACR22 Abstr#0147 https://t.co/J7b47ywbt0 https://t.co/pfhOIG5qXk

Links:

Richard Conway RichardPAConway ( View Tweet)
Patel @NaomiRheumMD et al. HbA1c in GiACTA. Tocilizumab assoc HbA1c reduction independent of steroids. Daily steroid dose assoc HbA1c @rheumnow #ACR22 Abstr#0461 https://t.co/9Nbewrpww8 https://t.co/NyeTyWICF6

Links:

Richard Conway RichardPAConway ( View Tweet)
BIOBADASAR study of cancer risk in RA patients with prev cancer treated with b/tsDMARD. No increased risk, but yet again abatacept numbers are making me slightly nervous! @rheumnow #ACR22 Abstr#0267 https://t.co/H8gYm9STT3 https://t.co/sEIS6Ljwao

Links:

Richard Conway RichardPAConway ( View Tweet)
Germany based 74 pt #FMF prospective non-interventional, multicenter observational study on Canakinumab - RELIANCE Registry 63% in remission in 2 yrs serious adverse drug reactions - 1.56 per 100 patient years @RheumNow #ACR22 abst#0138

Bella Mehta bella_mehta ( View Tweet)

Ab0349 #ACR22 BEL vs AZA ifn risks in non-renal SLE BEL: lower risk of severe ifn (HR 0.81) and hospitalization for ifn (HR 0.73) through 5 yrs Challenge to interpret data as 56% of patients were on glucocorticoids and other anti-rheumatic meds @RheumNow https://t.co/a0tNFn5Wqr
Eric Dein ericdeinmd ( View Tweet)
Study of IV tocilizumab for GCA that led to FDA approval of intravenous TCZ this year (2/2022) -one of Dr. C Langford's pick for #YearinReview @rheumnow #ACR22 https://t.co/luxDDluddM

Links:

TheDaoIndex KDAO2011 ( View Tweet)

Ab#0348 #ACR22: Meta-analysis of Belimumab for CLE w or w/o SLE 13 studies included: 70% with low risk of bias BEL improved clinical response at W52 vs non-users OR 1.44 Decrease risk of severe cutaneous flare OR 0.51 Most studies against placebo group @RheumNow https://t.co/2bSwNKRHZZ
Eric Dein ericdeinmd ( View Tweet)
TCZ in GCA: what does it mean for diabetes? post-hoc GiACTA: HbA1c obvs better with TCZ (PNL dosing) but then: even after adjusting for PNL dose, apparent benefit Is there protective effect? Interesting observation worth investigating ABST0461 @MGHrheumatology #ACR22 @RheumNow https://t.co/CF1as5y7Yy
David Liew drdavidliew ( View Tweet)
Low dose IL-2 works in Primary Sjogrens Syndr (pSS)? RCT 60 pSS pts rx w/ PBO vs LD-IL-2; latter lower ESSDAI @wk 24 (67% vs 27%; P=.004) & less Sxs (dryness,fatigue) @wk12 and expansion of TREGs & CD24highCD27+ B cells. https://t.co/39U6WX7ceM https://t.co/i56XDSvGXs

Links:

Dr. John Cush RheumNow ( View Tweet)
Exciting time to be doing research in GCA! Over half a dozen ongoing RCTs Challenging to recruit enough patients given (1) competing trials (2) reticence to join a trial when tocilizumab (standard of care) is available #ACR22 #Vasculitis22 @RheumNow https://t.co/mJm69gH4N9
Mike Putman EBRheum ( View Tweet)
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