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Evaluation of Bimekizumab in PsA

Antoni Chan, MD, PhD

Bimekizumab (BKZ) is a monoclonal IgG1 antibody that selectively inhibits interleukin (IL)‑17A and F. There have been more updates on the 2 year data on BKZ at #ACR24, and this is a summary of four studies being presented this year at ACR24.

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Pasoto et al. Holding MMF for 1 week after zoster vaccine (RZV) improves response with no increase in flare @RheumNow #ACR24 Abstr#0247 https://t.co/q757bMFp7I https://t.co/rwjz3q3MaO

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Richard Conway RichardPAConway ( View Tweet)
Pharmacologics: Cannabis absorption and metabolism is variable Inhaled absorption 10-35% THC is 97% protein bound, lipophilic and deposits in fat and spleen Liver function is critical for THC metabolism 16S18 @BharatKumarMD #ACR24 @RheumNow

Eric Dein ericdeinmd ( View Tweet)

Quinn @KQuinnRheum @petercgrayson et al. FDG-PET is not particularly useful in monitoring GCA on tocilizumab. Toc reduces but often not eliminate PET inflammation. PET activity does not predict relapse or vascular progression @RheumNow #ACR24 Abstr#0742 https://t.co/1qcJCGV118 https://t.co/6mBCgcbYo6

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Richard Conway RichardPAConway ( View Tweet)
Harkins @DrTrishHarkins et al. Serum disease activity markers in PMR. ROC analysis for active vs remission - fibrinogen (1.000), ESR (0.986), Haptoglobin (0.976), CRP (0.986), ALP (0.854). @RheumNow #ACR24 Abstr#0741 https://t.co/f8cX68Ov9Y https://t.co/zp5c7aQwxr

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Richard Conway RichardPAConway ( View Tweet)
Dunn et al. Are the medications recommended for RA-ILD by the ACR guidelines used in the real-world. NO! 4108 RA-ILD patients. Only 12% on one of the first line recommended therapies! @RheumNow #ACR24 Abstr#0214 https://t.co/OzW90OA1Vd https://t.co/S1MKmEDrLF

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Richard Conway RichardPAConway ( View Tweet)
IV or inhaled THC: Works quickly with high peak, feel euphoric but not sustained response Oral is much better for medicinal usage @RheumNow #ACR24 https://t.co/3PatgEFjZh https://t.co/wrrLMpfL5D

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Eric Dein ericdeinmd ( View Tweet)
How to take cannabis? Do NOT rec inhaled - makes drug level go up high/fast, benefit for rec use but not for medicinal - bronchitis, ?oral cancer Other risks: psychosis - risk in youth, memory loss (poor studies), dependence, respiratory if inhaled Clauw 16S18 #ACR24 @RheumNow https://t.co/coYNl7VOT3

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Eric Dein ericdeinmd ( View Tweet)

TAPIR study of continuing vs stopping steroids in ANCA vasculitis in remission. Relapse at month 6 in 16% vs 4%. OR 4.22, but low rate in either group. If treated Rituximab, no difference! Merkel et al. @RheumNow #ACR24 Abstr#0774 #ACRbest https://t.co/pKa4U5L2fW https://t.co/MjzE14SeGi

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Richard Conway RichardPAConway ( View Tweet)
The rising placebo response rates in PsA trials are linked to global recruiting patterns, with more studies in less affluent countries. Limited access to healthcare may drive this trend, highlighting the need for awareness among stakeholders. Plenary Abstr#0722… https://t.co/FplpSlIamR https://t.co/NIp76IS6TZ

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Which immunomodulators dampen recombinant zoster vaccine immunogenicity? In this 🇧🇷 study in autoimmune dx patients, overrepresented in non-responders are: - rituximab pts - 'combined therapy' strategies needed for them but reassuring for the others! #ACR24 ABST0248 @RheumNow https://t.co/he1ICa9WZg

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David Liew drdavidliew ( View Tweet)
Mycophenolate isn't great for vaccine immunogenicity, but withholding MMF for one week after both doses of recombinant zoster vaccine boosts Ab titres ++ in this Brazilian RCT. A week off post-vaccine: definitely worth considering in stable disease #ACR24 ABST0247 @RheumNow https://t.co/lajS5DzRbD

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David Liew drdavidliew ( View Tweet)
Safety data reassuring with UPA 15 mg vs PBO No UPA MACE events, low VTE Ab#0770 @RheumNow #ACR24 https://t.co/lMf2dCz2RX https://t.co/3DnPIoVOt8

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Eric Dein ericdeinmd ( View Tweet)
Upadacitinib (UPA), a new oral treatment option for GCA? Dr. Peter Merkel discusses SELECT-GCA. UPA15 + 26-week GC taper >> PBO with a 52-week GC taper for GCA remission. #ACR24 #ACRBest @RheumNow ABST#0770 https://t.co/UbQLVA8X7r

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Jiha Lee JihaRheum ( View Tweet)
Major update in tx for GCA beyond Toci SELECT-GCA showed upadacitinib 15mg daily achieving higher rates of remission with SHORTER (26wk) steroid use compared to placebo (52wk) No significant adverse safety signal w JAKi including MACE/malignancy @RheumNow #ACR24 Abstract 0770 https://t.co/45D0Txed2N

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Brian Jaros, MD Dr_Brian_MD ( View Tweet)
SELECT trial noted reduction in CV death, MI and stroke in obese pts without diabetes (other benefits: reduction in waist circumference, BP, lipids) @rheumnow # ACR24 https://t.co/GPK4Vg5bOt

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TheDaoIndex KDAO2011 ( View Tweet)

Results from SELECT-GCA ➡️UPA 15mg + 26W GC taper demonstrates superior efficacy & reduced GC use vs PBO + 52W GC taper ➡️No new safety signals Is UPA the new kid on the block in #GCA? Ab0770 #ACRBest #ACR24 @RheumNow https://t.co/pHzozYiid5

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Mrinalini Dey DrMiniDey ( View Tweet)
The TAPIR Trial on GPA shows higher (15.5%) relapse in the 0 mg prednisone arm vs. 4.2% in the 5 mg arm (OR 4.22), but does not impact PROs. Key finding: benefit of 5 mg/day seen only in non-rituximab regimens (20% vs. 2.6%, OR 9.50). Abstr#0774 Plenary 1 @RheumNow #ACR24… https://t.co/5DjW5Zwh0J https://t.co/UnsVPzJfs6

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)

SELECT-GCA: Upa in GCA Merkel Upa 15 mg v 7.5 v PBO w slower GC taper 70% new onset, 30% relapse. Few prev on IL6 Primary endpt: sustained remission at w52- UPA 15 mg beats PBO (p=0.0019) 34% relapse in UPA vs 60% PBO Less steroids, longer time to flare @RheumNow #ACR24 #ACRBest https://t.co/1OV2889Ny0

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Eric Dein ericdeinmd ( View Tweet)
Real-world data from @k_lauper's Jak-pot study (>9000 RA pt) on how quickly b/tsDMARDs work: JAKi, TNFi quicker than tocilizumab, abatacept Even though they all get to a similar place eventually, some get there quicker (but worth any safety tradeoffs?) #ACR24 ABST0501 @RheumNow https://t.co/YVpTBMe3gi

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David Liew drdavidliew ( View Tweet)
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