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Decreasing immunogenicity, improving efficacy of pegloticase in gout

d Bella Mehta, MBBS, MS

At #ACR20 three different medications are reviewed in different studies to decrease the immunogenicity of pegloticase – Methotrexate, Azathioprine and Mycophenolate Mofetil.  

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Outcomes Switching to Monotherapy: SEAM-RA Trial

d Eric Dein, MD

Combination therapy with biologic and conventional DMARDs can be highly effective at inducing remission in patients with RA. Once controlled, patients are often interested in stopping combination drug therapy due to concerns related to medication burdens, side effect profiles, or safety. 

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Feasibility of 18F-fluorodeoxyglucose Positron Emission Tomography to Monitor the Effect of Tocilizumab on Vascular Inflammation in Giant Cell Arteritis: A Prospective Observational Cohort Study https://t.co/Z91MhXJ5HK #gca #tocilizumab #pet what about the radiation?

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Peter Nash drpnash ( View Tweet)

The Use of Tocilizumab and Tofacitinib in Patients with Resolved Hepatitis B Infection: A Case Series https://t.co/2OBy0lxd6b #hepb #tocilizumab #tofacitinib no reactivation in resolved infection

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Peter Nash drpnash ( View Tweet)

Reducing Immunogenicity of Pegloticase (RECIPE) w/ concomitant use of MMF in pts w/ refractory gout is a phase II double blind RCT that shows sustained serum urate lowering effect in addition to decrease in monthly rate of flares. #ACRbest #Abst0952 @RheumNow Practice changing? https://t.co/Z7GwCXZftE
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Based on RECIPE, how many of you will use MMF concomitantly with start of pegloticase in treating refractory gout patients? #ACR20 @RheumNow

Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)

Dr Khanna presents RECIPE RCT of MMF to reduce immunogenicity of pegloticase. Sustained urate response ≤6mg/dL at 24 weeks 68% with MMF compared to 30% in placebo. @rheumnow #ACR20 Abstr#952 #ACRbest https://t.co/64nN5AqK3W
Richard Conway RichardPAConway ( View Tweet)
Today's #ACR20 lecture @r_burmester shows the biologic revolution was a result of serendipity -- this will spark the long-awaited new & improved name of our profession: serendipitology! Hi I'm Dr. Worthing I'm a Serendipitologist. I use drugs intended for infections, cancer etc.! https://t.co/buDqwAVK9u
Angus Worthing MD AngusWorthing ( View Tweet)

After the SEAM-RA study, in patients taking MTX and ETN in sustained remission would you? #ACR20 @rheumnow

Richard Conway RichardPAConway ( View Tweet)

We have great options all around! Both are efficacious in biologic (TNFi) failures for RA patients. Comparative Clinical Efficacy of Sarilumab versus Upadacitinib over 12 Weeks: Matching-Adjusted Indirect Comparison Analysis Abst#0827 #ACR20 @RheumNow https://t.co/1SsL9qLJD3

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k dao KDAO2011 ( View Tweet)

@RheumNow #ACR20 abs0710 early biologic therapy (BT) in JIA: Early BT=better outcome ( 81.8% on TNFi). BT start after 7,5mo from Dx correlates w/higher probability of active disease at 2 yrs (S=0,67 E=0,63). In active group at 2y 75% arthritis, 16,7% uveitis& 8,3% both. #ACRbest

Olga Petryna DrPetryna ( View Tweet)

Is it time to change RA EULAR guidelines to reflect what we do? SEAM RCT showed withdrawal of MTX better than D/C etanercept in controlled RA. ETN alone =ETN+MTX. I vote to d/c the Rx that failed or by pt preference! Abstr#939 @RheumNow #ACR20 https://t.co/l9TNM3Gt0e
Janet Pope Janetbirdope ( View Tweet)
RheumNow’s expanded coverage of the #ACR20 Annual meeting is sponsored in part by @bmsnews, @HorizonNews, @SanofiGenzyme, @Novartis. All content chosen by RheumNow and its Faculty.

Dr. John Cush RheumNow ( View Tweet)

SEAM-RA trial Abst#0939 Combo TNF/MTX Rx -> ETN monoRx superior to MTX monoRx in sustaining remisson, simliar to staying on combo Rx. #ACR20 @RheumNow. Benefit of continuing combo: protect HACA Ab and longevity of TNFi https://t.co/Q934naKnBq

Eric Dein ejdein1 ( View Tweet)
Dr Curtis presents SEAM-RA RCT of withdrawal of ETN or MTX in patients on combo therapy in sustained remission. 49.5% of ETN mono retained remission compared to 28.7% of MTX mono, and 52.9% who continued combo therapy. @rheumnow #ACR20 Abstr#939 #ACRbest https://t.co/wpAtBHJYUF
Richard Conway RichardPAConway ( View Tweet)
Listen to part I of our #ACR20 Day 1 recap. Listen through the link below or find us on Apple podcasts. https://t.co/W6EMQiF9Rf https://t.co/R1ieCFnIxz

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Dr. John Cush RheumNow ( View Tweet)

Another biosimilar Adalimumab. SB5 switch in RA, PsA & SpA N=354 No diff in effectiveness Some minor flares. Some changed dose unsure why. #ACR2020 @RheumNow @CRASCRRheum abstr#805 https://t.co/2Zb4H2jBXQ

Janet Pope Janetbirdope ( View Tweet)
OBRI Canadian registry showed real world retention data for Tofa and TNFi are both similar, but RA pts on TNFi w/o MTX d/c drug more compared to those who stay on MTX (does not matter with Tofa if they are on MTX) Abstr#808 #ACR20 @rheumnow https://t.co/TDmV0EJTp8

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k dao KDAO2011 ( View Tweet)

SEAM-RA: SDAI remission greater in pts on ETN alone vs. MTX alone; ⬆ pts in remission w/ combined tx vs. MTX alone. These may guide tx decisions re withdrawal in well-controlled RA @Rheumnow #ACR20 https://t.co/33GhuMuL3I

sheila RHEUMarampa ( View Tweet)
Wonderful Philip Hench Memorial Lecture from Prof Gerd Bursmester on the development of biologics in rheumatology from infections, the magic bullet, serendipity, perseverance, research to the present day @RheumNow #ACR20 #3S007 https://t.co/9H1AmZLTpJ
Dr. Antoni Chan synovialjoints ( View Tweet)

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