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GLP-1 Receptor Agonists: Impacts Beyond Metabolism?
The GLP-1 story has been hard to miss this year, and at ACR Convergence, it’s clear that these drugs are starting to make real waves in rheumatology. Across multiple abstracts, investigators have used a large real-world dataset, the TriNetX network, to explore how GLP-1 receptor agonists (GLP-1RAs) might influence cardiovascular, renal and immune-mediated outcomes in our patients.
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This retrospective study evaluated incidence of MACE & mortality among PsA pts on GLP-1RAs vs non-GLP-1RAs
After propensity score matching, pts on GLP-1RAs = ⬇️ risk of developing MACE & ⬇️ mortality vs. non GLP-1RAs
Interesting data, More research reqd
#ACR25 @RheumNow Abs0849 https://t.co/hiPpQH0K3O
Links:
sheila RHEUMarampa ( View Tweet)
TriNetX database 4000+ pts PsA + GLP-1 RA & 86000+ PsA non GLP-1 ctrls
Without much surprise GLP-1 treated pts had lower risk of MACE and death
Observational, retrospective study.
Now awaiting the prospective evidence.
RCT on the way but capturing MACE and death are always https://t.co/GWbAMC1mJK
Aurelie Najm AurelieRheumo ( View Tweet)
What is better in #PsA post #TNFi?
#RCT of #secukinumab v #ustekinumab
The big 🤔? #IL17Ai vs IL12/23i
🏆 #Cosentyx
✈️✅PASI
⚜️✅ACR50
Will H2H studies change our #prescribing?🤷♀️
#rheums Rx #IL17i>#IL12i/23i vs #derms
#ACRBest #ACR25 @RheumNow @ACRheum abst#LB06 https://t.co/RpC8ymDc7H
Janet Pope Janetbirdope ( View Tweet)
To #cycle within or go to another drug class I #axSpA?
#RCT of #TNFi-IR
👇
2nd #TNFi v #IL17i
#IJDM it doesn’t matter what choice as
#IL17i WAS NOT superior to TNFi cycling from 1st -2nd
👍 stay in #TNFi class = change to #IL17i
#ACR25 @RheumNow abst#LB09
#ACRBest @ACRheum https://t.co/VCdL5CUYUa
Links:
Janet Pope Janetbirdope ( View Tweet)
The CLASSIC study validated the performance of the 2009 ASAS classification criteria
Model A was chosen for the revised criteria since it achieved prespecified performance targets of SN ≥75% and SP ≥90%
🔸Pso was included
🔸⬆️CRP replaced dactylitis
#ACR25 @RheumNow Abs0854 https://t.co/tK52rQyaRa
Links:
sheila RHEUMarampa ( View Tweet)
In a global retrospective study of 90,536 PsA patients, those on GLP-1 receptor agonists (n=4,104) had significantly lower risk of major cardiovascular events and reduced mortality vs non-users. Most common GLP-1 RA: semaglutide. Supports future research on cardiometabolic https://t.co/ccOL10gD5b
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Time for the 2nd plenary session! 🎤
#0849 GLP-1 receptor agonists in #PsA linked with lower mortality & fewer major cardiac events in >90K patients.
Promising data for inflammation, weight & heart health in PsA care. @RheumNow #ACR25 https://t.co/8zyrSrumOP
Mrinalini Dey DrMiniDey ( View Tweet)
This morning in the plenary, same theme, but in PsA:
Similar metabolic/CV concerns
Similarly benefit from GLP-1 RA
looking at TriNetX data again, reduced MACE
Now prospective trials in rheum disease, for both metabolic benefits & disease activity?
#ACR25 ABST0849 @RheumNow https://t.co/DHZN1hwbIG
David Liew drdavidliew ( View Tweet)
Increased risk of psoriatic arthritis with obesity. A preview to Abstract#2687 Scher J @RheumNow #ACR25 https://t.co/cMbrQnq8YG
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
High prevalence of sleep related symptoms in PsA pts!
-Snoring 53%
-Morning fatigue 68%
-Obstructive Sleep Apnea in 50%
14% mild 19% moderate 17% severe
Estimated prevalence 36%
No correlation between OSA and PsA disease activity or comorbidities
But small cohort! https://t.co/VKe7qcHIRm
Aurelie Najm AurelieRheumo ( View Tweet)
Dr. Ogdie on emerging PsA tx:
“It’s not just about the pharmacotherapy but also about making the patient feel better”
Also, weight loss is incredibly important but also incredibly hard. Losing weight is more impt than the type of diet a patient should be on.
#ACR25 @RheumNow https://t.co/FN3EEowkDP
Links:
sheila RHEUMarampa ( View Tweet)
Why do we need to identify early PsA?
🔅Improve symptoms
🔅Prevent radiographic progression
🔅Preserve function
☝️Recent data show that erosions are prevalent in early PsA but lower if symptom duration is <6 mos.
#ACR25 @RheumNow https://t.co/sEGXzd8RiD
Links:
sheila RHEUMarampa ( View Tweet)
What are the RFs for progression of Pso to PsA?
🔸PsO disease severity - 3.2x risk —>PsA
🔸Phenotype - nail involvement
🔸Obesity - 6x higher risk of developing PsA
🔸MSK symptoms - arthralgia & heel pain
#ACR25 @RheumNow https://t.co/UPXuxBPyKI
Links:
sheila RHEUMarampa ( View Tweet)
The severity of skin psoriasis increases the risk of psoriatic arthritis. Scher J @RheumNow #ACR25 https://t.co/EI0ACWACHy
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Trying to reach RA, PsA patients on social media, to participate in studies?
Simple, informational messages work for recruitment
Message framing affects engagement but not recruitment
The more we understand, the better we can reach the right people
#ACR25 ABST0187 @RheumNow https://t.co/JoAthXhXvi
David Liew drdavidliew ( View Tweet)
A simple flow cytometry analysis of peripheral blood monocytes to predicts progression to clinical RA or PsA in at-risk patients?
Too good to be true!
284 RA 56 PsA 57 HC
-HLA-DR higher in PsA
-CD11c lower in RA
But no clear difference between Converters and non Converters https://t.co/f3Sett4eXd
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
PD-1+ effector memory T cells in PsA synovium are functionally active and regulate Th17 cytokines via STAT3/RORγt. Recombinant PD-L1 agonist significantly reduced T cell proliferation and IL-17A/F/IL-22 production highlighting checkpoint agonists as a novel therapeutic strategy https://t.co/I6eNa0j7aa
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Effect of BioDMARDs on Diabetes risk in 6400+ Psoriasis pts
IL-23i and IL-17Ai associated w/
-lower risks of diabetes
-Diabetic nephropathy
-Stage 3–5 CKD
and reduced risk compared to TNFi treated and bionaive pts
Adjustment on several variables, but not disease severity https://t.co/TDIHXJOC2T
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Retrospective study by Dr. Goudot et al. - pts w/D2T PsA had dactylitis, fibromylagia & ischemic cardiomyopathy
In multivariate analysis, FM & ischemic CM found to be RFs for D2T PsA
☝️Consider other dx if D2T PsA
#ACR25 @RheumNow ABS0566 https://t.co/FOXv6LbysZ
sheila RHEUMarampa ( View Tweet)
