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RheumNow Podcast - ACR 2021 Rehash (the good stuff..)
The ACR 2021 meeting has concluded. Dr. Jack Cush recounts a few more great abstracts from this past week’s virtual meeting.
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Predicting RA, and Treatment of Subclinical Arthritis
Identifying patients that will develop RA in situations of seropositivity without overt clinical arthritis or identifying patients with undifferentiated oligo/polyarthritis that will develop RA remains a challenge in the field of rheumatology.
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Can "Ultra-low" dose Rituximab work for RA?
The REDO trial presented data in abstract 1443 in an oral presentation challenging how low we can go with rituximab for rheumatoid arthritis. Their study randomized 118 patients with rheumatoid arthritis to 1000 mg, 500 mg, and "ultra-low" dose 200 mg.
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Potpourri of Biosimilar Trials: Dr. Jonathan Kay discusses a number of biosimilar trials presented at the #ACR21 annual meeting, including abstracts #0822, #0820, #0817 and #0823.
https://t.co/aQXrKKZXhb https://t.co/4Bn7rvogHY
Links:
Dr. John Cush RheumNow ( View Tweet)
Does Obesity Play a Role in Biologic Response? Dr. Eric Dein ( @ejdein1) discusses abstract #0588 presented at the #ACR21 annual meeting.
https://t.co/yJNOFv3KOC https://t.co/KvBrFlXLfW
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Dr. John Cush RheumNow ( View Tweet)
Factors Associated with Poor Vaccine Response in Rituximab: Dr. Yuzaiful Yusof (@Yuz6Yusof) discusses abstract #0437 presented at the #ACR21 annual meeting.
https://t.co/T0PFiZlbTa https://t.co/idj5T7j7ke
Links:
Dr. John Cush RheumNow ( View Tweet)
Comparative risks of skin SCC and BCC with different DMARDs. Abatacept appeared worst, HR 2.18, but may be residual confounding due to burden disease/comorbidities. Abstr#1942 #ACR21 @RheumNow https://t.co/UzOwuKKFmX
Richard Conway RichardPAConway ( View Tweet)
Who declines most with #scleroderma #ILD - early dcSSc, ⬆️CRP, ⬆️mRSS all w more ⤵️FVC. Results verified in SENSIS trial of SSc ILD where #nintedanib was superior to placebo abst#1846 #ACR21 @RheumNow https://t.co/eckUj0qwch
Janet Pope Janetbirdope ( View Tweet)
Should we be measuring drug levels in pts taking infliximab?
⭐️Drug monitoring vs. standard dosing showed 73% sustained control vs. 55% (RA, PsA, SpA, UC, Crohn's, PsO)
#ACR21
Abs#1946
#ACRBest @RheumNow
https://t.co/sWMen50ljP https://t.co/F4Wpqis3id
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Robert B Chao, MD doctorRBC ( View Tweet)
OK is this a swan or a swan song? Graph looks like a swan 🦢 but message is NO #MACE differences in PsA on csDMARDs v #biologics #ACR21 abst#1833 @RheumNow https://t.co/TM91z5wiFY
Janet Pope Janetbirdope ( View Tweet)
So are we in an era of #monotherapy with bDMARDs in #PsA? Ustekinumab & Secukinumab not different w or without #MTX. Abst#L12 @RheumNow #ACR21 https://t.co/Zp5owTpLvm
Janet Pope Janetbirdope ( View Tweet)
Important late breaker @TerrierBen, DBRCT of RTX vs GC (FFS=0) or CYC (FFS>0) for EGPA
RTX not superior to CYC (64% RTX vs 60% CYC BVAS remission d180, p = 0.745); similar in subgroups
Feel like this lends support to (~surprising) ACR/VF recs for EGPA?
#ACR21 #ACRAmbassador https://t.co/gpsPtXF6pj
Mike Putman EBRheum ( View Tweet)
#ACR21 L19: TitAIN: Secukinumab for GCA
⭐️Phase 2 study with n=52
⭐️70% of SEC sustained remission at wk 28 vs 20% PBO, 59% at week 52 vs 8%
⬇️Cumulative prednisolone through wk 52 (2.8g v 3.4g)
- Looking forward to larger study
@Rheumnow
https://t.co/cuM9LcEr4u https://t.co/TmyS0kixFg
Links:
Eric Dein ericdeinmd ( View Tweet)
#ACR21 L21. REOVAS: RTX for EGPA
⭐️CYC traditionally preferred for 5-factor score>0
▶️Remission rates and relapse-free survival comparable bw RTX and conventional. RTX not superior for induction
▶️No diff in ANCA+/-, naive v relapse, FFS
https://t.co/cuM9LcEr4u @Rheumnow
Links:
Eric Dein ericdeinmd ( View Tweet)
Racial disparities & Co-morbidities in PsA findings. Amongst important others, increased biologic use in Caucasians w/ PsA vs DMARDs in black PsA pts. View Abs 1780 for other relevant findings. #ACR21 #RheumNow #ACRbest @RheumNow https://t.co/0uKsa8i0bG https://t.co/R9YkxYqXws
Dr. Rachel Tate uptoTate ( View Tweet)
RHEKISS registry: SpA pts on bDMARDs at conception are NOT at inc. risk for adverse pregnancy outcomes. Discontinuation of bDMARDs after conception is assoc'd w/ inc. dz activity during/after pregnancy & flare risk. Abs 1730 #ACR21 #RheumNow @RheumNow https://t.co/b2wI9GZios https://t.co/wsuvv3hF0v
Dr. Rachel Tate uptoTate ( View Tweet)
b/tsDMARDs + tumor response in rheum irAEs
Excellent point by @CCalabreseDO @LCalabreseDO:
- despite progression in 5/10, DMARD contribution uncertain (bad cancer)
- without DMARD, ICI would have had to stop
crucial question, prospective study needed
#ACR21 ABST1519 @RheumNow https://t.co/omJnTNVscH
David Liew drdavidliew ( View Tweet)
Sub-analysis of ICHIBAN study looking at adverse events in tocilizumab treated patients with/without steroids. Steroids associated with small increase in adverse events across board. Abstr#1693 #ACR21 @RheumNow https://t.co/ldiovirKpo
Richard Conway RichardPAConway ( View Tweet)
For patients with inflammatory irAEs, what's your preference of bDMARD/tsDMARD?
(keeping in mind both irAE response and tumor response)
#ACR21 irAE Study Group run by @CCalabreseDO @NAbdelwahabMD @ReidMDMPH
@RheumNow
David Liew drdavidliew ( View Tweet)
#ACR21 Ab#1655. Respiratory Ifn in RA on bDMARD
▶️1 group was initiated into vaccination program vs usual care
⭐️Vaccinated group had ⬇️ admissions from respiratory ifns. 44% ⬇️ severe resp ifn
💉programs work!
@Rheumnow https://t.co/pljR6DbAtU https://t.co/goSHGID8qG
Links:
Eric Dein ericdeinmd ( View Tweet)
