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Rheumatology Roundup - ACR 2023
Drs. Jack Cush and Arthur Kavanaugh discuss highlights and key takeaways from ACR 23.
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#ACRbest Abstracts – Day 4
While there wasn’t much original new programming and research presented on the final day, that didn’t slow the RheumNow faculty from tweeting the noteworthy “Best of ACR” abstracts. Enjoy these below.
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ACR 2023 – Day 4 Report
The last day at ACR23 was a ghost town as most left, largely because there was limited programming on the fourth and final day. The main attraction on Day 4 was the late-breaking abstract – oral presentations. Here’s a list of the late breakers; below, I provide commentary on the ones that caught my attention.
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Will CAR T Cells also treat RA?
Dr. Jonathan Kay reports on abstract 0424 from #ACR23.
https://t.co/shb8tpDut4 https://t.co/xLn36Yg9fn
Dr. John Cush RheumNow ( View Tweet)
How do we manage difficult discussions about pregnancy in RA?
Most rheums know that it is important to get pregnancy planning right for women of childbearing age living with rheumatic diseases. That is easier said than done, though...
https://t.co/cXtqqVv6fp https://t.co/k5afTUKYf8
Dr. John Cush RheumNow ( View Tweet)
L20 at #ACR23
Phase 3 RCT of #Telitacicept vs. placebo in #RA
☝🏻B-cell neutralization by targeting BlyS and APRIL
✅ better ACR20 and 50 response at W24
✅ favorable structural response
✅ good safety profile
❓ few seronegative patients
A new small molecule to treat #RA?
PAJ https://t.co/fyrqAya41e
ARD & RMD Open ARD_BMJ ( View Tweet)
#ACR23 #EdLovering presenting on association b/w #RA, #CVD & #Dementia:
👉🏻CVD is not a signif mediator b/w RA &Dementia
👉🏻 signif synergy b/w RA & CVD on dementia (HR 2.45 vs those w/o RA&CVD)
👉🏻 ⬆️ risk of dementia in RA mostly in people with RA+CVD
#Mayoclinicrheumatology https://t.co/5kqs3HAACn
Elena MyasoedovaMD ☀️ ( View Tweet)
Impressive and important study supporting safety of TNF inhibitors among patients with RA-ILD. Elegant methods of target trial emulation. Congrats to the authors on plenary presentation!
#ACR23 https://t.co/P7keAoOX7M
Jeffrey Sparks MD MMSc jeffsparks ( View Tweet)
Nipocalimab (say it a couple of times) is a FcRn (neonatal Fc receptor) inhibitor. In short promotes degradation of IgG incl autoantibodies (and investigated in myasthenia).
Prof Taylor presents that it might work in CCP high titer RA at #ACR23.
#ACRambassador @ACRheum https://t.co/DqlsOv7AVI
Tue Kragstrup KragstrupTW ( View Tweet)
B cell signalling reduction to treat #RA?
Telitacicept RCT showed #efficacy in active RA w MTX -maybe blunted high responses but no active comparator, only #PBO so difficult to compare to current Rx and only from 1 country China. Past bDMARDs not reported
L20 @RheumNow @ACRheum
Janet Pope ( View Tweet)
As per #ACR23 ABST0433, what % of RA patients on US Medicare are on a DMARD within 1y of diagnosis?
I'm not talking your choice of b/tsDMARD.
I'm talking any cs/b/tsDMARD of any sort.
Hear from @JihaRheum to skip to the answer:
https://t.co/lI2M20JWKC
Truly stunning. @RheumNow
David Liew drdavidliew ( View Tweet)
Sex bias in RA: time to stop blaming hormones?
https://t.co/uPq87r4Ndv https://t.co/Yleu2LDV3g
Dr. John Cush RheumNow ( View Tweet)
Taylor et al. Novel blood assay for sero+ and sero- RA. Differentiates well from other diseases. May be very valuable for sero- RA diagnosis = sensitivity 83.7%, +LR 21.46, and -LR 0.17. Needs validation. Abstr#2586 #ACR23 @RheumNow https://t.co/jw41F8YohE https://t.co/kXi3km0b07
Richard Conway ( View Tweet)
Last abstract of #ACR23 was #ACRBest
Plasma cfDNA signatures (synovial mapped) to identify RA vs OA, other inflamm arthritis
Great performance, even with seroneg RA
A blood test to:
diagnose
?phenotype
?identify best b/tsDMARD
Could be massive
Peter Taylor ABST2586 @RheumNow https://t.co/tJX2jXV0Oe
David Liew drdavidliew ( View Tweet)
#ACRbest Yrin Preview @ACRheum
J Bathon
Take home
Symptomatic #Rx of ACPA+ people WITH #DMARD is too late to alter risk of #RA when drug is d/c
AI to read joint erosions on X-ray May be ‘too little too late’
#Steroids in #RA increase #MACE even after d/c
#ACR23 @RheumNow
Janet Pope ( View Tweet)
#ACR23 Yr in Preview
J Bathon
Shared decision making w tradeoffs showed sex differences for concerns & preferences in #RA present
dependent on how you ask the questions
Unmet needs (I think 🤔)
biomarkers of flare for #inflammatory #arthritis
Rx select’n/retention
@RheumNow
Janet Pope ( View Tweet)
Watch: Assessment and Treatment of Cardiovascular Risks in Rheumatoid Arthritis
Dr. Antoni Chan discusses abstract 0387 and abstract 0391 presented at #ACR23
https://t.co/avnarOGZui https://t.co/4CeAumv31b
Dr. John Cush RheumNow ( View Tweet)
Telitacicept a recombinant fusion protein targeting, neutralizing BLyS and APRIL, phase 3 study in RA MTX-IR at 24 wk, ACR20 (60% vs 27% PBO), ACR50 (21% vs 6% PBO), reduced DAS28-ESR, no radiographic progression, Wang L Abst#L20 #ACR23 #ACRBest @RheumNow https://t.co/nuvizqQZsR https://t.co/PRtlea3AqU
Dr. Antoni Chan ( View Tweet)
Abstract 2583 at #ACR23
👉Possible predictive model of at risk of RA patients with ACPA positivity based on baseline levels of peripheral blood lymphocyte sub-populations:
⭐️High % of B cell and low % of NK cells increase the probability of developing arthritis in ACPA + pts… https://t.co/3KEOI4eul0 https://t.co/irX6InWMbl
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
A model for prediction of progression to RA
Factors asso w/ progression
-ACPAs
-High % B cells
-Low % NK cells
Only in ACPA+ individuals
Low ACPA titers, High % NK cells and Low B cells = 76% non progressors
@RheumNow #ACR23 ABST2583 https://t.co/vNIwyrOJtJ
Aurelie Najm ( View Tweet)
