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Guselkumab in Psoriatic Arthritis
D1 and D2 trials compared guselkumab vs placebo in patients with active PsA, with the major difference between the two being that only biologic-naïve patients were enrolled in the D2 trial. Today, we discuss three abstracts presented at ACR 2021 that expand on that work with an additional year of data.
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NORD-STAR Trial: outcomes in tx-naïve, early RA pts after 48w of csDMARDs+GC vs bDMARD (ABAtacept, CerToliZumab, or ToCiluZumab)+MTX
➡️ Superior CDAI remission rates w/ ABA+MTX & CZP+MTX but not TCZ+MTX vs csDMARD+GC
➡️Imaging progression low in all
Abst#0825 #ACR21 @RheumNow https://t.co/QaFIF4WNEG
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
#Abs0588 Effectiveness of TNFi vs non-TNFis in obese patients with #rheumatic disease @MilenaGianfran:
👉🏼>16000pts @ACRheum RISE
👉🏼Abatacept➡️larger decreases in CDAI in obese pts
👉🏼Tocilizumab➡️larger decreases in CDAI in non-obese pts
@RheumNow #ACR21
https://t.co/bL5xnG1iNh
Mrinalini Dey DrMiniDey ( View Tweet)
B cell repertoire: the new 🔮?
An algorithm associating baseline CDAI to BCR sequencing outcomes w/
✨Isotypes frequency
✨Somatic Hypermutations
predicts MTX 12mo response w/ 78% sens & spe
#Abstr982 #ACR21 @RheumNow
https://t.co/SZaip6xUaO https://t.co/fbWq34gtzc
Aurelie Najm AurelieRheumo ( View Tweet)
#ACR21 #Abstr0866 Data from #COVID19 GRA Registry showed predictors of poor COVID outcome in 1922 #lupus pts:
Older age
Male
Areas outside Europe, 🇺🇸🇨🇦
Infection <June 2020
Any Corticosteroid dose
Not on therapy
On Rituximab
Comorbidities
⬆️disease activity
@RheumNow #ACRBest https://t.co/u0GF3aDsFA
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
AxSpA pts who achieve ASDAS low disease activity (LDA) 6 mo after bDMARD initiation
⭐️ 25% achieved ASDAS LDA
⭐️ASDAS LDA achievers were ♂️ + naïve to c/b DMARDs + with PROM / Clinical improvement
⭐️ASDAS LDA non-achievers=depression, uveitis, IBD
Abst# 0925 #ACR21 @RheumNow
swethaann23 swethaann23 ( View Tweet)
#ACR21 Abst#0588. TNF vs non-TNFi in obese RA pts
⭐️TNFi use ⬆️ disease activity vs ABA in obese pts
⭐️TNFi use ⬆️ activity vs TCZ in non-obese pts
⭐️No diff w RTX, Tofa
▶️Further research needed: Wt-based dosing? SC vs IV?
https://t.co/K8WycPTgxW @Rheumnow #ACRBest
Links:
Eric Dein ericdeinmd ( View Tweet)
SEC reduced SIJ bone marrow edema in active nr-axSpA pts. Majority of pts both in SEC and PBO arms showed no radiographic progression through 2 years. Abs 0921 #ACR21 #RheumNow @RheumNow https://t.co/yC2AZoacxF https://t.co/pjCL8HCanR
Dr. Rachel Tate uptoTate ( View Tweet)
CARRA STOP-JIA 400pts, Obs study w/ 3 treatments plans :
-Step up
-Early combination
-Biologic first
Which one do you think works best?
I'd say none: overall 40-60% not achieving CDI off steroids at 24 months.
Results: 42% for SU, 52% EC, and 44% BF #Abtr0960 #ACR21 @RheumNow
Aurelie Najm AurelieRheumo ( View Tweet)
Factors associated with Anti Drug Ab against TNFi over 2-y in axSpA pts are:
⭐️ 🔼 Disease activity
⭐️Development of adverse events
⭐️Treatment discontinuation
Abst #0936 #ACR21 @RheumNow
swethaann23 swethaann23 ( View Tweet)
Dr Naovarat reports on 18 year outcomes of HIV and rheumatic disease. 16 patients treated with TNFi, including 2 who switched to tocilizumab and ustekinumab. No major infections. Rising viral load in 1 led to discontinue. Abstr#0965 #ACR21 @RheumNow https://t.co/jcGPaURKmb
Richard Conway RichardPAConway ( View Tweet)
SKIPPAIN results: Spinal pain response after 8 weeks of SEC showed notable differences between HLA-B27 subgroups. Can subtype pre-determine tx efficacy/response? Abs 0917 #ACR21 #RheumNow @RheumNow https://t.co/FKpCqXpobM https://t.co/WbjjyTIaiG
Dr. Rachel Tate uptoTate ( View Tweet)
IV Golimumab efficacy and Early (ED) vs Late (LD) AS
⭐️ED better response than LD with PRO
⭐️Treatment-emergent adverse events/ serious adverse 🔼 LD as compared to ED
Abst #0912 #ACR21 @RheumNow https://t.co/5EaWAvfQ57
swethaann23 swethaann23 ( View Tweet)
French real-world AxSpA cohort analysis showed drug retention of SEC & TNFi were similar. In subgroups analyses, age, BASDAI at dx & BMI were similar. Abs 0911 #ACR21 #RheumNow @RheumNow https://t.co/ewtmpxKTNu https://t.co/Yh0nX3x83Z
Dr. Rachel Tate uptoTate ( View Tweet)
#ACR21 Abst#0836. TCZ switch from IV▶️SC in RA
⭐️11/37 ineffective on SC (30%)
⭐️TCZ IV >8mg/kg, no MTX, h/o ABA failure ass w/ risk of flare on SQ switch
🔥Very relevant w shortages, want more data re: confounders (adherence, disease control)
https://t.co/E9pD4SrXqz @Rheumnow
Links:
Eric Dein ericdeinmd ( View Tweet)
Getting closer to personalised medicine in AS, ECM-mediated biomarkers may help predict response to Adalimumab in AS. The biomarkers C1M, C6M and
PRO-C4 were lower in responders to adalimumab treatment after 24 weeks @RheumNow #ACR21 Abst#0915 https://t.co/K2YxPvUAwu https://t.co/w9kcBSFeG9
Dr. Antoni Chan synovialjoints ( View Tweet)
There is increase in ASDAS, BASDAI, CRP and faecal calprotectin levels although not reaching a clinical flare in AS patients who had CZP stopped compared to those who continue CZP full or reduced dose @RheumNow #ACR21 Abst#0916 https://t.co/Wlwirs1QXF https://t.co/jE4smHMXBI
Dr. Antoni Chan synovialjoints ( View Tweet)
Abst0919 #ACR21 @RheumNow Phase III COAST-V 52W (PBO)-controlled study examined the efficacy of IXE in pts with active AS. SF-36 bodily pain, improvements were observed at W16 & W52 whether inflammation was controlled or not per MRI, CRP, MRI+CRP, or BASDAI 5/6. https://t.co/uHLwFctzPr
Olga Petryna DrPetryna ( View Tweet)
Single Intraarticular Canakinumab in Knee OA - 18-week randomized, double-blind, double-dummy Placebo and naproxen-controlled - effect no different than Placebo. Some efficacy in subgroup with high hsCRP. Need for subtypes in OA @rheumnow #ACR21 #abst0728 https://t.co/YlKTMf56wF
Bella Mehta bella_mehta ( View Tweet)
@MilenaGianfran @JYazdanyMD present on differential effects of biologics on CDAI in obese patients with rheumatoid arthritis. Abatacept better than TNFi in obese. Tocilizumab better than TNFi in non-obese. Abstr#0588 #ACR21 @RheumNow #ACRBest https://t.co/UcEpMAmNVw
Richard Conway RichardPAConway ( View Tweet)
