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RheumNow Podcast – ACR Convergence Begins (11.5.2021)

Jack Cush, MD

Dr. Cush reviews the news, and kicks off ACR21 learning and how to take in the annual meeting.

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Industry Abstract Previews #ACR21 - Horizon, Aurinia, AstraZeneca

Jack Cush, MD

The pharmaceutical companies will feature the results of their pivotal clinical trials and data analyses at ACR Convergence 2021.  Below is a listing of some of their best studies for you to review and look for in the meeting.

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Rituximab Patients May Benefit from Third COVID-19 Vaccine Dose

ACR

New research presented this week at ACR Convergence, the American College of Rheumatology’s annual meeting, shows immunocompromised patients using rituximab (a drug used to treat diseases like rheumatoid arthritis) were able to produce antibodies against COVID-19 (seroconvert) after receiving a t

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JAK-pot Study: Cycling JAK Inhibitors Effective in Difficult-to-Treat RA

ACR

New research presented this week at ACR Convergence, the American College of Rheumatology’s annual meeting, shows that people with difficult-to-treat rheumatoid arthritis who do not have success with one Janus kinase inhibitor (JAK inhibitor) can achieve success either cycling to other JAKi medic

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Ultra-Low Dose Rituximab Controls Disease Activity in RA

ACR

New research presented this week at ACR Convergence, the American College of Rheumatology’s annual meeting, shows that in one study, the majority of rheumatoid arthritis patients on an ultra-low dose of the drug rituximab maintained low disease activity for up to four years, and rarely needed to switch to other biologic drugs or glucocorticoids to control their disease (Abstract #1443). 

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Management of Immune-Related Adverse Events - ASCO Guideline

Jack Cush, MD

The American Society of Clinical Oncology, Inc (ASCO) has updated its guidelines and recommendations for the management of immune-related adverse events (irAEs) in patients treated with immune checkpoint inhibitor (ICPi) therapy. Below are select statements from this guideline.

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Biologic dose tapering in #axialspondyloarthritis in 52% of patients if criteria are met (BASDAI)< 40, physician global score< 40 and no signs of disease activity the previous year, escalation to previous dose if there is a flare @RheumNow #ACR21 Abst#0364 https://t.co/4GntJ6jS11

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Dr. Antoni Chan synovialjoints ( View Tweet)

KEEPsAKE trial 1 (DMARD-IR) and 2 (DMARD/biologic-IR) on risankizumab (IL23i) for PsA: 👉phase 3 DBRPCT 24 weeks 👉150 mg week 0,4, 16 weeks 👉improved ACR20,ACR50,ACR70 👉improved PASI90 👉improved HAQ-DI 👉no increased safety signals #ACR21 Abstr#0438 #Plenary @rheumnow https://t.co/ioIBXgV4Hi
TheDaoIndex KDAO2011 ( View Tweet)
Prevention study using Abatacept in 100 patients with arthralgia is superior (61%) to placebo (31%) in improving subclinical inflammation in RA at-risk patients (ACPA+, MRI+, Arthralgia+) at 6 months. No new safety issue emerged @RheumNow #ACR21 Abst#0455 https://t.co/DoRItcHfBE

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Dr. Antoni Chan synovialjoints ( View Tweet)

#ClinicalPearl What lasts longer/⬆️retention in sero+ RA: Abatacept or TNFi or JAKi? #ACR21 abst#0463 @RheumNow Adjusting for confounding incl line of Rx / past bio Rx, #abatacept wins. But data not stratified for bio naive or exposed. Not sure if that would alter results https://t.co/1dEQncwPQF
Janet Pope Janetbirdope ( View Tweet)
Retrospective study of FAERS database: 186 irAE w/rheum manifestation 👉4.7% of all AEs 👉Arthritis, myositis, Sjogren, sarcoidosis were frequent 👉myositis assc w/ durvalumab, avelumab, atezolimumab and cemiplimab #ACR21 Abstr#0438 #Plenary @rheumnow https://t.co/t8UQWQicFc https://t.co/FGo6WCDQTp

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TheDaoIndex KDAO2011 ( View Tweet)
How can we tell whether a patient already on rituximab will have an immunogenic response to Pfizer COVID-19 vaccination? Better chance of response if: - RA or SLE, not AAV or IIM - high serum IgG pre-last RTX - longer time since last RTX Israeli data #ACR21 ABST0437 @RheumNow https://t.co/yyuFd0eDH6
David Liew drdavidliew ( View Tweet)

Phase 2 German study demonstrates superiority of TCZ vs PBO in FMF. SAA levels only normalized in TCZ treated patients. Interesting concept that needs to be replicated in larger trials. Abs 0193 #ACR21 #RheumNow @RheumNow https://t.co/awqOpwg3gH https://t.co/lGzYglnkyM

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Dr. Rachel Tate uptoTate ( View Tweet)
Abst0242 #ACR21 @RheumNow FROST: 1st line Rx of SJIA 73 pts. two study arms: biologics & GC/MTX arm. In biologic arm 14% IL-1i switched to IL-6i, 0% from IL-6i to IL-1i. 50%GC/MTX eventually initiated biologic therapy . 57% of pts d/cGC use, and 75% had cJADAS-10 score ≤ 2.5 https://t.co/vH0AnocTr2
Olga Petryna DrPetryna ( View Tweet)
How much ritux for AAV maintenance? Ever since we started using it, no-one's been sure. If absolute B cell depletion is your goal, @VUMCRheum data suggest >3.3mg/d is safest for that 500mg q6m = 2.7 mg/d 500mg q4m = 4.1 mg/d 1000mg q6m = 5.5mg/d #ACR21 ABST0416 @RheumNow https://t.co/mYAgKhHT7j
David Liew drdavidliew ( View Tweet)
Dr Springer on pharmacological response of RTX in ANCA-vasculitis. Suggest that 500mg every 6 months may not achieve sufficient B cell depletion in all. What are the clinical implications? Is anyone dosing 500mg as standard? Abstr#0416 #ACR21 @RheumNow https://t.co/w36hSYbW1B
Richard Conway RichardPAConway ( View Tweet)
Despite >20y of bDMARDs, our patients still have a 50% greater risk of cardiovascular issues (similar to family history or abdominal obesity) Cardiovascular disease in RA is not historic, it's today's reality we too often ignore. 2020 data @VUamsterdam #ACR21 ABST0286 @RheumNow https://t.co/Az4wHNUOGe
David Liew drdavidliew ( View Tweet)
PsA bDMARD use in Australia🇦🇺 (where once you qualify for a bDMARD in general, it's the physician's free choice) 1. cool Sankey diagram showing switches 2. given the chance, people switch in all directions & switch hard (registry linked with insurance) #ACR21 ABST0201 @RheumNow https://t.co/jcVPa8jXsR
David Liew drdavidliew ( View Tweet)
Abst#0268 ➡️Do lipids change w/ some bDMARDs in RA? YES! ⭐︎ TCZ: ↑ TC, LDL, TG & ↓ in hsCRP relative to initiating TNFi. ➡️Does this lipid ↑ confer risk for CVD? Not necessarily as it may not be atherogenic per Reynolds Risk Score! #ACR21 @Rheumnow https://t.co/Gy62mg6GhZ https://t.co/5uC8Zy0Lbr

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Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Study 144 pts Rx w/ Rituximab for Autoimmune renal Dz (AAV, FSGS, IgG4RD, LN, etc). 17% had Severe infections (SIE) w/in 3 mos; mostly pulm & GU. Risk factors=BMI, high creatinine. Hypogammaglobulinemia was frequent (58.5%) but not associated with SIE https://t.co/2jaxC4xLhc https://t.co/ajUKI35q2h

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Dr. John Cush RheumNow ( View Tweet)
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