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Tyk2 Inhibition Effective in SLE
Deucravacitinib, an oral, selective TYK2 inhibitor, has demonstrated efficacy in a phase II trial active systemic lupus erythematosus (SLE) patients.
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Retrospective study looked at 47 adults w/ dermatomyositis treated with tofacitinib. While clinically similar, those on TOFA were were younger (53vs 61), shorter Rx duration (24 vs 53 mos);there was signif CDASI improvement. #ACR22 https://t.co/HrC1GLZQRR https://t.co/yiHsxhpiWe
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Dr. John Cush RheumNow ( View Tweet)
Do oral JAKs in atopic dermatitis cause VTE? Meta-analysis (15 RCTs, 466 993 pts) does NOT show increased risk of VTE associated with AD & JAK inhibitors (HR 0.95) w/ low VTE incidence (0.05%) w/ JAKi and (0.03%) placebo. https://t.co/vcvW8N11cm https://t.co/N5zx0I0lrn
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Dr. John Cush RheumNow ( View Tweet)
JAKi Regulatory Decisions - FDA, EMA, Canada
New download available!
https://t.co/92qbWQbMm3 https://t.co/lEjyjwxYMo
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Dr. John Cush RheumNow ( View Tweet)
ACR 2022 Appraisal, Praise & Critique (11.18.2022)
It was great to be back at an ACR annual meeting, this one in Philadelphia - Philly was great. A walking town, rich in culture, history and good places to meet and mingle.
I loved the city, but not the convention center (not easy to navigate).
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Maya Buch on major adverse CV events in tofa vs TNFi. Post-hoc analysis of phase 3b/4 data looking at cohort enriched for CV events.
@RheumNow #ACR22 #LateBreaking
Julian Segan JulianSegan ( View Tweet)
L06 #ACR22 ORAL Surveillance Updates!
Composite of all ischemic CV events and HF did NOT show difference b/w TOFA vs TNFi
But, MACE numerically higher with Tofa w/ h/o ASCVD
Highest CV risk in TOFA 10 mg BID, 2/2 VTE risk
Most important risk is pt's individual risks
@RheumNow https://t.co/jPPX7f5GRE
Eric Dein ericdeinmd ( View Tweet)
Does tofacitinib work better in patients with PsA and AS who smoke?
Abstract #1036 #ACR22 @RheumNow
🚬519 ever smokers
🚭767 never smokers
💉In PsA only, TOF efficacy was greater in ever smokers vs. PBO
✋Overall, efficacy was generally comparable in ever v. never 🚬
Catherine Sims, MD DrCassySims ( View Tweet)
Post-hoc analysis of SELECT-COMPARE showing decreased residual pain at week 12 but not week 26 cf. ADA, regardless of residual inflammation. Does this just reflect differing onset of action?
@RheumNow ABST0297 #ACR22
https://t.co/9WyZAN3B16 https://t.co/fAC1bLw9EB
Julian Segan JulianSegan ( View Tweet)
Fleischmann et al. Safety of TYK2i Deucravacitinib in PsA/PsO in terms of labs. Really no effect on lab values other than increase in trigs. Guess this is why they don't have lab monitoring on label? @RheumNow #ACR22 Abstr#2132 https://t.co/ueIVKQc6jr https://t.co/u99QE71VQ5
Richard Conway RichardPAConway ( View Tweet)
Warren et al. TYK2i deucravacitinib in plaque psoriasis at 2 years. Sustained efficacy. No new safety signals seen. @RheumNow #ACR22 Abstr#2134 https://t.co/5SGKKrvwbc https://t.co/ynvfZiOrsp
Richard Conway RichardPAConway ( View Tweet)
New SLE Rx. Deucravitinib a TYK2i phase 2 RCT showed SRI4 endpoint. Subset of 3 mg bid was best vs 6 mg bid and 12 mg OD. Skin via CLASI-50 & other endpoints also positive. Awaiting phase III. Abst1117 #ACR22 @RheumNow https://t.co/fZI3AV5pML
Janet Pope Janetbirdope ( View Tweet)
Is #Tofacitinib an option in #PMR poly myalgia rheumatica? RCT of Tofa 5 mg bid vs prednisone 15 mg/d and tapering. Equal results. Needs a phase 3 trial but could be an option if needing to avoid prednisone ex osteoporosis, DM, etc. abst#1107 #ACR22 @RheumNow https://t.co/OgcgslwaB5
Janet Pope Janetbirdope ( View Tweet)
Kavanaugh et al. TYK2i deucravacitinib in PsA. Nice breakdown of MDA and its components over 16 weeks. MDA achieved 23-24% with deucravacitinib at 16 weeks vs 8% with placebo @RheumNow #ACR22 Abstr#2136 https://t.co/9IG8CeZzMh https://t.co/Vg8E20y7Z8
Richard Conway RichardPAConway ( View Tweet)
Mease et al. TYK2i Deucravacitinib in PsA. Phase 2 RCT 52 week results. PASDAS, DAPSA efficacy maintained through week 52. No new safety concerns. @RheumNow #ACR22 Abstr#1598 https://t.co/sRKkgkYtQJ https://t.co/YMXMEH3wsq
Richard Conway RichardPAConway ( View Tweet)
In RA pts initiating their first b/tsDMARD, Abs 1420 did not observe differences in 6- and 12-month effectiveness outcomes between ETN, ADA, and JAKi monotherapy. #ACR22 @RheumNow https://t.co/e8GA45Rrmd https://t.co/zooGxlTftO
Dr. Rachel Tate uptoTate ( View Tweet)
Pike et al. Deucravactinib (TYK2i) in SLE. + on SRI(4) week 32. + SRI(4),BICLA, LLDAS, CLASI-50, swollen and tender joint counts week 48. Strange, the lowest dose (3mg bd) seems best. @RheumNow #ACR22 Abstr#1117 #ACRbest https://t.co/o4902tvZs8 https://t.co/t8oeMRGUS7
Richard Conway RichardPAConway ( View Tweet)
TOFA and MTX: which one to withdraw first?
RCT in 100+ RA pts in remission after 1 yr, 1 yr follow-up
Withdraw MTX grp: Remission 30% LDA 40%
Withdraw TOFA grp: Remission 50% LDA 65%
diff NS small sample
8 SAEs, 72% recovery
https://t.co/tMnet32TWF
Abs#1586 #ACR22 @Rheumnow https://t.co/PWnkWYdlGk
Aurelie Najm AurelieRheumo ( View Tweet)
#abst2132 #acr22 @rheumnow safety of Deucravacitinib Ph2PsA&ph3PSO trial: no Δ from BL in hematology, chemistry, or lipid labs. JAK 1/2/3 Effects on hem, hepatic, CPK, and cholesterol lab parameters not observed over 16 wks of DEUC at doses up to 12 mg QD & in combo w/csDMARDs. https://t.co/bjGEYp4GcJ
Olga Petryna DrPetryna ( View Tweet)
Plenary:
Tyrosine kinase 2 (TYK2)
◦ Mediates signaling of Type I IFNs, IL-23, and IL-12
◦ Key cytokines involved in lupus pathogenesis
◦ Deucravacitinib oral TYK2 inhibitor
◦ Phase 2 RCT in SLE showed efficacy
Pike M Abs1117 https://t.co/eJhNsM02Vl #ACR22 @RheumNow https://t.co/C6JQqR1DLj
Dr. Antoni Chan synovialjoints ( View Tweet)