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#ACR BEST Abstracts from San Diego – Day 1
The RheumNow faculty reporters have been scouring the meeting for what they believe to be the best presentations from the first day at ACR 2023 in San Diego. From hundreds of online presentations, the poster floor and the plenary podium, here are some of the best abstracts from Sunday Nov. 12th. You can spot these on Twitter by looking for the (#ACRbest) hashtag.
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In PS-matched study, no significant difference in respiratory hospitalisation or death between RA-ILD patients on non-TNFi/JAKi vs. TNFi. This finding does not support systematic avoidance of TNFi in RA-ILD, England B Abst#1582 #ACR23 #ACRBest @RheumNow https://t.co/1zVjMWNZZS https://t.co/d8TRIvGaIe
Dr. Antoni Chan ( View Tweet)
Debaters and moderators acknowledge IL6i may not be the only steroid sparing agents that would work for #GCA. Abatacept, secukinumab, JAKi are being evaluated #greatdebate @rheumnow #ACR23
TheDaoIndex KDAO2011 ( View Tweet)
This is pretty nerdy, but I would love a documentary about filgotinib
JAK class wins/fails feel highly idiosyncratic to me
The difference between UPA & FIL from science perspective seems negligible; financially, it's many billions of $$$
@rheumnow #ACR23 Abstr 1325 https://t.co/efGwSSrxz7
Mike Putman EBRheum ( View Tweet)
Super interesting study re: impact of ORAL SURVEILLANCE on prescribing
Post safety report, JAK pts shifted younger w/lower comorbidities (esp CVD)
I know many have mixed feelings, but I believe in the risk & support this type of shift
@RheumNow Abstr0435 #ACR23 https://t.co/EBg9VOIbj1
Mike Putman EBRheum ( View Tweet)
ABS0450
⭐️Baricitinib non-inferior as well as superior to TNFi in terms of ACR50 response @ 12w in real world csDMARD refractory RA patients
➡️open-label, T2T w/ Baricitinib (n=102) vs TNFi (n=97)
➡️DAS28-CRP remission (<0.6) in 74% of Bari vs 47% of TNFi
#ACR23 @RheumNow https://t.co/yydS20hNzM
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
No more underpowered long-term safety studies
We need a "SELECT-SURVEILLANCE" study to replicate ORAL-SURVEILLANCE & tell us if UPA has the same MACE/cancer risk as TOFA
Minus that, I plan to go 100% TOFA when it becomes generic in 2026
@RheumNow #ACR23 Abstr1326 https://t.co/LyQ1Q8qReO
Mike Putman EBRheum ( View Tweet)
Who gives a ‘JAK’ why and how they work, as long as they do!
Several abstracts have studied the mechanism of action of JAK inhibitors (JAKi) in various diseases. JAKi alter many other mediators affected by the JAK STAT pathway. For instance, T cell signature in blood that is proliferative was associated with a response in RA.
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AS pts on UPA for 52 wks who were active or healthy weight/underweight at BL generally experienced greater decreases from BL in ASDAS-CRP and BASDAI vs pts who were inactive or overweight/obese. #ACR23 Abs #0540 https://t.co/OfgbmYUoAu @rheumno https://t.co/liptgbK2hJ
Dr. Rachel Tate ( View Tweet)
🔥 Absolute masterclass @philseo in the Clinical Year in Review #ACR23
➡️ Certain subpopulations have lower risk of AE with Tofacitinib
➡️ Knee OA 📈 75% by 2050
➡️ Exciting novel approaches in Rx of IA in development
➡️Better clinical trial endpoints needed for SLE https://t.co/5cjbZLPsCM
Caoilfhionn Connolly ( View Tweet)
Phase 2 RCT of TLL-018 (JAK1/TYK2i) vs Tofa in RA. 101 patients. ACR50 72% vs 42%. 83% of tofa-IR achieved ACR50 on TLL-018. Can't wait for the phase 3 data! Abstr#0840 #ACR23 @RheumNow #ACRbest https://t.co/wjGx4Edxyb https://t.co/n6CL8G01Wo
Richard Conway ( View Tweet)
TLL-018, the dual JAK1/Tyk2 inhibitor which caused all the chatter at #EULAR2023, now with more full data showing it absolutely smash tofacitinib in RA, with similar safety.
“This is a spectacular compound - unbelievably spectacular” - Roy Fleischmann
#ACR23 ABST0840 @RheumNow https://t.co/nIKQb4yYrJ
David Liew drdavidliew ( View Tweet)
More on TLL-018
How?
A: Everyone surprised. But maybe dual mech benefits re: pain via IFN
Where’s the multinational RCT in RA?
A: Priority on rapid registration in China, quickly. But ph2 trials for psoriasis happening in US, results so far look consistent.
#ACR23 @RheumNow
David Liew drdavidliew ( View Tweet)
Fascinating how upadacitinib may well have an effect on pain in RA, beyond inflammation.
Now seen similar for bari in RA & guselkumab in PsA. And, if real, for some people could be a massive get. Love to see dedicated studies
SELECT-COMPARE post-hoc #ACR23 ABST0429 @RheumNow https://t.co/Tk278mGJYY
David Liew drdavidliew ( View Tweet)
Ab#0596 #ACR23 @RheumNow
R Furie on Decravacitinib in SLE
48wk double-blind trial. PBO v DEU 3mgBID, 6 mgBID,12 mg qd
Higher response, faster time to SRI(4), BICLA and dual response v PBO. More likely to sustain response from w32-48. https://t.co/M34d3nQmwv
Eric Dein ( View Tweet)
Abs#518 @RheumNow #ACR23
Deodhar: TOFA in AS, by b/l CRP levels
30% nml CRP (<5 mg/L) v 70% Elevated
At wk 12, TOFA >> PBO regardless of b/l CRP
Difference in response: greater in pts w elevated CRP
Safety rates: elev. CRP c/w PBO, but nml CRP had trend of high AEs for tofa v PBO https://t.co/b9NRNkU8ub
Eric Dein ( View Tweet)
Upadacitinib on wearable device-measure activity
SELECT-AXIS 2
Abs#0530 #ACR23 @RheumNow
UPA had numerically higher mean daily step counts than PBO
11% improvement v PBO at wk 14 (diff of 345 steps/day)
Sedentary pts: 22% improvement in daily step count from b/l on UPA (4% PBO) https://t.co/Gq91TmvfZC
Eric Dein ( View Tweet)
Good Treatment review of biologics (IL-1, IL-6) in systemic JIA (Stills) including complications of #MAS and lung disease; also info on horizon therapies like JAK inhibitors and IL-18 targeting and novel biomarkers (calgranulins, IL-18 and CXCL9) https://t.co/Cbd7bKdIbb https://t.co/d9tn9fmSAy
Dr. John Cush RheumNow ( View Tweet)
Tofacitinib efficacy and safety in axSpA pts by baseline CRP levels
Elevated CRP pts with higher response in ASAS20, ASAS40, BASDAI50, etc.
AE trended higher in normal CRP pts taking Tofa compared to placebo
@RheumNow #ACR23 Abs#0518 https://t.co/nbiD36x1Pa
Robert B Chao, MD ( View Tweet)
Deucravacitinib (TYK2) data has been surprisngly good in SLE
Strong rationale in PsA as well; I liked this poster & the focus on pain scores / patient QOL
Probably my #1 draft pick for "drugs I'm buying right now"
@RheumNow #ACR23 Abstr0508 https://t.co/FHNvgUrYxp
Mike Putman EBRheum ( View Tweet)