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An update on JAK inhibitors and cardiovascular risks
Dr. Antoni Chan ( @synovialjoints ) shares #EULAR23 developments on JAK/TYK2 inhibitors.
https://t.co/VovWE2OuXW https://t.co/QXKZLh5RuK
Links:
Dr. John Cush RheumNow ( View Tweet)
JaL1/TYK2 inhibitor vs Tofacitinib in #RA at #EULAR2023 phase 2. @RheumNow https://t.co/0F3JQ9dVMA
Bella Mehta bella_mehta ( View Tweet)
Abstracts talking about #RA and JAKs and Biologic comparisons
Huge number of pts to analyze this aftrr the initial NEJM study. Abstract summary pics below
@RheumNow https://t.co/jl5S4fLq19
Bella Mehta bella_mehta ( View Tweet)
#EULAR2023 recommendation update summary from the 2018 in #PsA whats new!
- 3 more drugs now available in PsA. – Guselkumab, Upadacitnib, Risankizumab (1 more in the pipeline)
- safety now to to considered!
- consider the full picture - extraarticular manifestations
@rheumnow https://t.co/7GBILtCX4i
Bella Mehta bella_mehta ( View Tweet)
Obviously lots of real world data at #EULAR2023 on JAKi safety (cardiovascular & cancer, see ORAL Surveillance).
Real problem:
many still have shorter follow-up periods. Cancer in particular takes time. It’s great to see data now, but:
*longer follow-up needed* +++
@RheumNow https://t.co/YH4fZgNQjY
David Liew drdavidliew ( View Tweet)
Amazing the chatter in the room for this one. The idea that a new JAKi might genuinely outperform existing JAKi in hard-to-treat RA, without safety cost, is particularly enticing.
We all want to see the paper & healthy skepticism of ph2, but watch this space #EULAR2023 @RheumNow https://t.co/jEyk8zqZN8
David Liew drdavidliew ( View Tweet)
What about a new oral drug in active #rheumatoid #arthritis vs #JAKi #Tofacitinib? TLL-018 a potent JAK1/TYK2 inhibitor was compared with #Tofa and dose ranging of 10, 20, 30 mg of TLL-018 and many Pts w past TNFi and w JAKi. High dose won #EULAR2023 @RheumNow @eular_org LB0001 https://t.co/UXhT7LV1oD
Janet Pope Janetbirdope ( View Tweet)
EULAR 2023 – Day 3 Report
Day 3 was a sunny warm day in Milan at the 2023 EULAR Congress meeting. Here are a few of my favorite abstracts from today.
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An update on JAK inhibitors and cardiovascular risks
Dr. Antoni Chan ( @synovialjoints ) shares #EULAR23 developments on JAK/TYK2 inhibitors.
https://t.co/yZqHEg73bn https://t.co/CzVH62LEgL
Links:
Dr. John Cush RheumNow ( View Tweet)
Tune it at 1pm EST for RheumNow's daily #EULAR23 recaps. You can find us live on Twitter, YouTube and LinkedIn. https://t.co/t531csjXo8
Dr. John Cush RheumNow ( View Tweet)
Herpes Zoster vaccination in RA patients treated with Upadacitinib and MTX showed a satisfactory response,
slight reduction in response compared to general population in both antibody and cell mediated responses Winthrop K, Abst#OP0225 #EULAR2023 @RheumNow https://t.co/wxwbOYsn5K
Dr. Antoni Chan synovialjoints ( View Tweet)
We worried that JAKi + MTX might impair Shingrix efficacy, esp given JAKi HZ risk
Shingrix nested in upa RCT:
Response (seroconversion rate, titres, cellular response) less than gen pop, but still very good
+ only 2/95 had RA flares
Vaccinate away!
OP0225 #EULAR2023 @RheumNow https://t.co/i4ObRSyYh9
David Liew drdavidliew ( View Tweet)
#EULAR2023 #POS1133 Consistent with clinical response in Phase 2 RCT, therapy with Updacitinib alone and ABV599-HD (Elsubrutinib + Upadacitinib) modulated IFN-I signalling pathways (IFN gene expression & proteomics). Assuring therapeutic evidence @RheumNowNews https://t.co/27mtCNg76X
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Can’t escape ORAL Surveillance RCT talk
Lots of real world data on CV risk & JAKi here
(with all the selection, measurement bias)
First up: multinational JAK-pot study (n=>50k)
Even if you mirror the high-risk RCT cohort - not much there for MACE
OP0219 #EULAR2023 @RheumNow https://t.co/FfNspdivri
David Liew drdavidliew ( View Tweet)
JAKi use did not increase CV risk compared to TNF, no difference between Bari and Tofa, non significant increased IRR in patients >65 years, Merel Opdam, Abst#OP0221 #EULAR2023 @RheumNow https://t.co/Pu5X8RHJOY
Dr. Antoni Chan synovialjoints ( View Tweet)
Malignancy in real world datasets:
do we see differences between DMARDs - particularly JAKi, with ORAL Surveillance in mind?
RABBIT German data (limited risk window):
Point estimates slightly up vs TNFi, esp in high CV risk pts
but magnitude not big
OP0218 #EULAR2023 @RheumNow https://t.co/Ou7TgWvf3b
David Liew drdavidliew ( View Tweet)
The JAK-pot study did not show any significant differences in MACE and other CV outcomes in RA patients treated with JAKi, slight increase signal in VTE/PE, Romain Aymon, Abst#OP0219 #EULAR2023 @RheumNow https://t.co/oPMnw2QmW3
Dr. Antoni Chan synovialjoints ( View Tweet)
The future of lupus treatment is oral therapies?
There has been an explosion of trials in SLE, including nonrenal and glomerulonephritis studies. But, what about the JAKis and Tyk2 oral drugs in SLE?
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#EULAR2023 #POS0112 Consistent with clinical response, Post-hoc analyses of Phase 2 RCT of Deucravacitinib (Tyk2-i) showed this therapy suppressed both IFN and B cell pathways - a broader mode of action in reducing #SLE pathophysiology. Look forward to Phase 3 results @RheumNow https://t.co/UoZ2xS3IzC
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
JAK inhibitors have been effective in refractory inflammatory myositis, all open label, but no controlled trials. #EULAR2023
Dr. John Cush RheumNow ( View Tweet)