My ACR 2016 Highlights Save

Washington is always a great city to visit (even though there were a few protesters floating around the streets). I hope the posts I made were of interest to some readers. Here are my top 5 highlights from ACR 2016:

1. Preliminary GIOP guidelines: see my video summarizing the ACR guidelines, with a few of my comments.

2. GIACTA trial: this really is going to be a game changer in the treatment of GCA.

3. Non-medical switches to a bio-similar (Both NORSWITCH and DANBIO presented data on non-medical switches from Remicade to a biosimilar infliximab). We will see how great an impact these switch studies affect access to Remicade through payers in the near future.

4. Tofacitinib vs. Adalimumab in psoriatic arthritis. Significant improvements in ACR 20/50/70, change in HAQ-DI in both tofacitinib 5mg BID and 10mg BID group vs. placebo, which were similar to the results seen in patients randomized to adalimumab.

5. Osteoporosis update: Romosuzumab is coming fast, with three studies showing very favorable results presented at ACR16.
   
   a) The FRAME trial, which assessed the efficacy of Romosuzumab versus placebo for 12 months, followed by a cross over to denosumab after 12 months showed significant vertebral fracture reduction at 12 and 2 months (Relative risk reduction of 73% and 7% respectively). Although 18% of patients in the Romo group developed anti-drug antibodies, only 0.7% developed neutralizing antibodies. One case of atypical femoral fracture, and one case of osteonecrosis of the jaw (ONJ) were found in the Romo group, versus none in the placebo group.
   
   b) An RCT assessing osteoporotic women randomized to romosuzumab versus teriparatide found a significant increase in the total hip, femoral neck, and lumbar spine BMD (assessed by DXA) and hip volumetric BMD assessed QCT in the Romo group when compared to teriparatide. Estimated hip strength (assessed by FEA) was also significantly greater in the Romo group.
   
   c) The BRIDGE trial, an RCT assessing the efficacy of Romosuzumab in men with osteoporosis. Men were randomized to Romosuzumab 210mg SC monthly vs. placebo for 12 months. At 12 months, there was a significantly greater increase in BMD measured by DXA at the lumbar spine, total hip and femoral neck (12.1%, 2.5%, and 2.2% respectively) in the Romo group, compared to the placebo group. Romosuzumab therapy was generally well tolerated.

I hope everyone enjoyed the conference, and had a safe trip back home. Continue following RheumNow for future updates.