AS/Spondyloarthritis

The last day was jammed with important reports and research including the late breaking abstracts.   

A few things we know about opioids: use is common; it’s not efficacious in the treatment of spondyloarthritis; and, there is an opioid epidemic and its users are stigmatized. Abstract 0402 is a retrospective study that looked at patients with psoriatic arthritis or ankylosing spondylitis in the FORWARD databank. It sheds new light and leaves us with some food for thought

Strategies to identify patients with suspected inflammatory back pain in the general population is critical for timely and proper diagnosis.

A new target for treatment in AxSpA is the dual inhibition of IL17A and IL17F (IL17A/F). IL17A is a key driver of the inflammation in the AxSpA and Psoriatic Arthritis (PsA). IL17A and its structurally related IL17F share biologic functional properties. Inhibition of both cytokines (IL17A/F) should result in a greater clinical benefit in AxSpA and PsA than IL17A inhibition alone.

Vaccine efficacy remains an important and highly discussed topic at this year’s annual meeting given the ongoing COVID-19 global health crisis, current influenza season, and recently published 2022 ACR guidelines for vaccinations in patients with rheumatic and musculoskeletal diseases.

Day two at ACR 2022 was full of great sessions on imaging, vasculitis, lupus, vasculitis, spondyloarthritis, COVID, pregnancy, microbiome, economics and more. Here are the RheumNow faculty selections for #ACRbest abstracts today:

Data presented at ACR22 shows that cycling through TNFi in axSpA patients with primary lack of efficacy with first line TNFi has limited additional benefit in controlling disease. 

The RheumNow faculty reporters have been scouring the meeting and online presentations to find the best abstracts from ACR22. Here are some of their choice abstracts reported today on day 1 of ACR 2022 (#ACRbest).  

A new treatment for AxSpA that has come on the scene are JAK inhibitors. In clinic, considerations for JAKi use are body mass index, smoking status, prior use of biologics and patients with high inflammatory states such as high CRP and inflammatory change on MRI scan of the spine and sacroiliac joints. There are further studies at #ACR22 which help answer these questions.

When it comes to Spondyloarthritis we have numerous disease activity measures and much debate regarding best practices. When it comes to determining which to use in clinic, discrepancies occur. Do our activity measures truly represent disease? Are there some measures best suited to different populations? Does BASDAI work for women?

The pharmaceutical companies have will showcase their featured clinical trials and abstracts at ACR 2022.  These are their best studies for you to review and evaluate as part of your to-do list. In the least, you should be familiar with the names and objectives of some of these studies as they will be discussed and mentioned throughout the meeting. Abbvie

As we approach ACR22, there are many things to be excited about, especially with the reintroduction of in-person attendance. My attention this year is in research being presented in these three areas: ankylosing spondylitis; lupus management and treatment; and, subclinical RA.

Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic musculoskeletal disease which can be managed with both pharmacological and non-pharmacological options. The joint ASAS-EULAR recommendations for axSpA were first developed in 2006, and last updated in 2016. The current update reflects newly available evidence since the last version.