Novel Rx

Inhibition of B-cell Activating Factor (BAFF) has revolutionised the treatment of patients with systemic lupus erythematosus. However, outcomes of therapies within the same class (i.e. BAFF-inhibitor) when evaluated in randomised controlled trials have been inconsistent.

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).  

The management of RA patients with a history of cancer continues to be an area of concern. General recommendations are to treat patients with a history of solid organ cancer as no different to any other RA patient. Recently, the ORAL-Surveillance study demonstrated evidence of a greater risk of cancer with tofacitinib than with TNF inhibitors. In this setting, two posters both reassure and raise a new cause for concern.

A Japanese large scale claims data study was able to collect 5-year data to study the treatment patterns in Still’s. In May 2019, intravenous tocilizumab was approved in Japan for Still’s disease. The study was designed to see patterns of steroid exposure before and after the approval of this therapy.

Type I interferon (IFN) is a powerful immune activator that is present at high levels in the majority of patients with lupus, an autoimmune disease.

Rheumatoid arthritis treatment has come leaps and bounds in recent decades. Gone are the days of gold injections, chemical synovectomies, and physician-mandated bedrest (heaven forbid). Though the marketplace for RA treatments is becoming ever more crowded, there are still unmet needs.

The updated 2022 EULAR recommendations for the management of rheumatoid arthritis (RA) were initially presented by Dr. Josef Smolen at EULAR 2022, and are now in press delineating the most recent developments and perspectives in RA treatment.

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.