Rheumatoid Arthritis

5 months ago
This will change my practice!
#RCT #MMF + #MTX
superior to
#Cyclophosphamide then #Azathioprine
In
#Tayakasu’s #arteritis N=150
RCT ~1g BID #mycophenolate + 15mg/wk #Methotrexate
Vs #cyclo ➡️100mg #azathioprine
All got #glucocorticoids
#ACR24 @RheumNow @ACRheum #1696 https://t.co/OpRep1vsmx


5 months ago
Very neat simulated model of GC regimens in AAV pt on fixed RTX by @zach_wallace_md and co
Over 5 years:
- No difference in relapse btwn standard GC vs. minimal GC + avacopan
- Higher DMII rates in standard group
Adds to trial + real world data
@RheumNow #ACR24 Abst 1598

5 months ago
Alright help me out here; this is pretty implausible, right?
Why would be pts be 11% more adherent to UPA? What's the bio-plausibility here? UPA 10% better than other JAKs?
Could do a network meta analysis; betting this doens't replicate
#ACR24 @RheumNow Abstr#1362 https://t.co/vpPq3vu9Wf


5 months ago
#Rheumatoid #arthritis is an independent risk factor for death in nonmetastatic clear cell renal ca !
👇N=32K, 802 w RA also
Caveats
immunotherapy Offered = in RA
Cancer specific mortality not affected
By #RA
Frailty & RA affected outcomes
#ACR24 @RheumNow @ACRheum #1327 https://t.co/rAQ57BPA19


5 months ago
In this large 🇦🇺 RA cohort, median time on treatment for upadacitinib was lot higher than other JAKi
(28mo vs 17mo)
Why?
Patient selection, or a real difference between JAKi?
Would really like more comparative effectiveness data between JAKi
#ACR24 OPAL group ABST1370 @RheumNow https://t.co/OU2ayzqIc8


5 months ago
Spicy network SRMA, 123pts w/JAK-TNF-PLBO
TNF >> JAK w/respect to malignancy (expected) & better than PLBO (spicy!)
JAK > PLBO for heme cancers (makes sense); no significant (but slight trend) toward PLBO > JAK for all cancer
The debate continues
#ACR24 @RheumNow Abstr#0989 https://t.co/tBnb02gyzF


5 months ago
Which RA patients are at increased risk of JAKi adverse events? Does disease activity matter?
in the upadacitinib ph3 trials, high disease activity pts had more:
serious infections
HZ
MACE
VTE
Active RA is a massive contributor to many AEs in JAKi pts
#ACR24 ABST1393 @RheumNow https://t.co/DlFf9Sfbja


5 months ago
Zhang @jeffsparks et al. Even more evidence that MTX does not cause ILD, and in fact prevents ILD, in RA, OR 0.48 in meta-analysis. @RheumNow #ACR24 Abstr#1384 https://t.co/YvQnmmvNjF https://t.co/crYUwHahDb


5 months ago
The idea of patient-initiated follow-up for RA is enticing:
patient & physician time is already stretched
minimize unnecessary visits/improve access
but what actually needs to go into the design, to make it safe/workable?
A: plenty.
🇨🇦 pilot underway
#ACR24 ABST1041 @RheumNow https://t.co/03u4bhnQ0v


5 months ago
STAR trial of GC w/d in RA LDA
SEMIRA of GC w/d controlled RA on Toci
Very slight disease activity increase, but higher flares
No symptomatic adrenal insufficiency, but data of abnormal ACTH stim
No good evidence of steroid w/d symptoms
Beth Wallace
@RheumNow #ACR24 https://t.co/j6UPWlVNIu
