How many patients do you need to treat to prevent one RA conversion in at-risk individuals? APPIPRA and ALTO Interception studies, long term data Number Necessary to Treat to prevent 1 RA conversion across time: 1yr = 4 2yrs = 7 3, 4, 5 yrs = 9 6 yrs = 11 #ACR25 #ABSTRACT1678 https://t.co/GBzUJG8jVk

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So who with inflamm arthralgias might benefit from abatacept, in terms of delaying RA onset? ALTO study (APIPPRA continuation) 1y abatacept then follow If autoAb x5 (RF, ACPA IgG, IgA, anti-CarP, AAPA): sustained delay of RA If not: benefit only on Rx #ACR25 ABST1678 @RheumNow https://t.co/3Pc5ZLzVf6

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TNFi induction first year in RA leads to: - less D2T RA at 5y - more sustained remission from 10y onward - less DMARD utilization - less healthcare utilization in these real-world matched cohorts given biosimilar prices, this might be worth considering #ACR25 ABST1677 @RheumNow https://t.co/uL9nHtLkXZ

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Early TNFi treatment leads to -Less D2T at 5 yrs -More sustained remission at 10yrs -Less bDMARD escalation at 5yrs -More DMARD free remission at 5yrs and 10 yrs -20% reduction annual healths costs -11 mo delay in ttmt escalation Safety data were not presented #ACR25 https://t.co/jPMGUGPtqP

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SELECT-COMPARE RA UPA vs. ADA What do we learn from 7 years data? Not much Patients who did well on the first drug, keep doing well Patients who required switching for primary failure don't do as well, w/ 26% pts reaching DAS remission in UPA + MTX vs. 16% in ADA + MTX gp No https://t.co/JLUTRZuZOm

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In case you missed it in @ACR_Journals: HCQ for 1y does not prevent RA development in people with CCP3 >2x ULN, either: - during 1y of treatment - in 2y follow-up https://t.co/gtzNiSmutb but StopRA will give us plenty of insights - data is never wasted #ACR25 ABST1674 @RheumNow https://t.co/DDZib5VGtX

• A phase 2 trial of hydroxychloroquine in individuals at risk for rheumatoid art…
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SELECT-COMPARE (upadacitinib vs adallimumab in mod-severe RA, no CV enrichment) 7y data: safety profiles very similar, except for: - zoster - CK rise - lymphopenia - hepatic disorder In the general RA population, no new JAKi safety signals #ACR25 ABST1676 @RheumNow https://t.co/BA2JxONGfa

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Start strong, stay strong. With early anti-TNF induction (vs csDMARD T2T) - At 5 yrs: D2T RA in <1% vs 7% (OR 0.11, p=0.03) Drug-free remission 13% vs 6% (p=0.049) - At 10 yrs: more sustained remission (62% vs 45%) & fewer multi-MoA failures. @RheumNow #ACR25 Abstract #1677

What is the secret of a VNS RCT that works in RA? => Implant the device! RESET-RA RCT Sham controlled 3mo Then open label in active arm for 66mo 40% pts IR to >=3 bioDMARDs ACR 20 3 mo 42% vs. 19% CDAI LDA 27% vs. 11% 82% TNF IR pt had no change in treatment over 12mo 99% https://t.co/lfxa4YXUB4

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Implantable vagal stimulator led to benefit in TNF-inadequate responder RA in this sham-controlled double-blind RCT (RESET-RA study) - 82% off b/tsDMARDs at 12mo - also with benefit to control group after crossover at 3mo to an active device #ACR25 1675 @RheumNow https://t.co/yYwWCKm6HF

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In the SERENA study (n=292), secukinumab reduced PsA incidence to 0.49/100 PY over 5 years in PsO patients with nail involvement, an ~82% drop vs historic non-biologic rates (2.7/100 PY). 98.3% remained PsA-free; PASI 90 achieved in 63%. Abstract#1463 @RheumNow #ACR25 https://t.co/ySOuFJiwge

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Beyond biologics: RA meets bioelectric medicine. In RESET-RA, TNFi inadequate response or intolerant (n=124), vagus nerve stimulation led to significant & durable improvement 🔹 ACR20 3mo: 42% active vs 18% sham (p=0.0057) 🔹 Benefits through 12mo @RheumNow #ACR25 A#1675