Rheumatoid Arthritis
Nouf Al hemmadi NoufAhmedAlham2
3 months ago
SLGT-2 and GLP-1 in RA: More than Weight Loss https://t.co/SRKMHNlHZo
Future of rheumatology is bright , Shreya Sakthivel discussed her work on TriNetX database , looking specifically for effect of SLGT-2. GLP-1 on RA flare incidence.
@RheumKay
@RheumNow
#acr25
Nouf Al hemmadi NoufAhmedAlham2
3 months ago
New Paradigms in RA Treatment https://t.co/CqpI2znglE
@jeffsparks Highlights new trials in RA
1-Neuro immune modulation ( Vagal nerve stimulation).
2-Targeting pathogenic T cells
3-T reg CAR-T ( Peace maker).
@RheumNow
#ACR25
Here are 3 abstracts that caught my eye on Day 2 at ACR25. Notably these have takeaway messages that should support your current practices.
CAR T-cells have been a revolutionary development in rheumatology. We have seen a population of patients with severe refractory autoimmune conditions almost overnight presented with the prospect of not just improvement, but of a cure.
Aurelie Najm AurelieRheumo
3 months ago
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
David Liew drdavidliew
3 months ago
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
David Liew drdavidliew
3 months ago
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
Aurelie Najm AurelieRheumo
3 months ago
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
Aurelie Najm AurelieRheumo
3 months ago
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
David Liew drdavidliew
3 months ago
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
David Liew drdavidliew
3 months ago
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
Jiha Lee JihaRheum
3 months ago
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
Aurelie Najm AurelieRheumo
3 months ago
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
Poster Hall