ACR 2016 – Day 3 Highlights Save

Some big highlights from Tuesday at the 2016 ACR/ARHP annualmeeting included:

The plenary session by Dr. Roy Fleischman showed data from the EXXELERATE trial a head-to-head comparison of certolizumab and adalimumab in MTX-IR RA patients for 104 weeks. Strangely this was designed to be a superiority trial but only showed mirror equivalence between the 2 TNFi - with both achieving nearly 80% ACR20 results at week 24. Nonresponders at week 12 were crossed-over to the other TNFi and essentially showed that primary TNFi nonresponders can be switched to another TNFi and a lower ACR20 response was seen (~60%).

Guselkumab (an anti-IL23 monoclonal antibody) has recently been shown to be more effective than adalimumab or placebo in a plaque psoriasis trial.  At the ACR, Dr. Atul Deodhar presented data on this fully human monoclonal antibody against the p19 subunit of IL-23.  A trial of 149 patients with active PsA and active psoriasis (≥3% BSA), who have failed a prior TNFi, were randomized to either GUS or PBO. At week 24, the ACR20 response was 18% for PBO patients and 58% for those on GUS 100 mg. Similarly GUS out performed PBO, 78.6 vs 12.5 in skin responses (PASI 75).

The other big item was the report of the PRECISON trial that demonstrated that celecoxib is not inferior to either naproxen or ibuprofen in cardivascular outcomes.