ACR Best Abstracts - Day 4 Save

The final day (day 4) of the ACR 2020 meeting saw a flurry of late-breaking abstracts and other novel studies that excited our faculty. Below are some of their choices for #ACRbest.

1. 2020 #ACR20 RA guidelines were against steroid usage in RA. ESPOIR French cohort: 10 years of very low dose GC show increase events (death/CVD/fracture/severe ifn) even on low doses. HR increases every year. Cum GC dose-effect esp ifn, CVD.   Session 5M018 
2. Tocilizumab NOT effective in preventing mechanical ventilation or death in moderately ill COVID-19 pts. Double-blind, Placebo, RCT (n=243)   Abstract #L07   
3. Efficacy of TOFA vs PBO in AS. At week 16,  ASAS20 responders Tofa 56% v  PBO 29% ; ASAS40 Tofa 40% vs PBO 12%.  Abstract  #L11 
4. Dr MacDonald presents FAST study: Febuxostat versus Allopurinol Streamlined Trial.  6128  gout patients. HR 0·89 [95% CI 0·75-1·06] for cardiovascular events in febuxostat vs allopurinol. Mortality 7.2% vs 8.6%. Reassuring rcardiovascular safety of febuxostat   Abstract  #L08
5. Dr Cid presents phase 2 trial of anti-GM-CSF agent mavrilimumab in combination with steroids in GCA. 70 patients. Sustained remission at week 26 in 83.2% of mavrilimumab vs 49.9% of placebo p=0.0038.  #ACR20 Abstract #L06  
6. Anakinra in #Stills disease - Double blind, placebo controlled RCT in Stills disease total 12pts, 6 placebo, 6 Rx grp.  All pts reached ACR70 at week 2 without fever and sustained it at 12 weeks. 5/6 reached ACR90   Abstract #1633
7. Dr Baker reports on non-invasive vagal nerve stimulation to treat RA. 30 patients over 12 weeks. Mean DAS28-CRP decreased by 1.4. 53% achieved ACR20, 33% ACR50, 17% ACR70   Abstract #1995  
8. Deucravacitinib TYK2i for PsA. Phase2b 16wk, Double-blind, Placebo, RCT w/ ACR20/50/70 response vs. PBO, HAQ-DI response, enthesitis resolution, MDA vs. PBO; No serious AE  Abstract #L03  
9. Largest to date cohort study of pregnancies in women w/ ILD showed no maternal deaths suggesting that women w/ ILD may not need to avoid conception or terminate pregnancies, but pts w/ severe ILD were at higher risk for poor pregnancy outcomes.  Abstact #1446  
10. No need to stop Tofa w/the flu?  Post hoc analysis 7964 Tofa pts over 14-15 flu seasons reported similar flu rates compared to ADA, MTX, PCB.  Tofa cont. in 70% pts; 28.8% stopped; mean days to resolution similar.  Abstract #L04 
11. Do you have a problem with no-shows?  #ABS1584 discusses telemedicine and care access during COVID-19. Case Western observed a 0% cancellation rate,  <10% no-show rate, & 90% of scheduled telemed visits completed during COVID-19.
12. Remission in early RA- Do you want the good news or the bad? 55% of ERA pts in Cdn CATCH cohort reached remission in >3000 pts followed but short lived victory. Half in remission 1 yr later & 40% at 2 yrs .  Abstract #1715