#ACRbest Abstracts – Day 3 Save

Today was a big day for the Plenaries, Curbside Consults, ACR Business meeting (and induction of our new ACR President Dr. Deborah Desir) and Late-Breaking Posters. Our hot-button reporters have compiled these #ACRbest abstracts for you! (November 14, 2023 at #ACR23).

STEROIDS

There is a dose, duration and recency-dependent relationship between previous GC use and MACE. GC doses 5mg/day, durations of 30 days, and use one year prior to MACE were all associated with an increased risk of MACE, Wallace B Abst#2430 #ACR23 #ACRBest https://t.co/2ExboBvo2W pic.twitter.com/FuqXdFFwqP

— Dr. Antoni Chan (@synovialjoints) November 14, 2023

Wallace et al. Dose, duration, recency dependent relationship between GC and MACE. Even 5mg/day, 30 day use, and use 1 year prior associated with risk. 5mg, 7.5mg, 10mg pred for 90 days - 13%, 19%, 27% MACE increase Abstr#2430 #ACR23 #ACRbest @RheumNow https://t.co/50B5nGqxu9 pic.twitter.com/lNrUbZOm0o

— Richard Conway (@RichardPAConway) November 14, 2023

ARCTIC REWIND

ARTIC REWIND RCT 3 yrs csDMARD withdrawal

38% 3yrs csDMARDs free remission vs. 80% stable dose gpe

75% recovery after restart

Rx progression 19% in half dose gpe

More use bioDMARDs (18%) & GCs (50%) withdraw gpe

Trends towards lower infections@RheumNow #ACR23 #ACRBest pic.twitter.com/jhOINV7LLS

— Aurelie Najm (@AurelieRheumo) November 15, 2023

Excellent pragmatic RCT, TNF withdrawal in RA

Almost 2/3 flared by 1 yr; at 3 years up to 3 in 4

Supports my practice of generally continuing TNFs long term

Also highlights importance of pt preferences; 1 in 4 may do well if they wish to discontinue@RheumNow #ACR23 #ACRBest pic.twitter.com/G4l0DgBP2Z

— Mike Putman (@EBRheum) November 14, 2023

ANTI-FIBROTICS

Antifibrotics in RA-ILD @Juge_P_A Discontinuation in 46% (Mainly GI). Improved FVC trajectory - almost stops decline. Abstr#2479 #ACR23 #ACRbest @RheumNow https://t.co/nZW6TVKefL pic.twitter.com/5BX3PhFhOK

— Richard Conway (@RichardPAConway) November 14, 2023

PREGNANCY

#ACRBest https://t.co/nx3bzhmeBW

— Aurelie Najm (@AurelieRheumo) November 15, 2023

Pregnancies outcomes in vasculitis:
- Higher frequency of spontaneous abortion and preterm delivery
- 12% had pre-eclampsia
- Risk higher in multiparous > nalliparous
- Risk highest in small vessel vasculitis
Rector A, Abst#2425 #ACR23 #ACRBest @RheumNow https://t.co/TgbRWw9il5

— Dr. Antoni Chan (@synovialjoints) November 15, 2023

IV SECUKINUMAB

After attaining #remission or #LLDAS after a flare - HALF flare over f/u esp if tapering pred to <7.5 or 5 mg. #HCQ was protective. 65% got LLDAs and 45% rem in 1/2 yr - longer time to get #remission #2553 #ACR23 @RheumNow @ACRheum #ACRbest Asian cohort of #SLE largest@in world pic.twitter.com/yBBqYJZVOe

— Janet Pope (@Janetbirdope) November 15, 2023

SLE

After attaining #remission or #LLDAS after a flare - HALF flare over f/u esp if tapering pred to <7.5 or 5 mg. #HCQ was protective. 65% got LLDAs and 45% rem in 1/2 yr - longer time to get #remission #2553 #ACR23 @RheumNow @ACRheum #ACRbest Asian cohort of #SLE largest@in world pic.twitter.com/yBBqYJZVOe

— Janet Pope (@Janetbirdope) November 15, 2023

LATE BREAKERS

#ACR23 Late-Breaking Abstr#L10 Phase 2 crossover RCT of Dazodalibep, in #Sjogren pts with low ESSDAI but high ESSPRI. ESSPRI and FACIT-FATIGUE improved in both Stage 1 and also after X-over after 159 days. One to look out for those with high symptoms burden @RheumNow #ACRBest pic.twitter.com/yGGrPmUOHU

— Md Yuzaiful Md Yusof (@Yuz6Yusof) November 14, 2023

MANDARA -52wk,ph3 non-inferiority study comparing efficacy & safety of benralizumab & mepolizumab in EGPA receiving SOC
👉Benralizumab was non-inferior to mepolizumab in achieving remission at wks 36 & 48 (2.71%; 95% CI –12.54, 17.96; p=0.7278)#ACR ABSTL14 @RheumNow #ACRbest pic.twitter.com/S3aa3g5mnN

— sheila (@RHEUMarampa) November 14, 2023

How do we treat #VEXAS - UBA1 mutation
Large multicenter cohort - 110 pts, 99% M
Confirms the benefit of JAKi and tocilizumab
Others not so much@RheumNow #ACR23 #ACRBest#abstL03 pic.twitter.com/tRjO31IHiD

— Bella Mehta (@bella_mehta) November 14, 2023

#ACR23 Late-Breaking Abstr#L14 Which team are you on? IL5-i or IL5-receptor-i #EGPA. Phase 3 H2H RCT showed similar efficacy btw Mepolizumab and Benralizumab, with more pts fully tapering off GC at WK52 favouring BENRA. Rapid reduction in Eosinophils too @RheumNow #ACRBest pic.twitter.com/cXhSS80mA2

— Md Yuzaiful Md Yusof (@Yuz6Yusof) November 14, 2023

Lessons for #CVD in #inflammatory #rheumatic #diseases #ACR23 @RheumNow @ACRheum #ACRbest

-Negative #coronary #calcification doesn’t r/o presence of #microvascular #dysfunction

- work w #cardiologist for@proper@imaging for #Dx

-for #CAD or #pericarditis #Colchicine is GOOD pic.twitter.com/dMO1FpoA2a

— Janet Pope (@Janetbirdope) November 14, 2023

CV Events in AS by Rx
A#L11 @RheumNow #ACR23
43K pts from Korean data
Rates of incident MI or CV:
18.7 per 10,000 py in non-bDMARD pt
8.9 in TNF
12.9 in IL-17
TNFi reduced risk of CVD HR 0.7, not signif for IL-17
Supports idea of TNFi giving a cardioprotective effect?#ACRBest pic.twitter.com/SvVVDSU23z

— Eric Dein (@ericdeinmd) November 14, 2023

Amazing & thoughtful poster re:protocol violates in TICOSPA trial

51.2% of pts violated T2T protocol at least once... but did not impact primary outcome

Good baseline for future "strategy" style pragmatic trials@RheumNow #ACR23 #ACRBest Abstr2201 pic.twitter.com/FhctgFNdNP

— Mike Putman (@EBRheum) November 14, 2023