EULAR 2021 - Day 3 Report Save

Here are a few notable presentations from Day 3.

• BEAT- LUPUS Trial: OP0129 – I would consider this a pilot trial as it only included 52 patients with active SLE, but the gist was that active SLE patients were first treated with rituximab (RTX: 2 infusions) followed by randomization to either placebo or belimumab IV every 4-8 weeks after their 1st dose of rituximab. The primary endpoint was effecton dsDNA titers at 52 weeks.  Only, 32 patients completed treatment (belimumab or placebo) through 52 weeks, but in those on belimumab had a significant reduction in anti-dsDNA antibody levels compared to placebo (p<0.001) and overall had fewer lupus flares than those on PBO.  This one-two punch of RTX followed by BEL has been suggested and studied before with promising results.  Isnt it about time we saw a real big well designed trial on this? 
• 1 year SELECT-PsA2 Data: POS0196 – Dr. Phil Mease presented the extended 56 week followup of upadacitinb (UPA) in active PsA patients.  641 Active PsA patients were studied and 75% made it to the 56wk endpoint. Patients had previously been treated with >2 bDMARDs (41%) but nonetheless had significant responses in both skin and joints and efficacy was maintained over 52 weeks.  There were no new safety signals seen in this trial, but in general there were fewer adverse events when comparing the 15 mg to the 30 mg UPA groups.  Two patients had VTE on UPA, but also had other risk factors for VTE. 
• Deucravacitinib, a TYK2 inhibitor, in Active Psoriatic Arthritis: POS0198 – Dr. Mease also presented the data on this novel TYK2 inhibitor (DEUC) in PsA – a phase 2 trial of 2 different doses of DEUC (6 mg or 12 mg) or PBO was given to 203 PsA patients.  The ACR20 responses at week 16 favored DEUC (53% vs. 64% vs 32% for PBO). Other outcomes also favored DEUC – ACR50/70, HAQ-DI, MDA, SF-36, PASI 75 and enthesitis resolution. There were no serious adverse events or serious infections or venous thromboembolic events were seen.
• Guselkumab, IL-23 inhibition, Effective in PsA: OP0230 – Dr Laura Coates presented the data from the phase 3 trial of Guselkumab (GUS0 in Active PsA wherein 285 active PsA patients how were active despite prior treatment with 1-2 TNF inhibitors were enrolled and randomized to either PBO or GUS.  The week 24 results showed significantly better ACR20 responses with GUS (44% vs 20% PBO), with similar superiority for all secondary endpoints.