EULAR 2022 – Day 3 Report Save

By now, those of us attending the meeting know how to find a free coffee or sprite, have found comfortable meeting nooks and know our way around (lots of sneaker mileage)!  And congrats to you virtual Rheums for mastering the multi-screen, multitask simultaneous consumption posters, tweets and oral abstract presentations!  Power on; there’s one more day.

Here are several of my favorite presentations from Day 3.

• GLORIA promotes Steroids!  Abstract #OP0263 – Dr. Martin Boers presented the results of his 2-year pragmatic, double-blind, placebo-controlled randomized trial of prednisolone (5 mg/day) vs. placebo for 2 years in RA patients over 65 yrs of age. All background therapies were maintained.  At the end of 2 years there was a significant lowering of DAS28 scores (-0.32) compared to placebo, even greater in ideal patients (-0.62), also with improvement in Xray outcomes (-1.7 units). But all of this comes with a significant difference in “harms” or adverse events that were 24% higher in the prednisolone group (mostly infections) compared to placebo patients (adjusted RR 1.24, 95%CL 1.04, p=0.02; number needed to harm 9.5).  The question is whether these small clinical and Xray benefits outweigh the small, but increased risk of (mostly minor) infection?
• ARIAA – Abatacept in Pre-Clinical RA Has persistent effects! Abstract #POS0531.  The ARIAA study compared the effect of 6 mos. of abatacept vs placebo in patients with pre-clinical RA. At ACR 2021 we showed clear benefits as far as MRI inflammation and progression to RA rates being lower in ABA treated patients.  After 6 mos., both patient groups were followed off all therapy for an additional 12 months.  At the end of 18 mos., the initially ABA treated patients still had less progression to RA (ABA 35% vs PBO 57%; NNT 8).  This is the first trial to show that DMARD or biologic treatment of pre-clinical RA results in fewer cases of RA developing.
• CAR-T Cell Therapy in SLE. Abstract OP0279 – Dr. G. Schett presented data on 5 SLE patients treated with novel CAR-T cell therapy.  All had severe, refractory disease, having previously failed therapy with severe SLE with failure of standard treatment including pulsed steroids, hydroxychloroquine, mycophenolate, cyclophosphamide, intravenous immunoglobulins, rituximab and belimumab.  All SLE treatments were stopped, patients were pretreated with cyclophosphamide/ fludarabine followed a CD19-CAR-T cell single infusion. Pretreatment SLEDAIs 8-16 dropped dramatically to 0-2; all improved complement levels, dropped dsDNA titers and  CD19 CAR T-cell therapy was well tolerated and may induce rapid remission of severe refractory SLE.
• Bimekizumab BE COMPLETE trial. Abstract OP0255 - Merola et al. presented the results of the BE COMPLETE trial, a phase 3 study of bimekizumab (a dual IL-17A/17F inhibitor) in 388 Psoriatic Arthritis (PsA) patients who previously failed a TNF inhibitor.  By week 16, the ACR50 responses favored BKZ (43.4%) over PBO (6.8%) while also showing a PASI90 of 69%, and MDA in 40+%. No new safety signals were found.  Encouraging data for a future therapy in PsA!