JAKs and Other Drugs in PMR

Save

This has been an interesting ACR meeting in terms of PMR updates. I would argue that we are still far too wedded to glucocorticoids only in the management of PMR. Yes, some patients will do fine with just glucocorticoids but we persist far too long with a glucocorticoid only strategy in others who clearly need an alternative as glucocorticoid adverse events multiply.

#ACR 2024 BEST Abstracts from Day 3

Save

Lots of lupus research and the New ACR Guidelines on Lupus Nephritis management were presented today. These and other highlights as featured on our Twitter (X) feed from ACR24 in Washington, DC.

GLP-1 Agonists Show Promise in Slowing Kidney Disease in Lupus Nephritis

Save

A retrospective cohort study presented at #ACR24 explores the benefits of GLP-1Ras in reducing the risk of end-stage renal disease (ESRD) for patients with lupus nephritis. Drawing on data from the TrinetX global research database, the study examines how GLP-1Ras may reduce ESRD progression in a population where 10-20% progress to ESRD within five years, even with immunosuppressive therapies.

ORAL Surveillance - Is Statin Use the Problem/Solution?

Save

The findings from ORAL Surveillance Study have been a dominant conversation at recent ACR Convergence, with the seminal findings and subsequent analyses a target of debate. Subsequent post-hoc analyses, follow-up studies, and claims data analyses have been used to further interpret the data, though a clear answer on safety is not certain. A study presented on Sunday reported on a new post-hoc analysis that provides new insights.

Taking AI Out of AutoImmunity: Predicting disease before it develops

Save

the predictive value of a positive ANA test—especially in the absence of other clinical symptoms—remains a challenge. A positive test often leads to further testing, yet it does not necessarily indicate whether a patient truly has an underlying autoimmune disease. The development of AI and machine learning algorithms presents an opportunity to interpret autoantibody tests and predict autoimmune diseases. Here are three studies looking at this issue.

ACR 2024: What Exactly do JAKs and TYKs Do?

Save

Let me start by confessing something embarrassing: the immune system is just too complex for me to understand. I suspect the onslaught of new drugs with new mechanisms at ACR 2024 may have left many of you feeling similarly. This may be particularly true for the TYK/JAK/STAT signaling pathway, where each agent has a slightly-different combination of binding affinity to various JAK and TYK signaling dimers. In this article I want to share some diagrams from ACR 2024 that may help.

Addressing CV Risk in RA: Are we doing enough?

Save

ORAL surveillance was a post-authorisation safety study of tofacitinib 5mg and 10mg versus TNF inhibitors, focusing on rates of adverse events, including MACE. A higher incidence of MACE was observed with the use of tofacitinib. Statins are recommended in patients with a history of atherosclerotic disease or 10 year predicted risk of MACE. But, how many patients with rheumatoid arthritis, at risk of MACE, are actually taking a statin?

#ACR 2024 BEST Abstracts from Day 2

Save

Here’s a collection of some of the best abstracts presented on day 2 of ACR 2024 as selected by the RheumNow faculty.

 

ACR 2024 - Day 2 Report

Save

Plenary sessions began the day, followed by thousands on the abstract floor. Here are a few of my favorite presentations from day 2 at ACR 2024.

Shedding Weight and Pain: The Promise of Anti-Obesity Medications in RA

Save

With the advent of FDA-approved anti-obesity medications such as semaglutide and tirzepatide, a new avenue for managing this challenging patient population has emerged. But how might these drugs impact the trajectory of RA, and are we on the cusp of a paradigm shift?

JAKi in inflammatory myositis?

Save

Abstract 1731 is a small RCT of baricitinib in inflammatory myositis comparing early start baricitinib to later start.

Where there’s smoke, there’s flare: how pollution fuels RA

Save

Associations between air pollution and disease activity in rheumatoid arthritis have previously been demonstrated. Abstract 0978 sought to determine the association between fire smoke and other pollutant exposures with the risk of RA and RA-associated interstitial lung disease (RA-ILD).