Gender Gap Confirmed for TNF Inhibitor Response in Axial SpA

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Men with axial spondyloarthritis (axSpA) were more likely than women to obtain substantial relief with tumor necrosis factor (TNF) inhibitors, a multinational study indicated.

ICYMI: Bimekizumab is Coming…in Third Place

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Of the many exciting advancements for patients with psoriatic arthritis at ACR Convergence, one upcoming therapy stood out: the dual IL-17A/F inhibitor bimekizumab. Nearly two dozen bimekizumab abstracts will be featured at this year’s meeting and it recently received authorization in Europe and the U.S. for psoriasis. That makes this the year I plan to figure out where this drug will be useful for my patients with PsA. 

ICYMI: Methotrexate: shall we split up?

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Methotrexate is widely used in rheumatic diseases yet poses common tolerance issues, especially for the oral form; and bioavailability is known to be limited for doses over 15mg. In the SMART study, Prasad et al. present the first RCT comparing either single dose (25 mg) or split-dose (10 mg morning, 15 mg evening, same day) once weekly MTX for 24 weeks.

ICYMI: ACR Plenaries: Changing the Practice of Rheumatology

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Over the years of navigating the annual meeting, I found the sessions with the most impact to my practice were the Plenary Sessions. During these sessions, the latest research is presented, new ideas are floated, and old myths debunked. Here are the top ACR2023 Plenary abstracts I found impactful for my practice.

ICYMI: Maintain Vigilance for CV Risk Postpartum in Autoimmune Diseases

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Pregnant women with autoimmune rheumatic diseases (ARDs) and antiphospholipid syndrome (APS) face significantly increased risks of cardiovascular events (CVEs). This increased risk is often attributed to ARDs, its medications or comorbidities associated with it.

EULAR 2023 Recommendations on Fatigue

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Fatigue is highly prevalent in inflammatory rheumatic and musculoskeletal diseases (I-RMDs) patients, is often unaddressed and yet it has significant effects on patient quality of life. A EULAR task force set out to develop recommendations for the management of fatigue in people with I-RMDs.

ICYMI: Here at Last: Treatment Options for VEXAS

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We have known about the VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome for nearly 3 years, but there has been relatively little to say about how to treat it. To date there have been over twice as many publications about VEXAS (263 publications) as there have been patients described with respect to treatment strategies (116 patients). One of the late breaking abstracts may finally have rectified this imbalance.

ICYMI: Reduction of AxSpa-Associated Acute Anterior Uveitis with Certolizumab

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Acute anterior uveitis is the most common extra-musculoskeletal manifestation in axial spondyloarthritis (axSpA) affecting up to 50% of patients in some age groups. AAU can have a significant impact on quality of life with risk of permanent visual deficits if not adequately treated. 

CDC: Chronic Fatigue Syndrome 2021-2022

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The current CDC report estimates that 1.3% of adults had myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), based on the most recent population based National Health Interview Survey (NHIS 2021–2022).

ICYMI: Cancer and TNF inhibitors

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Cancer risk minimisation is a high priority for people with rheumatic diseases, as it is for the general population. Tumor necrosis factor inhibitors (TNFi) have a long history of association with cancer risk discussions. An oral presentation by Suarez-Almazor et al provided more supportive data on using TNFi in this population.

ICYMI: Urinary biomarkers precede loss of kidney function for lupus nephritis

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In Abstract 0850, Dr. Andrea Fava from Johns Hopkins presents research on the value of urinary biomarkers as measure of intrarenal inflammation.

ICYMI: Glucocorticoids-free zone in SLE?

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For over 70 years, glucocorticoids, (GC) have been a part of standard therapy in SLE. They are classically used to not only induce remission or treat an acute flare, but also as maintenance therapy. They are a valuable 'friend' if used wisely, and can become a 'foe' if used excessively.