JAK/TYK2

Upadacitinib: revisiting safety data in RA and GCA For the last several years, conversations about JAK inhibitors have often started and ended with safety. The shadow cast by ORAL Surveillance has made clinicians more cautious and regulators more restrictive. Yet in practice, https://t.co/6Wes2npkFd
Dr. John Cush @RheumNow( View Tweet )
kidney-147499_640.png

Deucravacitinib and Renal Function: Insights from the PAISLEY Trial

Akhil Sood, MD

In the phase 2 PAISLEY trial, deucravacitinib met its primary and secondary endpoints, demonstrating efficacy across multiple clinical and patient-reported outcomes. However, the impact on renal function has remained unclear. An abstract presented at ACR provides new insights.

Read Article
Should we be using JAKi more in female SpA patients? In recent years, data has emerged suggesting that female patients with spondyloarthritis, both psoriatic arthritis and axial spondyloarthritis, may have worse outcomes than male patients. A number of post-hoc analyses of https://t.co/smLao0q2hv
Dr. John Cush @RheumNow( View Tweet )
Tofacitinib in AxSpA in Developing Countries Dr. Antoni Chan reports on abstracts 0582 and abstract 0554 presented at #ACR25 https://t.co/4kTv90PhIC https://t.co/WRUBP0O21b

Links:

Dr. John Cush @RheumNow( View Tweet )
acr_session2.jpeg

ACR25 Best Abstracts - Day 4

Jack Cush, MD

Here's the last installment of our "ACR Best" abstracts as chosen by the RheumNow faculty.  Most of these were from the final, day 4, but a few were noteworthy holdovers from day 3. Enjoy!

Read Article
Excited about this target trial emulation in RA-ILD Compared to RTX, NO significant difference in hospitalization/transplant/death for JAK, ABA, IL6 or TNF Trends toward ABA and JAK looking better than RTX Need trials for sure, but I like this project a lot @RheumNow #ACR25 https://t.co/FQcphRvyHK

Links:

Mike Putman @EBRheum( View Tweet )
#Deucravacitinib #Tyk2i in active #PsA to 52weeks #PBO was crossed over at 16weeks Ongoing improvement for high bar outcomes ex % in #minimal #disease #activity #MDA #Xray #progression was reduced with real data (not imputed) #ACR2025 @RheumNow @ACRheum https://t.co/kAMym2x8HQ

Links:

Janet Pope @Janetbirdope( View Tweet )
GCA,woman

Stopping therapy in GCA

David Liew, FRACP

They say the easiest bit about GCA, like PMR, is the first week after you start steroids. Those fond memories belie the challenge of ongoing treatment in GCA. In a steroid-only world, there is only misery. Steroid-sparing therapies have changed this completely.

Read Article
Deucravacitinib (TYK2) in PsA from POETYK trials Improved ACR20 at wk16 (NNT ~5), less benefit for ACR70 (NNT ~20) Steady improvements during open label extension (all pts received drug) Would expect approval for PsA soon... where will this fit in your approach? @RheumNow https://t.co/325h2hf0AE

Links:

Mike Putman @EBRheum( View Tweet )
Year in Preview GCA: GC over-prescribed, bDMARDs more effective than MTX, and more options available (TOC, JAKi) @RheumNow #ACR25 https://t.co/L9fx1LCCnw

Links:

Jiha Lee @JihaRheum( View Tweet )
#ACR25 Abstr#LB20 At EULAR, data for Phase 3 RCT of Deucravacitinib, Tyk2-i in active #PsA showed ACR20 was met at WK16. Here, data showed sustained response through WK 52 across core domains inc. those who switched PBO->DEU. No major safety assoc. with JAK-i.A few acne @RheumNow https://t.co/tmzQMOtjev

Links:

Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
POETYK PsA 1 and 2 Deucravacitinib TYK2 inhibitor Ph3 RCT 52 wks data Deucra 336pts PBO 334pts then crossover wk 16 to 52 Pooled analysis wk 16 ACR 20 54% vs. 31% Enthesitis reduction LEI 52% vs. 45% Dactylics resolution 58% vs. 44% POETYK-PsA 1 Wk 52 ACR 20 63% ACR50 44% PASI https://t.co/LYJbU8fYwI

Links:

Aurelie Najm @AurelieRheumo( View Tweet )
safety data

Upadacitinib: revisiting safety data in RA and GCA

Mrinalini Dey, MD

For the last several years, conversations about JAK inhibitors have often started and ended with safety. The shadow cast by ORAL Surveillance has made clinicians more cautious and regulators more restrictive. Yet in practice, many of us continue to reach for upadacitinib when we

Read Article
Cohort study comparing 3yr safety outcomes of JAKi vs. TNFi in AS pts JAKi use: ⬆️incidence of HZ infxn but not significant; ⬆️all-cause mortality (HR 4.94) and GI bleed (p=0.04) Individualize tx. consider potential complications #ACR25 @RheumNow Abs2633 https://t.co/pjKAazQFwW

Links:

sheila @RHEUMarampa( View Tweet )
In a retrospective TrinetX analysis of 3 year safety outcome in AS, JAKi use was linked to higher mortality and GI bleeding vs TNFi, but lower malignancy risk. Infection rates were similar, with a trend toward more herpes zoster in JAKi users. Abstract#2633 @RheumNow #ACR25 https://t.co/pPY0wpAKA3

Links:

Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Agrawal et al. Case study of tofacitinib + bDMARDs in refractory IA. 7 SpA, 2 RA, 1 JIA. Effective and safe. @RheumNow #ACR25 Abstr#2338 https://t.co/Y0B3W4csJX

Links:

Richard Conway @RichardPAConway( View Tweet )
#ACR25 Abstr#LB02 Is there a role for JAK-i for the treatment of IgG4-RD? Opel label RCT in China (N=58) showed NO relapse in Tofacitinib + GC taper vs GC Taper alone (54%). No serious infection. Interesting and a PBO-controlled is warranted @RheumNow https://t.co/dFvAmcGfCT

Links:

Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
When every option fails, bold moves remain. In 5 multi-resistant RA pts, TNFi + JAKi combo brought remission in most without major AEs. Not standard, not risk-free, but in young, low-infection-risk pts, it may offer a path forward. @RheumNow #ACR25 Abstract#2272

Jiha Lee @JihaRheum( View Tweet )

To be continued (or discontinued?): Abstract 2360: Compared to TNFi, IL-17i & JAKi users had 🔹 Higher odds of med switching <180 days 🔹 Shorter time to discontinuation @RheumNow #ACR25 #axSpA https://t.co/IOHaFSJqHn

Links:

Akhil Sood MD, MS @AkhilSoodMD( View Tweet )
SELECT-COMPARE RA UPA vs. ADA What do we learn from 7 years data? Not much Patients who did well on the first drug, keep doing well Patients who required switching for primary failure don't do as well, w/ 26% pts reaching DAS remission in UPA + MTX vs. 16% in ADA + MTX gp No https://t.co/JLUTRZuZOm

Links:

Aurelie Najm @AurelieRheumo( View Tweet )
~1 in 6 pts with #sarcoidosis May have #cardiac involvemt 1/3 respond to #MTX + #steroids Followed by repeat #PET Failures get 👇 #infliximab >#adalimumab 👇 #JAKi Better survival >yrs ago R heart involved ⬆️risk of MTX nonresponse #ACR25 @RheumNow @ACRheum abst#1664 #ACRbest https://t.co/kYt9JRNSVH

Links:

Janet Pope @Janetbirdope( View Tweet )
SELECT-COMPARE (upadacitinib vs adallimumab in mod-severe RA, no CV enrichment) 7y data: safety profiles very similar, except for: - zoster - CK rise - lymphopenia - hepatic disorder In the general RA population, no new JAKi safety signals #ACR25 ABST1676 @RheumNow https://t.co/BA2JxONGfa

Links:

David Liew @drdavidliew( View Tweet )
Infection data from SELECT-GCA: Glucocorticoids seem to drive overall infectious risk UPA use associated with higher zoster - vaccinate!! @RheumNow #ACR25 Abst# 0895 https://t.co/ueVbFPxG0Q

Links:

Brian Jaros, MD @Dr_Brian_MD( View Tweet )
Avouac et al. Lipid changes after JAKi initiation. 85 patients. Increases at 6 months. Largely appeared driven by HDL increase, and correlated CRP decrease. Appeared transient with return to baseline with time. @RheumNow #ACR25 Abstr#1333 https://t.co/CQ6u3ck1Ch

Links:

Richard Conway @RichardPAConway( View Tweet )
POETYK-PsA 1 & 2 Phase 3 RCT TYK2i Deucravacitinib Pooled analysis 640+pts PBO vs. 640+pts DEUCRA 6mg QD MDA 12% vs 22% All elements of MDA response sig different except for Leeds enthesitis index DAPSA Remission 2% vs. 9% PsARC 42% vs. 61% PASDAS -1 vs. -1.7 mCPDAI -1.2 vs. -1.9 https://t.co/OTOFxTOrRp

Links:

Aurelie Najm @AurelieRheumo( View Tweet )

Recent Blogs

JAKi for PMR: Safe, or a Concern for Older Adults?

David Liew, FRACP
Dr. David Liew
JAK inhibitors obviously have dominated a lot of the discussion in our therapeutic landscape over the last couple of years. What about their use in polymyalgia rheumatica? Let's consider. Read Post

Infections Rheums Should Worry About

Cassandra Calabrese, DO
TB.EMimage.CDC_.jpg
With the increasing development and use of new biologics and oral targeted therapies to treat RA and other immune mediated inflammatory diseases, an awareness of infection risk and prevention has become of increasing interest as well. While our patients may be susceptible to many different types of infections depending on immunosuppressive regimen, age and co-morbidities, I’ll highlight a few of the “usual suspects”. Read Post
How well do you know this week's rheumatology news?
Take the rheumIQ quiz
Take the RheumIQ Quiz

×