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ACR meeting education

ACR22 Takeaways: Pre-RA, Lupus, PsA and AS

Nov 29, 2022

ACR22 Convergence left us bountiful with information from all over the world. Here are a few of my personal highlights and key takeaways. 

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Patient Reported Outcomes in PsA Using Novel IL 17A Inhibitor Dr. Sims ( @DrCassySims) discusses abstract 0199 presented at #ACR22.
BE OPTIMAL Study - Bimekizumab (IL-17A and IL-17F inhibitor) for treatment of PsA. Similar ACR 50 (~50%) response rates of Bimekizumab, adalimumab, and placebo (switched to BKZ at wk 16). ~60% PASI100 in BKZ #ACRBest Abs#L02 @RheumNow #ACR22
Ritchlin et al. Bimekizumab in bDMARD naive PsA. 52 week results. Not surprisingly, week 16 outcomes sustained. No joint difference to ADA, skin slightly better @RheumNow #ACR22 Abstr#L02

Dual inhibition of IL17A and IL17F in AxSpA

Nov 14, 2022

A new target for treatment in AxSpA is the dual inhibition of IL17A and IL17F (IL17A/F). IL17A is a key driver of the inflammation in the AxSpA and Psoriatic Arthritis (PsA). IL17A and its structurally related IL17F share biologic functional properties. Inhibition of both cytokines (IL17A/F)

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#L02 #acr22 @rheumnow Bimekizumab ph3 in PsA: meaningful clinical improvement, improved mTSS, no new safety signals. Wk 52 ACR50: 53.0% PBO/BKZ, 54.5% BKZ, 50.0% ADA; MDA 53.7% PBO/BKZ, 55.0% BKZ, 52.9% ADA . mTSS change from baseline ≤0.5): 87.3% PBO/BKZ, 89.3% BKZ, 94.1% ADA
Get the skinny on Bimmy! Gotta learn this name #Bimekizumab in bio naive PsA N=852 Bimmy=IL17 A & F inhibitor Great data on skin & joints. Where will it fit in as we have other IL17Ai’s is IL17F giving added value? #ACR22 #ACRBest @RheumNow
L14 #ACR22 Bimekizumab BE MOBILE 1 and 2 Sustained efficacy to Wk52. ASAS40 in BKZ incr from W16 (47% nrAxSpA, 45% AS) to W52 (61%, 58%). Efficacy in TNF-naive & TNF-failure. AEs: Nasopharyngitis (12% nrAxSpA, 9% AS), URI (9, 6%), candidiasis (7, 6%), COVID (7, 2%) @RheumNow
Bimekizumab (BKZ) in AxSpA to Wk52 ◦ sustained efficacy ◦ suppression of inflammation ◦ improvements in function and quality of life ◦ no new safety signals were observed ◦ consistent with the safety profileWk24 data Baraliakos #L14 #ACR22 @RheumNow
Kiltz et al. Greater efficacy of secukinumab in normal BMI than high BMI AS patients. Decremental effect with increasing BMI. @RheumNow #ACR22 Abstr#1495
Benesova et al. Higher treatment response to secukinumab in both male and female AS patients when diagnosed earlier. No such effect seen in PsA patients. Emphasises need to reduce diagnostic delay in AS. @RheumNow #ACR22 Abstr#1497
BE COMPLETE study: Bimekizumab (IL-17A and IL-17F inhibitor) efficacious in phase 3 trial for treatment of PsA. No new safety signals. Abs#1599 @RheumNow #ACR22
Does Bimekizumab, anti-IL17F, work in PsA? #ACR22 @RheumNow Abstract #L02 💊Phase 3, randomized, placebo-controlled study 💉Biologic naive patients ✋ Week 52: 53-54% BKZ groups achieved ACR502 (v. 50% in TNFi) 📍benefits sustained to week 52 🛑No new safety signals
axPsA and AS adult pts exhibit different genetic risk factors & serum IL-17 levels. GUS demonstrated significant pharmacodynamic effects and clinical improvement in axPsA and non-axPsA pts. Abs 1038 #ACR22 @RheumNow
Deodhar et al. Bimekizumab (IL-17A/Fi) in nr-axSpA. Efficacy shown across all outcomes. Confirms bimekizumab works across spectrum of axSpA (not surprisingly). @RheumNow #ACR22 Abstr#0544
IL17A/Fi BImekizumab BKZ to Wk 24 achieved reduction in ◦ total spinal pain (SP) ◦ nocturnal SP ◦ morning stiffness (BASDAI) ◦ fatigue (FACIT-F) Deodhar et al, BE MOBILE 1,2 Abst 0409 @RheumNow
IL-17A/F inhibition with Bimekizumab in active nr-axSpA Wk 16 ASAS40 vs PBO • Rapid improvement 47.7 vs 21.4% • TNF naive 46.6 vs 22.9% • TNFIR 60 vs 11.8% • Wk 24 >50% ASDAS <2.1 • Improved MRI • Serious TEAE 0.4% Deodhar Abs0544 #ACR22 @RheumNow
What’s new to treat PsA? Let’s discuss anti-IL-17A, Izokibep #ACR22 @RheumNow Abstract #0199 💪 Izokibep 40 v. 80 mg q2 weeks SQ v. placebo 💪 135 patients, 28 sites 💪 At 12 weeks, all patient reported outcomes and PsAID subdomains significantly improved (dose dependent)
2022 ASAS-EULAR Recommendations of AxSpA management 1) NSAIDs still first line 2) Analgesics/opioids contraindicated 3) TNFi, IL-17i first line bDMARDs, followed by JAKinibs 4) Tapering but not discontinuation of bDMARDs in sustained remission Abs#0542 @RheumNow #ACR22
The new IL-17A/F inhibitor, bimekizumab, was comparable to current established therapies in active #AnkylosingSpondylitis. Check our NMA poster today. #ACR22 #SpA #medtwitter @TheBold_MD @cplch19 @UTSWRheum @ACRheum @RheumNow @DrCassySims
Advance growth

Practical use of JAK inhibitors in select groups in Axial SpA

Nov 12, 2022

A new treatment for AxSpA that has come on the scene are JAK inhibitors. In clinic, considerations for JAKi use are body mass index, smoking status, prior use of biologics and patients with high inflammatory states such as high CRP and inflammatory change on MRI scan of the spine and sacroiliac

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Withdrawing IL17i will more likely cause a relapse, but pts will respond when reintroduced -Dr Scher #PsA @rheumnow #acr22 #acrreview

Industry Abstract Previews of ACR 2022

Nov 11, 2022

The pharmaceutical companies have will showcase their featured clinical trials and abstracts at ACR 2022.  These are their best studies for you to review and evaluate as part of your to-do list. In the least, you should be familiar with the names and objectives of some of these studies as

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Update: axSpA Recommendations

Nov 09, 2022

Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic musculoskeletal disease which can be managed with both pharmacological and non-pharmacological options. The joint ASAS-EULAR recommendations for axSpA were first developed in 2006, and last updated in 2016. The current update

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2022 EULAR Recommendations for Screening and Prophylaxis of Chronic and Opportunistic Infections

Nov 07, 2022

A EULAR Task force has developed recommendations for screening and prophylaxis of chronic and opportunistic infections in patients with autoimmune inflammatory rheumatic diseases (AIIRD).

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