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TNF inhibitor


Inflammatory Arthritis and Hidradenitis Suppurativa

Dec 09, 2022

Hidradenitis suppurativa (HS) (also called acne inversa), is a chronic inflammatory skin disorder affecting apocrine gland-bearing skin in the axillae, groin, and under the breasts and is characterised by persistent or 

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Lifestyle Modifications may enhance TNF Inhibitors in axSpA

Bimekizumab Efficacy in TNF-Refractory Psoriatic Arthritis

Dec 07, 2022

Bimekizumab, a selective inhibitor of interleukin (IL)-17F and IL-17, has shown superior efficacy and safety in a 16 week trial in patients with active psoriatic arthritis who previously failed therapy with tumour necrosis factor-α (TNFi) inhibitors.

The BE COMPLETE study was a phase

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TARGET Trial - Cardiovascular Risk Reduction in Rheumatoid Arthritis

Dec 05, 2022

A recent randomised clinical trial suggests immunomodulators reduce arterial inflammation, and thereby cardiovascular (CV) risk, but shows no significant benefit to TNF inhibitors over triple therapy in patients with rheumatoid arthritis (RA).

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Comparing Biosimilar Growth in the US, Germany, and Switzerland

Dec 05, 2022

The biosimilar landscape will change dramatically in 2023, following the successful rollouts in other countries in Europe. This analysis of the uptake and price of biologic therapy in Germany, Switzerland and the United States suggest that anticompetitive practices in the US could allow

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MTX side effects more prominent in PsA than RA pts. Study of 240 PsA & 86108 RA pts starting either MTX or TNFi. TNFi AE same betw PsA & RA, but MTX adverse greater in PsA (44.8% vs. 29.4%), especially N/V, abdominal pain, depression, tinnitus
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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TNFi cycling in axSpA: Results from CorEVITAS Registy study Dr. Rachel Tate ( @uptotate) reviews abstract #1499 presented at #ACR22.
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A Multidimensional Approach in the Management of Axial Spondylarthritis

Nov 21, 2022

There has been much focus on the pharmacologic management of axSpA. Despite optimal control of inflammation, symptoms of fatigue and pain can persist. Long term use of analgesics including opioids carries significant risks. Strategies to improve response to treatment in this population is

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ACR 2022 Appraisal, Praise & Critique (11.18.2022)

Nov 18, 2022

It was great to be back at an ACR annual meeting, this one in Philadelphia - Philly was great. A walking town, rich in culture, history and good places to meet and mingle. 

I loved the city, but not the convention center (not easy to navigate). 

The meeting itself was very

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Gender Differences in Axial Spondyloarthritis

Nov 17, 2022

Rheumatic conditions such as SLE and RA exhibit female predominance. In contrast, increasing evidence suggests that gender differences occur in axial spondyloarthritis in terms of time to diagnosis, clinical manifestations, treatment outcomes and quality of life. The exact mechanisms are

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Abstr #2192 risk of serious infxn in newborns of mothers on TNFi by placental transfer - % serious infection in TNFi in high vs low placental transfer (2.1% vs 1.6%) - HR (high vs low) 0.98 (95% CI 0.36-2.61) - No significant difference in risk of serious infxn @RheumNow #ACR22
Which is better for CV risk in RA: triple therapy DMARDs or TNFi? TARGET study n=159 using PET/CT surrogate (endpoint responsiveness👀) - either led to benefit - both equally good - benefit *not* linked to change in DAS28 A direct CV effect of RA Rx? ABST2215 #ACR22 @RheumNow
Flatman et al. Risk of infections in children with third trimester TNFi use, high vs low (CTZ, ETN) placental transfer. No difference but wide CIs, aHR 0.98 (0.36, 2.61) @RheumNow #ACR22 Abstr#2192
Are TNFi or IL-6Ri safe in rheumatic irAEs from ICI Rx? Multiple big US centers retrospective: TNFi, IL-6Ri vs MTX p>0.05, but may be approx 2x risk of cancer progression Has made me more cautious about TNFi, IL-6Ri - use MTX when you can Lovely work! ABST1669 #ACR22 @RheumNow
Maya Buch on major adverse CV events in tofa vs TNFi. Post-hoc analysis of phase 3b/4 data looking at cohort enriched for CV events. @RheumNow #ACR22 #LateBreaking
L06 #ACR22 ORAL Surveillance Updates! Composite of all ischemic CV events and HF did NOT show difference b/w TOFA vs TNFi But, MACE numerically higher with Tofa w/ h/o ASCVD Highest CV risk in TOFA 10 mg BID, 2/2 VTE risk Most important risk is pt's individual risks @RheumNow
Guimarães et al Portugese registry data suggests similar retention rates in change of MOA compared to 2nd TNFi following failure of 1st TNFi. @RheumNow #ACR22 Abstr#2149
Ogdie @AlexisOgdie et al. CorEvitas, PsA treatment after 1st line TNFi failure. Switching MOA probably more effective @RheumNow #ACR22 Abstr#1600
Does lifestyle impact Tx. response? #Abstr 1510 looked at effect of lifestyle on TNFi response in #axSpA - The study found higher BMI (obese, overweight) and smoking were less likely to respond to TNFi - Important to discuss lifestyle when starting tx. @RheumNow #ACR22
Abs 1417 finds physicians prefer ABA over TNFi for RF/ACPA+ pts w/ higher disease severity, older age, the presence of extra-articular manifestations, and comorbidities such as heart failure. My question: Trouble getting it first line? #ACR22 @RheumNow
Jones et al. Non-smokers, normal BMI, and current drinkers! with AxSpA more likely to respond to TNFi. @RheumNow #ACR22 Abstr#1510
#ClinicalPearl woman with non-radiographic axSpA have LESS inactive disease vs MEN but NOT true if radiographic axSpA. 5 yr global study N=2633, independent of TNFi use - not sure why there are differences. Misclassification dx- unlikely. abst#1614 #ACR22 #ACRBest @RheumNowNews
CorEVITAS Abs 1499 #ACRbest #ACR22 cycling to a second line TNFi provides limited benefits to pts with AxSpA who discontinued a first line TNFi. @RheumNow