Thread by @rheum_cat

#ACR22 spondyloarthritis treatment oral abstract session

🌟Abs 0542 @sofiaramiro82
@official_asas @eular_org revised recommendations for axSpA management

https://twitter.com/Official_ASAS/status/1549711465879412736?s=20&t=dJDrNfaOueitQz6L1IdoDA

#ACR22

@sofiaramiro82 @Official_ASAS @eular_org Abs 0542

Key differences:
🔑added JAK inhibitors to bDMARD considerations
🔑specific EMM recs: monoclonal TNFi for uveitis, IBD; IL17i for PsO
🔑consider taper if in sustained remission

#ACR22

@sofiaramiro82 @Official_ASAS @eular_org 🌟Abs 0543 Rudwaleit, al.
post-hoc analysis of RAPID-axSpA (certolizumab)

❓: is there a disconnect between composite measures (response criteria used in trials) and inflammation (CRP, MRI)?

#ACR22

@sofiaramiro82 @Official_ASAS @eular_org Abs 0543 cont'd

🔎MRI scores of inflammation ⬇by >50% in the majority of participants
but
📉ASDAS or BASDAI ⬇of >50% was only seen in ~50%

They conclude that clinical response measures may underestimate tx effects

#ACR22

@sofiaramiro82 @Official_ASAS @eular_org 🌟Abs 0544 Deodhar, et al.

BE-MOBILE-1, bimekizumab (IL-17 A&F inhibitor) for nr-axSpA, phase 3 RCT
n=254
wk 16 ASAS40: 48% vs 21% PBO

main TEAE: URIs

#ACR22

@sofiaramiro82 @Official_ASAS @eular_org 🌟Abs 0545 Weinstein, et al
phase 4 RCT, golimumab withdrawal in nr-axSpA
n=188
randomized to: continued GOL, reduced GOL q2m, withdrawal

#ACR22

@sofiaramiro82 @Official_ASAS @eular_org Abs 0545 cont'd
1* outcome: % without flare

👉continued GOL was superior to withdrawal

More data on biologic withdrawal in axSpA

#ACR22

@sofiaramiro82 @Official_ASAS @eular_org 🌟Abs 0546 @proftdr

CONSUL: RCT of adding celecoxib to golimumab vs golimumab alone
outcome: change in mSASSS at wk108

#ACR22

@sofiaramiro82 @Official_ASAS @eular_org @ProftDr Abs 0546 cont'd

See the discussion from #EULAR2022

https://twitter.com/rheum_cat/status/1532012844857819136?s=20&t=dJDrNfaOueitQz6L1IdoDA

#ACR22

@sofiaramiro82 @Official_ASAS @eular_org @ProftDr 🌟Abs 0547 Rogge, et al
immune profiling study: how does IL17A inhibition vs TNF inhibition affect the systemic immune response?

IL17A: limited effects
⚡TNF: profound effects, including poss on susceptibility to infx

#ACR22