Richard Conway, a vasculitis specialist, discusses pivotal findings from ACR 2024. Peter Nash delves into the role of JAK inhibitors, while Janet Pope reviews treatment strategies for polymyalgia rheumatica and giant cell arteritis. Eric Dian analyzes intriguing oral abstracts on rheumatoid arthritis, and David Liu emphasizes cardiovascular risks associated with treatments. They explore the safety of JAKs, advances in managing RA during COVID-19, and the efficacy of new therapies for PMR and GCA, showcasing innovative strategies for improving patient outcomes.
Recent studies show promising efficacy of new agents like apremilast and zazocitinib in treating psoriatic arthritis, indicating significant advancements in therapy.
A meta-analysis suggests that while JAK inhibitors may carry a slightly higher malignancy risk compared to TNF inhibitors, the overall risk isn't markedly higher than placebo.
Research indicates that maintaining JAK inhibitor treatment during COVID-19 vaccinations is crucial to prevent disease flares and ensure adequate immune response.
Deep dives
Engagement and Resources at ACR 2024
The ACR Convergence 2024 in Washington, D.C., promises to be an exciting event filled with numerous opportunities for engagement. Attendees are encouraged to visit booths, including the one featuring new Room Now products, and participate in live sessions such as the daily recap, which will summarize the highlights of each day at 6 p.m. eastern time. For those unable to attend, regular updates are available through platforms like Twitter, providing minute-by-minute information on ongoing sessions. This multifaceted approach helps ensure that both in-person and remote participants can stay informed about significant developments during the conference.
Innovative Treatments for Psoriatic Arthritis
Recent studies presented at ACR 2024 reveal promising advancements in the treatment of psoriatic arthritis, particularly focusing on newer agents like apremilast and zazocitinib. A phase four trial indicated that apremilast can reduce inflammation associated with axial psoriatic arthritis, challenging previous perceptions of its effectiveness in this area. Additionally, zazocitinib, an oral selective TIC2 inhibitor, demonstrated higher remission rates and improved disease activity in participants of a phase 2b trial. Another notable finding was the efficacy of sonolocumab, a novel IL-17A and F nanobody, which achieved impressive ACR 50 scores in a phase 2 trial, moving toward phase 3 investigations.
Safety Concerns with JAK Inhibitors and Malignancy Risks
A significant meta-analysis assessing the risks of malignancy associated with JAK inhibitors uncovered intriguing findings regarding their safety profile. Results suggested that while TNF inhibitors exhibited a significantly lower risk of malignancy compared to JAK inhibitors, the overall malignancy risk for JAK inhibitors was not markedly higher than placebo. Furthermore, the study highlighted a potentially lower risk for hematological malignancies when compared to placebo. These findings provoke critical discussions regarding the safety of JAK inhibitors, especially given the recent concerns that arose from oral surveillance data.
Impact of Vaccination on Patients Taking JAK Inhibitors
Recent research from ACR 2024 has shed light on the critical question of whether patients on JAK inhibitors should pause their medication during COVID-19 vaccinations. A study found that halting biologics led to an increased likelihood of disease flare compared to those who continued their medications during vaccination. Moreover, antibody responses were measured, revealing that while JAK inhibitors may cause slightly lower antibody responses, the overall response remained adequate. This highlights the importance of maintaining treatment continuity, as stopping JAK inhibitors could lead to worsened disease control without substantial benefits concerning vaccination efficacy.
Advances in JAK Inhibitors and Their Future Directions
The JAK inhibitor class continues to evolve with studies focusing on their efficacy across various rheumatic diseases. Not only has there been substantial interest in upadacitinib's application for giant cell arteritis and polymyalgia rheumatica, but also in other less commonly treated conditions like Behçet's disease. Positive outcomes from recent trials suggest that JAK inhibitors could become integral therapies in treating these challenging conditions, potentially opening the door for their inclusion in clinical practice. Ongoing investigations into new JAK inhibitors and combination therapies promise to enhance treatment options while balancing safety considerations, cementing their place in modern rheumatology.
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The Case for JAKi in PMR
The Real Value of JAKi is Beyond RA
When, What and How Long to Treat GCA & PMR
Worried about CV Risk and JAKi? What about the Steroids?
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