David Liew, a renowned rheumatologist from Melbourne, joins an expert panel to discuss groundbreaking findings from the ACR Annual Meeting. They explore the effectiveness of Upadacitinib for treating giant cell arteritis and the complexities surrounding patient enrollment for trials. The conversation shifts to the skepticism around methotrexate for polymyalgia rheumatica and the potential of JAK inhibitors in myositis. Safety concerns regarding these therapies, particularly in cardiovascular health, underscore the importance of ongoing research.
The SelectGCA trial showcased Upadacitinib's significant effectiveness in achieving remission for giant cell arteritis, although safety concerns persist.
Baricitinib demonstrated notable efficacy in treating newly diagnosed polymyalgia rheumatica, positioning itself as a superior alternative to methotrexate.
Deep dives
Giant Cell Arteritis Treatment Insights
The discussion highlights the significance of the SelectGCA trial, which examined Upadacitinib's efficacy for treating giant cell arteritis (GCA). This double-blind, randomized controlled trial involved 428 participants across 24 countries and demonstrated a 15% absolute improvement in sustained remission rates at week 52, comparing Upadacitinib with placebo. Participants receiving the 15 milligram dose of Upadacitinib alongside a shorter steroid taper exhibited a remission rate of 46%, in contrast to 29% for the placebo group. While the findings are promising, the safety of the drug remains a concern, as the study was not large enough to definitively assess potential adverse effects, particularly those seen with other inhibitors in the past.
Baricitinib's Role in Polymyalgia Rheumatica
The conversation turns to the Bachelor study centered on the use of Baricitinib for newly diagnosed polymyalgia rheumatica (PMR). The investigation contrasted a treatment regimen of Baricitinib against a placebo and revealed a striking 77% response rate compared to a mere 13% in the placebo group after 12 weeks. Even after tapering the dosage, substantial efficacy persisted, demonstrating that short-term usage could still offer significant benefits in terms of steroid sparing. This study's results challenge the previous reliance on methotrexate, establishing Baricitinib as a more effective option for managing PMR.
Emerging Applications of JAK Inhibitors
The podcast explores the potential of JAK inhibitors, particularly Upadacitinib and Tofacitinib, in treating inflammatory myositis. Recent studies show promising results, suggesting that Tofacitinib demonstrates better outcomes than conventional treatments for patients suffering from severe forms of the disease. Though not yet formally approved for this indication, these findings indicate a significant shift in treatment strategies for hard-to-treat patients. The conversation acknowledges ongoing research and the emerging understanding of various JAK inhibitors' roles, looking forward to further data which could solidify their places in therapeutics.
Join us for an in-depth discussion about the ACR Annual Meeting! This expert panel will explore the latest research and clinical applications of JAK and TYK inhibitors in managing rheumatic diseases.
Stay informed about the cutting-edge therapies shaping the future of rheumatology care.
Dr. Janet Pope
London, Ontario
Dr. David Liew
Melbourne
Dr. Michael Putman
Milwaukee
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