Author: Victoria Konzett
Cope et al. (0835) investigated the efficacy of T-cell co-stimulation with Abatacept on prevention of disease onset in an autoantibody-positive population with arthralgia at risk of developing RA, over a one-year treatment and one-year follow-up period (APIPPRA). Arthritis-free survival was longer in patients receiving Abatacept vs placebo (99 days, 95%-CI 38-161), albeit Kaplan-Meier curves diverging mostly in the treatment period, and partially re-approximating in the follow-up period.
Kjørholt et al. (L07) compared TNF inhibitor (TNFi) tapering to withdrawal against treatment continuation in the multicenter ARTIC-REWIND study, of which 3-year results were presented. Patients (n=92) in sustained remission upon stable TNFi treatment for at least 6 months were randomized into a treatment continuation and a tapering/withdrawal arm, and flares (DAS>1.6, ∆DAS≥0.6 and ≥2 swollen joints, or physician/patient agreement) assessed over a 3-year follow-up period. 25% of patients stayed flare-free in the tapering group, compared with 85% in the continuation group. Systemic steroids were used more frequently in the tapering/withdrawal group (23% vs 13%), despite remission having been regained in 81% of patients after treatment reinitiating within the next clinical visit in the tapering group.
Wang et al. (L20) investigated Telitacicept, a recombinant fusion protein targeting BLyS and APRIL, in a 24-week phase 3 trial in Methotrexate insufficient responders (IR) with active RA (479 patients). Response rates were significantly higher with Telicacicept vs placebo (ACR20 at week 24; 60% vs 26.9%; p<.001) and radiographic progression halted in most patients in the treatment arm, indicating good efficacy and an acceptable safety profile of this compound.
Taylor et al. (0839) investigated the prevention of Immunoglobulin G (IgG) recirculation via blockage of neonatal Fc receptors (FcRn) in a phase IIa proof-of-concept study on Nipocalimab, in 53 ACPA/RF positive patients with active RA despite at least one advanced therapy. No statistically significant superiority over placebo could be demonstrated, albeit numeric differences were observed in various outcomes (∆DAS28-CRP at week 10; -1.17 vs -0.62; p=.224).
Zeng et al. (0840) presented the final results of a phase II, head-to-head study on TLL-018, a novel TYK2/JAK1 inhibitor, that was tested against Tofacitinib in 101 MTX IR from China (~50% bDMARD IR, ~30% JAKi IR). ACR50 response rates of up to 72% were observed for the novel compound (42% for Tofacitinib; p<.001), warranting further investigation of this drug in phase 3 and multinational trial programs.
Interesting safety data on JAKi was presented, among others by Buch et al. (0451), who identified age and baseline cardiovascular risk as important drivers of treatment-related adverse reactions in the Filgotinib drug development program.
ABOUT THE AUTHOR
Victoria Konzett
Victoria is a resident in internal medicine and PhD fellow at the Division of Rheumatology at the Medical University of Vienna, Austria.
Her major research interests are clinical and translational research projects in rheumatoid and psoriatic arthritis, focusing mainly on trial data, at risk stages and outcomes research in both diseases.
Victoria is a member of the Newsletter Sub-Committee and the Young Division of the Austrian Society of Rheumatology.