These are some of my interests in the ACR meeting 2013 in San Diego. It's a kind of overview. I'll use it to comment directly and/or to show the links to further information on this blog (at most times). So it's a work in progress. I'll date all the the entries, because otherwise I wouldn't know myself, when I'd written which entry. I've kept the colour coding. Black entries are past the meeting. The original text is at the end in small letters.
01.11.2013
AC0025
Poster #2353:
A dual target inhibitor - BTK and JAK3 (AC0025). Preliminary rat study.
29.10.2013
Adalimumab and smoking
Poster #2439:
Smoking not associated with reponse to adalimumab in axial SpA. The smoker's
choice?
29.10.2013
Alginate-Chitosan beads
I'm very
skeptical, but I'll have my time to see how this develops as the study is on
rabbits (#76).
27.10.2013
Apremilast
There are a
few posters on apremilast (PDE4) in psoriatic arthritis.
27.10.2013
B cell differentiation inhibition
There's a new
approach. The cereblon E3 ubiquitin ligase complex is modulated by CC-220,
which results in an inhibition of B cell differentiation. I must admit, that I
hear of this for the first time. Two abstracts: #41 and #42.
27.10.2013
Brodalumab
Phase 2
study, 24 weeks physical function in psoriatic arthritis. #318
27.10.2013
CC-220
See: B cell
differentiation inhibition
27.10.2013
CD40
Poster #40 on
blockade of CD40 - CD40L pathway, which "dampens multiple immune
responses". Preclinical characterization.
27.10.2013
Clazakizumab
Poster #2385:
Anti-IL-6 MAB clazakizumab shows higher potency than tocilizumab. Will this be
an advantage? Maybe tocilizumab should be available before clazakinumab comes
to the market (which might take a while!)
29.10.2013
Delayed release prednisone
Poster #2265:
Delayed release prednisone. I question the study, because I don't consider two
hours of morning stiffness as stable disease and would change therapy. The
authors compare prednisone given in the evening with a delay mechanism with
prednisone given in the morning. They should have compared the delayed release
prednisone with common prednisone, given in the evening, at the time. If
someone present a study done this way ... , but I guess no one will, at least
the drug company can't be interested.
29.10.2013
Methods, as in the abstract: “CAPRA-1, a 12-week, double-blind, controlled study,
randomized patients to IR-prednisone taken in the morning or DR-prednisone
taken once daily at bedtime (eg, 10pm) in addition to standard DMARD treatment.
…”
01.11.2013
Fibrofog and Alzheimer's
This is good
news! the data by Katz et al. don't support a transition from fibrofog to
Alzheimer's disease.
27.10.2013
Fibromyalgia
Poster #1108
on methylphenidate in Fibromyalgia - conclusions with too many hypothesis.
Dianne
Whiting presented an interdisciplinary program for Fibromyalgia. Exercises,
Yoga, education, CBT, more.
Poster #1092 on low dose naltrexone in Fibromyalgia - luckily it ended: may be effective, further trial needed. My 2 ct.: dead end street.
Poster #1092 on low dose naltrexone in Fibromyalgia - luckily it ended: may be effective, further trial needed. My 2 ct.: dead end street.
28.10.2013
Fish oil and knee OA
Poster #2147:
Fish oil doesn't have an effect on structural progression of knee OA. They used
9 g, which would be 18 cps. in Germany.
29.10.2013
Fostamatinib
OSKIRA-2, a
phase 3 study. I'll have to check the to posters with earlier publications. #455
and #456.
27.10.2013
Poster #1295
talks about mechanisms for fostamatinib induced blood pressure elevation. And,
how about data on radiographic progression?
28.10.2013
Free fatty acids
Poster #1842:
Free fatty acids affect arthritic cell. Exact nature not known yet.
29.10.2013
GLPG0634 (JAK1 inhibitor)
#478 Study on
dogs and monkeys.
27.10.2013
Poster #2381:
GLPG0634 effects on DAS28 and ACRxx, but only in a four week study. Good
respose rates though.
29.10.2013
HAQ and consequences of physical activity
Poster #2273:
Patient Survey on HAQ reveals an unrecognized aspect of disease activity in RA:
consequences of physical activity.
29.10.2013
HM-0523
A novel Syk
inhibitor. Abstract #474 tells us that HM-0523 significantly ameliorates the
severity of arthritis in rodents.
27.10.2013
Iguratimod
There's a
study on iguratimod, which has received Japanese approval in Sept. 2012. Too
bad, only N=23! So they should present a larger overview. I don't know, why the
company isn't pressing to get an approval by FDA or EMEA.
28.10.2013
Ixekizumab
#343 shows a
phase 2 study.
27.10.2013
Knee osteoarthritis
A look at a satellite symposium on glucosamine, chrondroitin sulfate, and hyaluronic acid in knee osteoarthritis.
http://rheumatologe.blogspot.de/2013/11/osteoarthritis-satellite-symposium-at.html
04.11.2013
Life events and developing RA
Poster #2402:
Association between life events and an increased risk of developing RA.
29.10.2013
Mavrilimumab
Poster #2378:
Mavrilimumab shows a study on lung AE in cynomolgus monkeys. Not very
reassuring.
29.10.2013
But there's more, I've found all in all studies, which are worth discussing.
But there's more, I've found all in all studies, which are worth discussing.
Methotreate
Study #1362
claims: iSyMind reduces MTX induced nausea. A pilot trial of N=4. These people
have chuzpe! Perhaps they think of a change of paradigm?
28.10.2013
Poster #1977:
Pain related anxiety as a barrier to use methotrexate (MTX) - needle,
autoinjector etc. tested on healthy volunteers.
29.10.2013
NI-0101
Poster #????:
Novel anti-human TLR4 MAB (NI-0101). Cell study!
29.10.2013
Omega-3 fatty acids and SLE
Poster #2538:
SLE patients benefit from omega-3 fatty acids.
29.10.2013
Opiods in Osteoarthritis
EA Wright and
colleagues looked at the development of opioid prescriptions in patients with
knee osteoarthritis. The authors found a steady increase. The public impact of
higher opioid use should be carefully monitored.
27.10.2013
Psoriatic Arthritis - conventional DMARDs
A study be E
Lie and colleagues (#343) looked at conventional DMARDs in psoriatic arthritis.
The drug survival rate of SSZ after two years is about 30%, LEF is at 41%, and
MTX lies at 62%. And MTX achieves higher rates of ACR20, ACR50 and ACR70
at 6 months.
27.10.2013
Sleep disturbances in rheumatic conditions
Poster #1930
i s on sleep disturbances (SD) in different rheumatic conditions. SD leads to
higher disease activity.
Authors
stress to look also at SD and not only at joint swelling and pain. I'd like to
add fatigue.
29.10.2013
Strontium ranelate
A study of
strontium ranelate in long bone fractures with delayed union. Single arm study
though. Not convincing.
28.10.2013
It seems that
the drug company of strontium ranelate is desperately seeking a new field. How
about comparing strontium ranelate to a bisphosphonate in the same indication?
01.11.2013
Tender Point Measurement at home (FMS)
There's a
study suggesting that self measurement of tender points will have a positive
effect. I see in it a method to promote pain sensitization. And: don't
physicians and patients have better topics than tender points to talk about?
27.10.2013
Tocilizumab
SC equal to
IV. I hope, we"ll soon see an approval to be able to use it.
27.10.2013
Poster #1207:
Efficacy of tocilizumab in pats. with AA amyloidosis. But not all responding.
alhkim
@alhkim thinks of dz heterogeneity.
I'm surprised
that it should work at all in AA amyloidosis. I was waiting for some study, as
Prof. Kishimoto mentioned it earlier this year.
28.10.2013
Tofacitinib
There have
been eight posters on tofacitinib today. #438 to #445. Most were circling
around the question of side effects.
ORAL Sequel
had a higher rate of SAE than ORAL Standard (#438).
Tofacitinb
has the same rate of gastrointestinal events as TNFi (3439).
Cardiovascular
events are not increased (#440).
Tofacitinib
has a higher rate of herpes zoster (#441).
Tolerability
with and without DMARDs are equal (#442).
US and rest
of the world pats. are equal in respect of efficacy and side effects (#443).
Dosing every two
weeks has less side effects (#444).
Tofacitinib
is an independent risk factor in multi morbid elderly patients (#445).
27.10.2013
Effects of
smoking in pats. receiving tofacitinib. Need for longer observation #1418
28.10.2013
Poster #1977:
After a plethora of posters on tofacitinib, just one with data on radiographic
progression.
29.10.2013
Triple therapy
There's a
study on discontinuation rates of triple therapy in RA, result: high rate, but
further work is needed.
28.10.2013
Unique self joint examination tool
Poster #2242:
Despite a unique self joint examination tool, pat. and physicians joints counts
differ significantly.
29.10.2013
Ustekinumab
Poster #????:
Actually more than one poster on ustekinumab in psoriatic arthritis. It's
approved in Europe, now.
29.10.2013
VX-509
Poster #2350:
New data by VX-509 (JAK3i). Pain, HAQ-DI etc. are better, but DAS28 or ACR20 aren’t
shown.
29.10.2013
Weather and RA
Poster #1359
addresses the question: Does RA disease activity correlate with weather
conditions? DAS28 is lower under sunny and dry weather conditions.
28.10.2013
There have been two posters/abstracts addressing the issue, look here: http://rheumatologe.blogspot.de/2013/11/influence-of-weather-on-rheumatoid.html
06.11.2013
06.11.2013
This is the scientific part of my ideas on the 2013 ACR meeting in San Diego. I plan it to write part of it, while I'm still at the meeting and not afterwards. So it's a work in progress. I'll keep topics in alphabetical order per day and rearrange the text at home. I'll go into details to some of the topics, when I'm back home.
Alginate-Chitosan beads
I'm very skeptical, but I'll have my time to see how this develops as the study is on rabbits (#76).
Apremilast
There are a few posters on apremilast (PDE4) in psoriatic arthritis.
B cell differentiation inhibition
There's a new approach. The cereblon E3 ubiquitin ligase complex is modulated by CC-220, which results in an inhibition of B cell differentiation. I must admit, that I here of this for the first time. Two abstracts: #41 and #42.
Brodalumab
Phase 2 study, 24 weeks physical function in psoriatic arthritis. #318
CC-220
See: B cell differentiation inhibition
CD40
Poster #40 on blockade of CD40 - CD40L pathway, which "dampens multiple immune responses". Preclinical characterization.
Fibrofog and Alzheimer's
This is good news! the data ba Katz et al. don't support a transition from fibrofog to Alzheimer's disease.
Fostamatinib
OSKIRA-2, a phase 3 study. I'll have to check the to posters with earlier publications. #455 and #456.
GLPG0634 (JAK1 inhibitor)
#478 Study on dogs and monkeys.
HM-0523
A novel Syk inhibitor. Abstract #474 tells us that HM-0523 signicifantly ameliorates the severity of arthritis in rodents.
Ixekizumab
#343 shows a phase 2 study.
Opiods in Osteoarthritis
EA Wright and colleagues looked at the development of opioid prescriptions in patients with knee osteoarthritis. The authors found a steady increase. The public impact of higher opioid use should be carefully monitored.
Psoriatic Arthritis - conventional DMARDs
A study be E Lie and colleagues (#343) looked at conventional DMARDs in psoriatic arthritis. The drug survival rate of SSZ after two years is about 30%, LEF is at 41%, and MTX lies at 62%. And MTX achieves higher rates of ACR20, ACR50 and ACR70 at 6 months.
Tender Point Measurement at home (FMS)
There's a study suggesting that self measurement of tender points will have a positive effect. I see in it a method to promote pain sensitization. And: don't physicians and patients have better topics than tender points to talk about?
Tocilizumab
SC equal to IV. I hope, we"ll soon see an approval to be able to use it.
Tofacitinib
There have been eight posters on tofacitinib today. #438 to #445. Most were circling around the question of side effects.
ORAL Sequel had a higher rate of SAE than ORAL Standard (#438).
Tofacitinb has the same rate of gastrointestinal events as TNFi (3439).
Cardiovascular events are not increased (#440).
Tofacitinib has a higher rate of herpes zoster (#441).
Tolerability with and without DMARDs are equal (#442).
US and rest of the world pats. are equal in respect of efficacy and side effects (#443).
Dosing every two weeks has less side effects (#444).
Tofacitinib is an independent risk factor in multi morbid elderly patients (#445).
Sunday, 27th of October.
Fibromyalgia
Poster #1108 on methylphenidate in Fibromyalgia - conclusions with too many hypothesis.
Dianne Whiting presented an interdisciplinary program for Fibromyalgia. Exercises, Yoga, education, CBT, more.
Poster #1092 on low dose naltrexone in Fibromyalgia - luckily it ended: may be effective, further trial needed. My 2 ct.: dead end street.
Poster #1092 on low dose naltrexone in Fibromyalgia - luckily it ended: may be effective, further trial needed. My 2 ct.: dead end street.
Fostamatinib
Poster #1295 talks about mechanisms for fostamatinib induced blood pressure elevation. And, how about data on radiographic progression?
There's a study on iguatimod, which has received Japanese approval in Sept. 2012. Too bad, only N=23! So they should present a larger overview. I don't know, why the company isn't pressing to get an approval by FDA or EMEA.
Methotreate
Study #1362 claims: iSyMind reduces MTX induced nausea. A pilot trial of N=4. These people have chuzpe! Perhaps they think of a cange of paradigm?
Strontium ranelate
A study of strontium ranelate in long bone fractures with delayed union. Single arm study though. Not convincing.
Tocilizumab
Poster #1207: Efficacy of tocilizumab in pats. with AA amyloidosis. But not all responding.
alhkim @alhkim thinks of dz heterogeneity.
I'm surprised that it should work at all in AA amyloidosis. I was waiting for some study, as Prof. Kishimoto mentioned it earlier this year.
Tofacitinib
Effects of smoking in pats. receiving tofacitinib. Need for longer observation #1418
Triple therapy
There's a study on discontinuation rates of triple therapy in RA, result: high rate, but further work is needed.
Weather and RA
Poster #1359 addresses the question: Does RA disease activity correlate with weather conditions? DAS28 is lower under sunny and dry weather conditions.
Monday, 28th of October
AC0025
Poster #2353: A dual target inhibitor - BTK and JAK3 (AC0025). Preliminary rat study.
Adalimumab and smoking Poster #2439: Smoking not associated with reponse to adalimumab in axial SpA. The smoker's choice?
Clazakizumab
Poster #2385: Anti-IL-6 MAB clazakizumab shows higher potency than tocilizumab. Will this be an advantage? Maybe tocilizumab should be available before clazakinumab comes to the market (which might take a while!)
Delayed release prednisone Poster #2265: Delayed release prednisone. I question the study, because I don't consider two hours of morning stiffness as stable disease and would change therapy. The authors compare prednisone given in the evening with a delay mechanism with prednisone given in the morning. They should have compared the delayed release prednisone with common prednisone, given in the evening, at the time. If someone present a study done this way ... , but I guess no one will, at least the drug company can't be interested.
Fish oil and knee OA
Poster #2142: Fish oil doesn't have an effect on structural progression of knee OA. They used 9 g, which would be 18 cps. in Germany
Free fatty acids
Poster #1842: Free fatty acids affect arthritic cell. Exact nature not known yet.
GLPG0634
Poster #2381: GLPG0634 effects on DAS28 and ACRxx, but only in a four week study. Good respose rates though.
HAQ and consequences of physical activityPoster #2273: Patient Survey on HAQ reveals an unrecognized aspect of disease activity in RA: consequences of physical activity.
Life events and developing RA Poster #2402: Association between life events and an increased risk of developing RA.
Mavrilimumab
Poster #2378: Mavrilimumab shows a study on lung AE in cynomolgus monkeys. Not very reassuring.
Methotrexate and anxiety Poster #1977: Pain related anxiety as a barrier to use methotrexate (MTX) - needle, autoinjector etc. tested on healthy volunteers.
NI-0101
Poster #????: Novel anti-human TLR4 MAB (NI-0101). Cell study!
Omega-3 fatty acids and SLE
Poster #2538: SLE patients benefit from omega-3 fatty acids.
Sleep disturbances in rheumatic conditions
Poster #1930 i s on sleep disturbances (SD) in different rheumatic conditions. SD leads to higher disease activity.
Authors stress to look also at SD and not only at joint swelling and pain. I'd like to add fatigue.
Tofacitinib Poster #1977: After a plethora of posters on tofacitinib, just one with data on radiographic progression.
Unique self joint examination toolPoster #2242: Despite a unique self joint examination tool, pat. and physicians joints counts differ significantly.
UstekinumabPoster #????: Actually more than one poster on ustekinumab in psoriatic arthritis. It's approved in Europe, now.
VX-509 Poster #2350: New data by VX-509 (JAK3i). Pain, HAQ-DI etc. are better, but no DAS26 or ACR20 is shown.
Tuesday, 29th of October
