Day 4 conference highlights

2 minute read

As the curtains draw to a close on ACR21, the final day is all about late-breaking content.

The last day is the most exciting day – so much late-breaking content, not enough word count!

I started by looking at the REOVAS trial, a double-blind randomised control trial comparing the use of rituximab (1g at day 0 and 15) versus conventional therapy (cyclophosphamide) as induction for patients with newly diagnosed EGPA (abstract #L21).

Results showed that rituximab was not superior to conventional therapy for outcomes of remission rates, relapse rates and total cumulative use of prednisolone. 

Next is the TRAIL1 trial, a randomised, double-blinded placebo-controlled trial investigating the potential benefits of pirfenidone in the treatment of RA-ILD (poster #L10).

Unfortunately, the trial was underpowered to detect the composite primary endpoint, but results did show a slower rate of decline in lung function (change in FVC and FVC%) in the pirfenidone group. Furthermore, there was no significant difference in adverse effects. Currently PBS listed for idiopathic pulmonary fibrosis, pirfenidone could be an option for our patients.

Lastly, we have an investigator-initiated randomised placebo-controlled trial to examine if outcomes of PsA treatment with ustekinumab in combination with methotrexate were different from ustekinumab alone (poster #L12).

Results show that additional methotrexate had no positive impact on ustekinumab efficacy for arthritis, enthesitis, dactylitis, skin score, qualify of life and function, suggesting that we may not need to either add or maintain on-going methotrexate after starting ustekinumab.

That’s it from me folks! There are just too many interesting topics to cover. I hope that everyone gets an opportunity to have a browse through ACR21 or check out the Twitter feed for some quick updates.

  • L21 Rituximab versus Conventional Therapeutic Strategy for Remission Induction in Eosinophilic Granulomatosis with Polyangiitis: A Double-blind, Randomized, Controlled Trial
  • L10 A Randomized, Double-Blinded, Placebo-Controlled, Phase 2 Study of Safety, Tolerability and Efficacy of Pirfenidone in Patients with Rheumatoid Arthritis Interstitial Lung Disease
  • L12 Neither Add-on nor Withdrawal of Methotrexate Impacts Efficacy of IL12/23 Inhibition in Active PsA: Data from a Multicenter Investigator-initiated Randomized Placebo-controlled Clinical Trial on Arthritis, Dactylitis, Enthesitis, Psoriasis, QoL and Function

Dr Bonnia Liu is a final year rheumatology trainee pursuing dual training in rheumatology and nuclear medicine at Austin Hospital in Melbourne.

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