As we have come to expect, EULAR 2024 was a busy and productive meeting, packed with news and lively discussions among rheumatologists. The conference, which took place in Vienna, Austria, highlighted a wealth of innovative research and significant advancements in rheumatology. From new treatments to groundbreaking clinical studies, the abstracts presented this year showcased exciting progress in understanding and managing various rheumatic diseases. Here, we share some of the standout data and findings that caught everyone’s attention and promise to influence future clinical practices.
Upadacitinib shows promise in phase III trial for giant cell arteritis
Findings from the phase III SELECT-GCA trial (NCT03725202), highlighted upadacitinib’s potential as an effective oral therapy for giant cell arteritis (GCA). The trial aimed to evaluate the safety and efficacy of upadacitinib, a JAK inhibitor, known for its strong inhibition of IL-6 and IFN-γ, crucial cytokines in GCA pathogenesis.
The double-blind, placebo-controlled trial included 428 patients aged 50 and above, diagnosed with new-onset or relapsing GCA. Participants were randomized to receive either upadacitinib 7.5 mg or 15 mg daily, along with a 26-week glucocorticoid taper regimen (GC), or placebo with a 52-week GC taper regimen. Patients previously treated with JAK inhibitors, IL-6 inhibitors or chronic systemic glucocorticoids were excluded.
Results revealed that 46% of patients treated with upadacitinib 15 mg achieved sustained remission at week 52, compared to 29% in the placebo group (p=0.0019). Secondary endpoints also favored upadacitinib 15 mg, with 37% of patients achieving sustained complete remission from week 12 to week 52, compared to 16% with placebo (p=<0.0001). Additionally, upadacitinib significantly reduced the risk of flare-ups, improved FACIT-Fatigue scores, and lowered cumulative glucocorticoid exposure (1,615 mg versus 2,882 mg; p=<.0001).
Safety profiles were comparable between the upadacitinib and placebo groups, with similar rates of VTE, serious treatment emergent adverse events, and malignancies (excluding non-melanoma skin cancer). Some numerical differences in serious infections and MACE were noted, being higher in the placebo group, while rates of herpes zoster, lymphopenia, anaemia and non-melanoma skin cancer were higher in the upadacitinib group.
Nipocalimab significantly improves sjögren’s disease activity in phase II study
Late-breaking results from the phase II DAHLIAS dose-ranging study (NCT04968912) show that nipocalimab significantly improves Sjögren’s disease (SjD) activity. Patients receiving nipocalimab 15 mg/kg experienced over 70% relative improvement on the primary endpoint compared to placebo, with statistically significant (P=0.002) and clinically meaningful enhancements in ClinESSDAIa scores at 24 weeks. Improvements were noted as early as Week 4 and continued throughout the study.
These findings mark the first positive results for nipocalimab in SjD, a chronic and debilitating autoantibody disease with no approved advanced treatments. Additionally, patients showed clinically meaningful improvements in secondary endpoints, including organ assessments, physician evaluations, and composite clinical trial tools, alongside trends of symptom relief in mouth, eye and vaginal dryness.
The safety and tolerability profile of nipocalimab was consistent with previous studies, with reductions in total IgG and autoantibodies aligning with its mechanism of action.
COSPIRIT-JIA trial shows high response rates in juvenile PsA and ERA
The ongoing COSPIRIT-JIA trial enrolled 101 children with active juvenile PsA (JPsA) or enthesitis-related arthritis (ERA). At 16 weeks, efficacy and safety data were presented at EULAR 2024. Nearly 90% of participants achieved ACR30 with ixekizumab, and 95% with adalimumab, although the trial wasn’t designed for direct comparison. The adaptive trial included biologic-naïve and experienced patients. Ixekizumab response was higher in biologic-naïve patients. Adverse events were mostly mild or moderate, with no discontinuations due to adverse events. The study continues with follow-ups planned up to 264 weeks. Both drugs showed promising results in improving JPsA and ERA symptoms.
SHR0302 shows significant improvement in rheumatoid arthritis in phase III trials
Results from a phase III trial showed that the selective JAK1 inhibitor SHR0302 significantly improves clinical signs and symptoms in patients with moderate-to-severe active rheumatoid arthritis (RA). The trials included 566 patients who had shown poor response to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). Participants were randomized to receive either placebo, SHR0302 4 mg or 8 mg daily for 24 weeks.
The SHR0302 groups showed substantial improvements in ACR response criteria, with 70.4% (4 mg) and 75.1% (8 mg) achieving ACR20, compared to 40.4% in the placebo group. Additionally, SHR0302 improved ACR50 and ACR70 responses, and DAS28-CRP scores and reduced glucocorticoid use. The improvements persisted over 52 weeks with good safety and tolerability, showing no new safety signals or deaths. Infections were slightly more frequent in SHR0302 groups, with few serious adverse events reported. SHR0302 offers a promising new treatment option for RA patients.
Disclosures:Â This article was created by the touchIMMUNOLOGY team utilizing AI as an editorial tool (ChatGPT (GPT-4o) [Large language model]. https://chat.openai.com/chat.) The content was developed and edited by human editors. No funding was received in the publication of this article.
