ACR Convergence 2022 Closing Session Discusses Research Highlights

PHILADELPHIA—Expert panelists gathered in the closing session at ACR Convergence 2022 to give their take on what they saw as some of the most notable research findings and other insights to come out of the meeting, touching on a number of topics on the leading edge of the field.

COVID-19 Prophylaxis & Vaccinations

Alfred Kim, MD, PhD, assistant professor of rheumatology at Washington University in St. Louis, Mo., mentioned studies that he said help clarify how to navigate COVID-19 treatments and vaccinations for people with rheumatic disease.

Patients receiving B cell depleting therapies for immune-mediated inflammatory diseases (IMIDs) who develop COVID-19 have a high risk of poor outcomes. Pre-exposure prophylaxis with tixagevimab/cilgavimab (Evusheld) has been available under an Emergency Use Authorization from the U.S. Food & Drug Administration since December 2021.

In a study out of the Cleveland Clinic, Calabrese et al. assessed the outcomes of more than 400 patients with IMID who were treated with tixagevimab/cilgavimab for COVID-19 prevention and had been vaccinated against COVID-19.¹ They found that only 13 patients had a breakthrough COVID-19 infection. Twelve of those had a mild disease course and recovered at home; one patient was hospitalized, but there were no deaths.

In another study of nearly 1,300 adult patients with autoimmune diseases who had had at least two doses of COVID-19 vaccine, Connolly et al. found that a third dose was associated with a reduced risk of a breakthrough infection during the Omicron wave.²

“I think there’s … good data … to give [our patients] confidence and push them in the right mind state [to] feel they can get these additional doses,” Dr. Kim said.

RA Prevention

Kristine Kuhn, MD, PhD, associate professor of rheumatology at the University of Colorado, Denver, noted the findings of the StopRA trial, which found that hydroxychloroquine did not seem to prevent development of RA in people with anti-CCP antibodies.³

“Unfortunately, it was a negative trial, but I think we are all waiting to see what the detailed results of that will be,” Dr. Kuhn said. She said the concept of prevention in those at risk is still viable.

“We’re getting better at identifying who we might want to intervene on at an earlier time point, but then I think we’ve got to get better at identifying the right medication,” she said.

Diet & Exercise for Knee OA

Daniel K. White, PT, ScD, associate professor at the University of Delaware, Newark, said a trial looking at intensive diet and exercise for patients with osteoarthritis (OA) was important because it was conducted in the community setting.⁴