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Victoria Johnson joined the MJH Life Sciences in 2020 and has written for NeurologyLive, CGTLive, and now HCPLive. You can reach her at vjohnson@mjhlifesciences.com

Articles

Multi-Stakeholder Collaboration Makes 2024 a Landmark Year for Biosimilars

Chelsie Derman is an assistant editor for 

who covers psychiatry, sleep medicine, and geriatrics. She joined MJH Life Sciences in September 2023 after graduating from The College of New Jersey with a bachelor’s degree in journalism and professional writing. In her free time, she enjoys creative writing and reading.

From FDA approvals to updated guidelines, 2024 brought transformative advancements in sleep medicine, offering new hope for managing complex sleep disorders.

Sleep Medicine Year in Review: 2024

Tim Smith joined the MJH Life Sciences team as an assistant editor for HCPLive in August 2022. He graduated from UC Berkeley with a degree in political science, working in multimedia journalism as a staff writer prior to joining MJH. In his spare time, he enjoys reading, watching TV, listening to podcasts, and rock climbing. You can contact him at 

In this episode of Crisis Point, this year’s news regarding benzene found in acne products is discussed by David Light, Neal Bhatia, MD, and Christopher Bunick, MD, PhD.

Crisis Point: Benzene Concerns in Acne Care

Atogepant 60 mg, an oral CGRP receptor antagonist, demonstrated rapid and effective migraine prevention, reducing frequency and improving function in 4 weeks.

Atogepant 60 mg Demonstrates Superior to Placebo for Migraine by Day 1

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clinical page is a resource for content on every specialty, disease, and topic available on our medical news site.

Clinical Topics

Sustained remission was observed in more patients receiving rituximab and concomitant avacopan compared with those treated with concomitant prednisone.

Rituximab Plus Avacopan Increases Remission Rates in ANCA-Associated Vasculitis 

A review and a research study take a closer look at the small vessel disease that's generally tied to hepatitis C but may arise in autoimmune disorders. The latter finds new markers for severity.

Cryoglobulinemia: The Basics, and Two Revelations

Phase 3 Upadacitinib Trial Shows Promising Results for GCA Treatment

, Daniel Blockmans, MD, PhD, discussed a phase 3, randomized, placebo-controlled trial that compared 2 doses of upadacitinib versus placebo among a cohort of patients with giant cell arteritis (GCA). The findings, presented at the 

2024 European Congress of Rheumatology (EULAR)

 conference, focused on the first 52-week study period. The second study period is scheduled to conclude in March 2025.

In this first year, 428 patients were randomized to receive upadacitinib 15 mg (n = 209), upadacitinib 7.5 mg (n = 107), or placebo (n = 112). The placebo group received a 1-year taper of steroids, which is the standard of care for GCA. The upadacitinib groups received 6 months of steroids as background therapy.

The primary endpoint was the proportion of patients in sustained remission at 52 weeks. The results were positive, with the 15 mg upadacitinib group showing significantly better outcomes compared with the placebo group. Although the 7.5 mg upadacitinib group did not reach statistical significance, it was close and fell between the placebo and 15 mg groups. Additionally, 9 out of 11 multiplicity-controlled secondary endpoints with upadacitinib 15 mg were positive.

Blockmans noted he and his team were pleasantly surprised by the low incidence of side effects. There were only 2 cases of major cardiovascular events, both in the placebo group. Venous thromboembolism rates were balanced between groups, and there was no increase in cancer incidence, despite the elderly average patient age of 71.5 years.

While upadacitinib is not yet approved, he is hopeful for even better treatments. Current treatments like steroids and tocilizumab, an interleukin (IL)-6 inhibitor, can manage the clinical symptoms and acute phase response, but they do not cure the disease. He and his team aim to find drugs that have fewer side effects than steroids and a deeper impact on the underlying vasculitis.

The goal is to eliminate the smoldering vasculitis present in steroid or tocilizumab-treated patients, which can eventually lead to aortic dilation. This potential will be further investigated in the second year of the trial and other future studies that include imaging and reimaging to determine if the vasculitis has truly been resolved.

Disclosures: Blockmans has no relevant disclosures to report.

Daniel Blockmans, MD, PhD, discussed the results of a phase 3 trial that revealed upadacitinib significantly improved outcomes in patients with giant cell arteritis.

Conference

Phase 3 Upadacitinib Trial Shows Promising Results for Giant Cell Arteritis Treatment

Advances in Research and Emerging Therapeutic Options in Vasculitis, with Anisha Dua, MD, MPH

There has been a significant surge of interest and research in antineutrophil cytoplasmic antibodies (ANCA) vascularity, making it an exciting time for understanding management options, pathophysiology, biomarkers, and disease approaches. In an interview with 

, Anisha Dua, MD, MPH, highlights the importance of this research, especially given the life-threatening nature of diseases like eosinophilic granulomatosis with polyangiitis (EPGA), granulomatosis with polyangiitis (GPA), and microscopic polyangiitis (MPA). Her focus is on ANCA vasculitides, shedding light on advancements in therapeutic regimens for EPGA and exploring the roles of plasmapheresis and glucocorticoid strategies in GPA and MPA.

Despite these advancements, the diagnostic landscape remains challenging, lacking a perfect blood test or imaging study. Dua emphasizes ongoing efforts to refine diagnostic abilities with better biomarkers and prognostic clues. The next frontier involves identifying patients' responses to specific treatments based on individual markers or features, aiming to minimize the glucocorticoid burden and address long-term steroid toxicity concerns.

She touches upon ongoing research and diagnostic challenges, addressing questions about when to escalate therapy or adopt more aggressive immunosuppression. Dua emphasizes the need for predicting relapses and intervening early to prevent major damage and discusses ongoing research in the field, especially in eosinophilic diseases, drawing insights from pulmonary and allergy colleagues.

Dua mentions the MIRRA trial, which studied mepolizumab and was approved for use in EPGA. The mechanism of mepolizumab, targeting IL-5 in the th2 or eosinophilic pathway, provides a promising approach. Other drugs like benralizumab and an IL-4 blockade are under development, offering potential options for patients. In GPA and MPA, some studies focus on sparing glucocorticoids.

Dua expresses optimism about the evolving landscape, with new therapeutic targets and options under development. Despite the challenges of managing vasculitis, she encourages clinicians to engage with these complexities, learn from varied experiences, and stay updated on the latest advances.

“What I like about [RWCS] is that there's a lot of back and forth and a lot of different people who have had varying clinical experiences,” Dua concluded. “It's always really nice to have more voices at the table and to hear how people are approaching these diseases differently. Then, we can learn from each other.”

Dua consults for AMGEN, GSK, Sanofi, AstraZeneca, Abbvie, and Sandoz. She receives grant funding from the Rheumatology Research Foundation Clinician Scholar Educator Award, and serves on the board of directors at the Vasculitis Foundation and the Chicago Rheumatism Society.

Anisha Dua, MD, MPH, delves into recent research advancements, diagnostic hurdles, and emerging therapeutic options in vasculitis.

Advances in Research, Emerging Therapeutic Options in Vasculitis, with Anisha Dua, MD, MPH

Vasculitis

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