Orencia (abatacept)

Agreed positions included caution with JAK inhibitors (JAKi) in older patients and in those with CV/VTE risk; preference for IL-6 receptor inhibitors or JAKi for monotherapy or prominent systemic inflammation; in RA-ILD, use a b/tsDMARD with a non-TNFi mechanism; rituximab as first choice in rheumatoid vasculitis; abatacept in infection-prone patients; discouraging JAKi in prior malignancy; and TNFi as acceptable during pregnancy. Two statements did not reach consensus: preferential use of non-TNFi in obesity and heightened caution with tofacitinib in osteoporosis or fracture risk. This Delphi-validated, profile-based framework provides a practical tool to support evidence-informed clinical decision-making.

P2, N=30, Active, not recruiting, Emory University | Trial completion date: Jan 2026 --> Mar 2027 | Trial primary completion date: Jan 2026 --> Mar 2027

P3, N=400, Recruiting, Duke University | Not yet recruiting --> Recruiting

P2, N=160, Recruiting, Boston Children's Hospital | Active, not recruiting --> Recruiting

P2/3, N=45, Not yet recruiting, Duke Clinical Research Institute

P=N/A, N=72, Recruiting, Hospital for Special Surgery, New York | Trial completion date: Dec 2025 --> Dec 2026 | Trial primary completion date: Dec 2025 --> Dec 2026

P1, N=20, Not yet recruiting, National Cancer Institute (NCI)

P2, N=27, Active, not recruiting, NYU Langone Health | Trial completion date: Aug 2026 --> Jan 2027 | Trial primary completion date: Aug 2025 --> Jan 2027

P2/3, N=64, Recruiting, Federal Research Institute of Pediatric Hematology, Oncology and Immunology

We aimed to analyse incident malignancies under treatment with JAKi, tumour necrosis factor inhibitors (TNFi), abatacept (ABA), rituximab (RTX), interleukin 6 inhibitors (IL6i) or conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs - bionaive) in patients with rheumatoid arthritis (RA) observed in daily rheumatological care. IR of malignancies in selected patients receiving JAKi in a real-world setting was numerically higher than the IR reported for tofacitinib in the Oral Surveillance study. However, we found no statistical evidence of an increased risk of malignancies with JAKi compared to TNFi, although patients on JAKi were older and had longer disease duration and more previous b/tsDMARDs treatments. Further analyses assessing exposure in terms of treatment duration are needed.

Case Report A 69 -yo f with a PMH of type 2 DM, hypertension, obstructive sleep apnea, high-grade PT3NO urothelial cancer with status post-cystectomy, and two cycles of ICI with nivolumab presented to the clinic 11 days following her second dose of chemotherapy with nivolumab with symptoms of dyspnea...Myocardial biopsy results showed interstitial lymphocyte infiltrates with myocardial injury confirming the suspected diagnosisGoal-directed medical therapy was initiated for heart failure with a newly reduced ejection fraction with IV lasix, hydralazine, and isosorbide dinitrate...Even though evidence guiding treatment of ICI-induced myocarditis is not evidence-based, inflammatory responses of a higher grade on endomyocardial biopsy should prompt intensification of immunosuppression with regimens like mycophenolate mofetil,abatacept or alemtuzumab (11-13) in addition to high-dose steroids...This case described the diagnostic approach and management of ICI-induced myocarditis with third-degree heart block and cardiogenic shock. Initial workup with cardiac biomarkers, ECG, TTE, and myocardial biopsy during right heart catheterization was critical in treatment decision-making and ruling out other potential causes.

P2, N=15, Active, not recruiting, Roswell Park Cancer Institute | Trial primary completion date: Apr 2023 --> Jul 2023