Round 1 Results

The first round of the RheumMadness tournament is complete!  We received 142 bracket submissions from participants in 13 countries – the most we’ve ever had.

To see how your bracket is doing, head over to the RheumMadness Tourneytopia website.

Results for reach matchup in the first round are reviewed below, including how the  Blue Ribbon Panel (BRP) voted compared to participant picks. Huge thanks to our amazing panel for their thoughtful consideration.

Overall, the first round was incredibly close – 4 of the 6 match-ups were decided by a single vote!  In fact, we had to pull in an extra Blue Ribbon Panel member to break a tie for BeSt vs. TICORA.

Match-up 1: Etanercept for RA (4) defeats Etanercept + MTX (3)

This was a real nail-biter! In the end, Etanercept for RA won in a 4-3 vote. This team will move on to face Infliximab for RA in the next round.

Comments from BRP members who voted in favor of Etanercept for RA:

  • “First in human is a big deal”
  • “First out of the gate study on TNFi…game changer at the time”
  • “Presenting the first biologic drug in RA – quite transformational!”

In contrast, a BRP member who voted in favor of Etanercept + MTX said, “This trial was pivotal to the FDA’s approval of etanercept in MTX non-responders.”

Did they get it right?  According to participant brackets, 59% picked Etanercept for RA and 41% picked Etanercept + MTX.

Match-up 2: TICORA (4) defeats BeSt (3)

This was the closest match-up we’ve ever had. Because Dr. Worthing’s group wrote the scouting report for TICORA, he had to abstain from this vote.  Chaos ensued, as the rest of the BRP members were split, 3-3.  To settle the score, we called in an alternate BRP member, Dr. Donald Thomas (creator of The Lupus Encyclopedia, @lupuscyclopedia) to break the tie.  Ultimately, in the words of Dr. Thomas, “TICORA out Bested BeST.”  WOW what a matchup. TICORA will now move on to face TEAR Triple Rx in the next round.

One BRP member who voted in favor of TICORA said this: “Both are relevant concepts (early treatment and radiographic outcomes vs T2T) behind our current practice. Still, the proof of T2T is an important concept that has expanded beyond RA and is relevant to our current approach to treatment.”

In contrast, we have two comments from BRP members who voted for BeSt, as follows:

  • “Reversing the old RA “pyramid” treatment paradigm, this study showed that early aggressive treatment, whether with conventional or biologic DMARDS, leads to better outcomes.”
  • “BeSt revolutionized clinical trial design in rheumatology.”

Did they get it right?  According to participant brackets, 54% picked TICORA and 46% picked BeSt.

Match-up 3: Pathogenic ANCA (4) defeats CCP & Enolase (3)

Pathogenic ANCA won this one in another 4-3 vote and will move on to face Abs Before SLE in the next round.

Two BRP members had this to say in support of Pathogenic ANCA:

  • “An elegant animal model that demonstrated that ANCA is more than just a biomarker.”
  • “Pathogenic ANCA more definitively established causality.”

In contrast, a BRP member who voted in favor of CCP & Enolase said this: “Tantalizing to provide a possible reason for our patients condition, and could promise prevention or cure to so many with RA — even if that ball is still rolling around the rim!”

Did they get it right?  According to participant brackets, 61% picked Pathogenic ANCA and 39% picked CCP & Enolase.

Match-up 4: CYC for PAN (5) defeats CYC in Scleroderma (2)

CYC for PAN pulled away late in a 5-2 victory over CYC in Scleroderma. Dr. Fauci’s Favorites will move on to face ULT During Flare in the next round.

The BRP said this in favor of CYC for PAN:

  • “This study was a game changer in the management of PAN.”
  • “Not just a game changer but a life-saver for patients.”
  • “Despite having fewer players, CYC for PAN broke the ground for cyclophosphamide to be used by later teams like CYC in Scleroderma. And the remission efficacy may win the #RheumMadness 2023 Slam Dunk contest!”

In contrast, one BRP member said this in favor of CYC for Scleroderma: “Sorry, Dr Fauci but the Scleroderma lung studies were studied and re studied and subgroup analyzed to death when they game out.”

Did they get it right?  According to participant brackets, only 45% picked CYC for PAN and 55% picked CYC in Scleroderma.  Upset city!

Match-up 5: ALMS Trial (4) defeats HCQ Withdrawal (3)

Oh. My. Goodness. The BRP did NOT choose hydroxychloroquine. They picked ALMS in a 4-3 shocker. ALMS will move on to face RAVE in the next round.

It seems the BRP felt the need to defend their choices as we had more comments about this one than any other match-up.  Those who favored ALMS had this to say:

  • “ALMS transformed the management of lupus nephritis (but this was a very hard pick).”
  • “More ambitious of a trial.”

In contrast, those who picked HCQ Withdrawal said this:

  • “A study I still quote today in daily practice when patients ask if they can stop HCQ. Bit of a no brainer for me.”
  • “Still a pillar in the management of SLE. Great study, always have by your side when “sparring” against ophthalmology LOL.”
  • “HCQ is truly the moneyball of rheumatology! (Even if the A’s didn’t actually win that World Series!)”

Did they get it right?  This one was INCREDIBLY close among participants, with 52% picking ALMS and 48% picking HCQ Withdrawal. What a match-up!

Match-up 6: Origin of RA (6) defeats Origin of sJIA (1)

This was the only blow-out in the first round, with Origin of RA taking the victory 6-1.  To the RheumMadness Leadership team, this means we need more pediatric rheumatology in the tournament next year.  Calling all pediatric rheumatology fellowship programs – please submit teams and write scouting reports so we can have more peds topics!  Origin of RA will move on to face cortisone in the next round.

Here’s what the BRP had to say in favor of Origin of RA:

  • “This was the first recognition that there were different forms of inflammatory arthritis, not just gout.”
  • “Paradigm shifting.”
  • “Landre-Beavais is the James Naismith of rheumatology! Still had more patients, but his paper came out 97 years later, and although JIA’s origin was transformational, fortunately JIA affects many fewer people than RA.”

In contrast, the lone supporter of Origin of sJIA said this: “Kudos to the team for dissecting an article this old! A study that moved the needle from “evil humours.”

Did they get it right?  According to participant brackets, 77% picked Origin of RA and 23% picked Origin of sJIA.

What’s up next?

Results for the next 4 rounds will be released on the following dates:

  • Round 2: Saturday, March 25 (the Seronegative Sixteen)
  • Round 3: Tuesday, March 28 (the Entheseal Eight)
  • Round 4: Saturday, April 1 (the IgG Four)
  • Round 5: Monday, April 3 (the Interleukin Two, aka the championship!)

[wysija_form id=”1″]

Leave a Reply

Your email address will not be published. Required fields are marked *