The Entheseal 8 (third round) of RheumMadness is complete!  After a tournament full of upsets, this round seemed to go smoothly for the favorites. To see how your bracket is doing, head over to the RheumMadness Tourneytopia website.

Results for reach matchup in the second round are reviewed below, including how the  Blue Ribbon Panel (BRP) voted compared to participant picks.

Match-up 1: Etanercept for RA defeats TICORA (5-1)

TICORA missed the target in this one, losing to Etanercept for RA in a 5-1 vote from the BRP. Here’s why the panel picked Etanercept for RA:

• “Introduction of successful biologic therapy into RA with just gorgeous dose response curves was groundbreaking. T2T strategy of TICORA is nice but was already also being studied in other concurrent trials in RA like the BEST trial.”
• “Etanercept was the original quantum shift in ‘modern’ era rheumatology.”

Did the panel get it right? YES. According to participant picks, the BRP nailed this one. Here’s a breakdown of all participant picks for the winner of this round:

• Etanercept for RA: 25%
• TICORA: 20%
• TEAR Triple Rx: 20%
• Etanercept + MTX: 13%
• Infliximab for RA: 12%
• BeSt: 8%

Match-up 2: Abs Before SLE defeats Clonal Selection (5-2)

Abs Before SLE pulled out the win in this match-up, defeating Clonal Selection 5-2 in BRP votes. Here’s why:

• “Both studies are giving us lots of clues about pathophysiology that we still have yet to decipher. But Abs before SLE provides more practical information to fuel discovery and perhaps at the moment more relevant to rheumatology – or at least at the moment is a more famous paper in rheumatology.”
• “Coach Burnet of Forbidden Clones wrote the transformational playbook about antibody formation that was later exploited by Coach Arbuckle’s Abs Before SLE team. So Abs should advance.”

The majority of participants also picked Abs Before SLE in this match-up.  Here’s a breakdown of all participant picks for the winner of this round:

• Abs Before SLE: 46%
• MSU & NLRP3: 20%
• Clonal Selection: 15%
• Pathogenic ANCA: 11%
• CCP & Enolase: 8%

Match-up 3: RAVE defeats CYC for PAN (6-1)

Rituximab tied cyclophosphamide in RAVE, and the BRP felt that was enough for the win in RheumMadness, with RAVE defeating CYC for PAN 6-1. Here’s what they had to say:

• “RAVE was an elegant trial and finally allowed us to have a less toxic treatment option for ANCA+ disease.”
• “Cyclophosphamide is on the decline in rheumatology, and for AAV rituximab is increasingly standard of care thanks to this trial. Both trials impressively conducted with very little preliminary data to support efficacy.”

In contrast, the lone supporter of CYC for PAN said this: “RAVE and CYC for PAN were equally important for patients, but the Fauci/Wolff study was just more transformational and groundbreaking.”

What did participants think? The overwhelming majority picked RAVE.  Here’s a full breakdown of participant picks for this match-up:

• RAVE: 46%
• HCQ Withdrawal: 18%
• ALMS Trial: 11%
• ULT During Flare: 11%
• CYC for PAN: 8%
• CYC in Scleroderma: 6%

Match-up 4: Cortisone defeats HAQ (6-1)

Cortisone entered the tournament as a heavy favorite, and it continued its dominant run in this matchup, defeating HAQ 6-1. Here’s what the BRP had to say:

• “Research papers come in all shapes and sizes, but not too many lead to Nobel prizes.”
• “The granddaddy”. Can’t imagine a rheum without steroids in their back pocket!!

In contrast, the lone supporter of HAQ said this: “You can’t play the game today without both cortisone and PROs like HAQ. But only one will survive well into the future. Clinicians and clinical researchers will always need the HAQ. It may bust brackets, but HAQ gets my vote.”

The majority of participants also picked cortisone to win this round. Here’s a full rundown of participant picks:

• Cortisone: 65%
• LUMINA: 17%
• HAQ: 11%
• Origin of RA: 6%
• Origin of sJIA: 1%

What’s up next?

Results for the next 2 rounds will be released on the following dates:

• Round 4: Saturday, April 1 (the IgG Four)
• Round 5: Monday, April 3 (the Interleukin Two, aka the championship!)

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