The EULAR 2018 wound down on Saturday with fewer oral presentations but many posters. In my last report I put together a collection of impressions and some thematic highlights not covered in previous reports. Also some of these represent research and reporting trends – some healthy, others not so – that were evident at the EULAR 2018 meeting.
Our colleagues in gastroenterology measure drug levels with certain biologics used in inflammatory bowel disease in order to increase the dose for optimal benefit if the patient has a low trough level (i.e. targeting drug level).
There have been GI trials with T2T with drug levels but they are not always suggesting that the strategy is superior to usual care. Also, this is really not a common practice in rheumatology.
We are supposed to treat to a target (T2T) in RA. In other words, measure many components of the disease and its activity and calculate a score and if the patient is not in remission (or a low state if remission is not achievable) we are to make a treatment change.
The annual EULAR meeting just came to an end today. Rooms are gradually emptying out. People look both content to have updated their knowledge and relieved that four very busy days have concluded. Time to summarize.
I was delighted to see that investigators presenting work at EULAR 2018 haven’t lost interest in our old friend methotrexate, with a number of abstracts examining issues of safety, dose and route of administration.
Low incidence of methotrexate induced liver abnormalities
Day 3 highlights include Behcet’s responds to apremilast and that biologics do not differentially affect TKR/THR post-operative infection rates. Be sure to check out today's podcast as well.
A big concern of most is the risk of infection with use of tumour necrosis factor inhibitor (TNFi) and biologic drugs. While studied in both trials and in post-marketing studies, it is unknown if infection risk is dose-dependent.
In abstract OP0229 UK researchers have shown high biologic blood levels are associates with an increased risk of total infections in RA, but not serious infetions.
We're crazy busy at EULAR all week. Instead of this review, we recommend that you tune into our multiple podcasts from experts and faculty attending EULAR 2018 in Amsterdam. You can find these on iTunes, SoundCloud or Stitcher.
Each year I attend I hope that I’m going to come across something that changes my practice and this year, I think I may have struck gold at a session on Giant Cell arteritis at EULAR in Amsterdam.
