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#ClinicalPearl #SLE Rx tomorrow? Combine #Ritux+#Belimumab variable response, CART Rx for severe refractory #lupus, antiCD38i, drugs i. RCTs=hope for pts. #EULAR2022 T Dorner @RheumNow @eular_org https://t.co/2BReU5bhG0
Janet Pope Janetbirdope ( View Tweet)
No need to switch TNFi during pregnancy. Study compared high placental vs. low placental transfer TNFi- no sig difference for SIE in childhood. Dr. L Flatman comparing different TNFi in pregnancy: 26,000 offsprings #EULAR2022 @rheumnow OP0130 https://t.co/IF5hepQoHc
TheDaoIndex KDAO2011 ( View Tweet)
#SLE hospitalized pts had worse outcomes than matched controls ? Due to interfonopathy and poor handling of viral infections - worse if #Rituximab or #MMF T Dormer BUT vaccination works if enough B cells responding to #Covid vaccine #EULAR2022 #Lupus scientific session @RheumNow https://t.co/MBb3Dvxmqp
Janet Pope Janetbirdope ( View Tweet)
Million $$$ questions presented to Prof T Dorner: anifrolumab vs. belimumab for #SLE? He prefers belimumab d/t more data on multiple organ manifestations ^ it might be protective in pts w/ COVID19 infection. If skin dz is predominant, then anifrolumab #EULAR2022
@rheumnow
TheDaoIndex KDAO2011 ( View Tweet)
#Belimumab safety in pregnancy
EudraVigilance database retrospect study 47 preg: BEL stopped 1st trimester (group A) vs. cont'd (group B)
- no diff in fetal death
- more preterm birth/low birth weight, congenital malform'n in group A (not stat sig) #EULAR2022 @rheumnow POS0705 https://t.co/sLQ3MHNcWa
TheDaoIndex KDAO2011 ( View Tweet)
#COVIDvaccine is effective in active and inactive #SLE disease. Noted reduced response for MMF, MTX, GC>10 mg/day. Threshold of B cells is 9+ cell/uL to have a vaccine response. Prof T Dorner #EULAR2022 @rheumnow https://t.co/qyNUZxMccD
TheDaoIndex KDAO2011 ( View Tweet)
#SLE responses with #anifrolimumab separate vs standard of care+placebo& LLDAS at 12 weeks-predictor was high Type I IFN (younger, ⬆️disease activity) but diff sig for response w #belimumab. At bedside diff to tell pts with various signatures apart. #EULAR2022 @RheumNow Dorner https://t.co/98Sb3MIEps
Janet Pope Janetbirdope ( View Tweet)
#OP0143 #EULAR2022 We need to screen/monitor our patients with #lupus for infection. Amsterdam cohort (>200 pts) reported association of infection and flare. 50% were on steroid. Infection type did not influence flare @RheumNow https://t.co/Pxpx5hXLv9
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Another promising drug for #SLE! Monoclonal Ab to BDCA2 ; phase II study noted improvement in joint manifestation but not impressive in cutaneous dz. - Prof T Dorner #EULAR2022 @rheumnow https://t.co/eKwQyomJUD
TheDaoIndex KDAO2011 ( View Tweet)
#ClinicalPearl 2/3 of pts with #SLE have Type 1 interferon signature. So, 1/3 of #lupus is NOT driven by this pathway. Importance may be what is targeted in each pt but doesn’t necessarily predict response to #anifrolimumab #EULAR2022 @eular_org @RheumNow T Dorner SLE session https://t.co/vMOC8yGJ2V
Janet Pope Janetbirdope ( View Tweet)
#OP0144 #EULAR2022 Promising Digital use in monitoring disease activity for clinicians. Researchers in Amsterdam developed the first e-health #SLE T2T. High acceptance rate re: usability. Need more validation and in different languages @RheumNow https://t.co/7LravXhoJ8
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#ClinicalPearl #SLE has ⬆️mortality until v advanced age and if not in remission or v low disease activity Mortality is higher. Ideas: control disease activity, prevent damage, limit prednisone. @RheumNow #EULAR2022 T Dormer Session #Lupus https://t.co/90cpsBVgAb
Janet Pope Janetbirdope ( View Tweet)
#OP0141 #EULAR2022 What do our #lupus patients think about Treat-to-target (T2T) and are they involved? A patient survey showed improvement in QoL as most important. They were open to T2T concept but concerned of more visits + new drugs. 61% felt they were involved @RheumNow https://t.co/rT500lhrih
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#POS0114 #EULAR2022 Can we identify #lupus patients better in electronic health records? Barbero et al. used machine learning and developed a model to distinguish SLE diagnosis vs "near-misses". AUC: 0.90. Further validation can help future epidemiological studies @RheumNow https://t.co/vpLH8SWlWm
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Severe heme relapses are common in #SLE pts w/prior severe heme episodes: ATTIKON SLE cohort 800 pts
👉13% w/severe heme dz: TMA, MAS, plt < 30K, hemolysis hgb < 8
👉heme issues preceded SLE dx in 1/3 of pts
👉>50% pts had severe heme flare
👉0 deaths #EULAR2022 @rheumnow POS0116
TheDaoIndex KDAO2011 ( View Tweet)
Low rates of hypersensitivity reactions (HSR) to #anifrolumab
Pooled data MUSE & TULIP-1/-2 w/1100 pts:
👉1 anaphylaxis (0.15%)
👉12 HSR (3%)
👉43 infusion reaction (9%): N/V/headache
👉most easily treatable w/antihistamine, GCs, acetaminophen
#EULAR2022 POS0708 @rheumnow
TheDaoIndex KDAO2011 ( View Tweet)
#POS0086PARE #EULAR2022 What #lupus symptoms/target mattered most to the patients?A survey in 342 found reduction in joint pain, rash & non-joint pain as most important. Reduced infection risk was the least. Important to be aware in assessing patients & guide studies @RheumNow https://t.co/pGXxklj1mt
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#OP0002 #EULAR2022 What immune tests to monitor during pregnancy in #lupus? A meta-analysis found:
💠32% had a flare (new IS or Pred>9mg/d)
💠⬇️C3 and/or C4 in 1st Trimester predicted LN or SLE flare
Worth checking C3/C4 in each trimester @RheumNow https://t.co/fPEXwReK7u https://t.co/BX6fzKzfvC
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#POS0183 #EULAR2022 Pooled analyses of 5 Belimumab RCTs showed better response vs PBO in those:
💠SLEDAI=>10
💠dsDNA+ve + ⬇️C3 and/ ⬇️C4
💠⬇️C3 and/ C4 pre-treatment
💠Response high regardless SDI, Steroid, #lupus duration
@RheumNow https://t.co/fLggazbRQu
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#POS0190 #EULAR2022 Disappointing news. Despite +ve Phase 2 RCT, Results from Phase 3 RCTs of Baricitinib in #lupus is inconclusive
💠SRI4 was met in BRAVE1 but not BRAVE2 despite identical study
💠BILAG MSK & Skin improved in BRAVE1 only
BICLA wasn’t reported @RheumNow https://t.co/IfJRYEwFY8
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
