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#Editor’s #Choice
@MatsJunek
Who #relapses in
#ANCA #vasculitis
In #Pexivas trial
#Renal #failure may be protective from relapses.
Seems to be the case in renal #lupus #GN too~my opinion
?Why 🤷
#EULAR2024 #EULARBEST @ARD_BMJ
@RheumNow @eular_org @ACR_Journals https://t.co/kUD1qjnwqE
Links:
Janet Pope Janetbirdope ( View Tweet)
I was allocated to bring down the warning, & I did apologise up front to both the EMA and Janet #EULAR2024. It's a tough gig regulating impactful medicines with risk-benefit, especially when our world is full of other medicines with risk-benefit trade-offs (like prednisolone). 2/ https://t.co/6YPhYHbhg8
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David Liew drdavidliew ( View Tweet)
So how do we get from slightly increased numbers of uncommon events in a single study (ORAL Surveillance)?
Regulators think differently to us, which partly is the difficulty of a restrictive warning.
So being the Aussie I am, I asked - does it pass the 'pub test'? 4/ #EULAR2024 https://t.co/Ih9H87wH22
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David Liew drdavidliew ( View Tweet)
Having said that, the EMA warning has elements making it extremely tough:
- still very broad criteria that capture 80% of people who were starting JAKi
- the need for "no suitable treatment alternatives" before using a JAKi, right across all diseases (not just RA) 3/ #EULAR2024 https://t.co/IsrYO7qzqM
Links:
David Liew drdavidliew ( View Tweet)
So I think there is plenty we could do instead.
better regulation
better risk stratification
better counselling
better risk factor management
(and definitely read this if you want to be a good clinician: https://t.co/RA6ktQB7gm)
18/ #EULAR2024 https://t.co/bC5nmi8SoM
Links:
- The Art of Communicating Risk and Benefit to Promote Shared Decision‐Making, In…
- https://twitter.com/drdavidliew/status/1801144689774735739/photo/1
- https://twitter.com/drdavidliew/status/1801144689774735739/photo/1
- https://twitter.com/drdavidliew/status/1801144689774735739/photo/1
- https://twitter.com/drdavidliew/status/1801144689774735739/photo/1
David Liew drdavidliew ( View Tweet)
My friend the late, great @philipcrobinson and I wrote @TheLancetRheum about what we could learn from COVID about preventative medicine.
https://t.co/55j8rduvyn
It's worth us thinking how we can do better by our patients.
18/ #EULAR2024 https://t.co/zlDKYngsu0
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David Liew drdavidliew ( View Tweet)
Here's my 'pub test' for whether the warning is appropriate. And, debate aside, I do believe that it behoves any regulator to consider the unintended consequences of their regulation, because regulation has real consequences. 5/ #EULAR2024 https://t.co/aurbAwgl9P
David Liew drdavidliew ( View Tweet)
The original direct comparison study! https://t.co/hqrPKfNW1y
Bella Mehta bella_mehta ( View Tweet)
Computer vision/ image analysis is performing very well in rheumatology and can extend help to low resource settings easily! #EULAR2024 https://t.co/8doM7foriM
Bella Mehta bella_mehta ( View Tweet)
SLE RPI may be used more frequently
and can connect the digital dots! @RheumNow https://t.co/UdVIyZJhJV
Bella Mehta bella_mehta ( View Tweet)
Deep learning models are detecting CPPD in radiographs pretty well!! Abst#0112 #EULAR2024 presented by @ThomasHugle ...@RheumNow https://t.co/9z3VVbyyh0
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Bella Mehta bella_mehta ( View Tweet)
Day 1 #EULAR2024 Do you want to learn about the effectiveness of rituximab for systemic features of #Sjogren and potential strategies to overcome non-response? Please come to my talk today (OP0076) and say hi 👋🏼 😃 Room C7 at 1720 hr CET @RheumNow https://t.co/uo2ivC5AeY
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2024 OP0077 Please find an interview with my dear colleague @edvital on the importance of achieving and sustaining B cell depletion for improved clinical response in #lupus #SLE @RheumNow
https://t.co/4rTtFWxSvs https://t.co/4esoFTsgzC
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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2024 OP0124 EULAR recommended target oral Pred =<5mg/d. Should the threshold of LLDAS be changed to LLDAS5? Multicentre study showed the protection gained from mortality, irreversible organ damage accrual and flare was no different btw the two targets @RheumNow #EULARBEST https://t.co/GbP25tTmX8
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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2024 OP0145 Can we reclassify people with ANA+ RMD to improve clinical outcomes & stratify for basket trials? Deep machine learning identified distinct classes of ANA-RMD with distinct phenotypes & predicted long-term outcomes better than the legacy diagnoses @RheumNow https://t.co/W2hmmj0v8Y
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2024 OP0149 When the Doctor says YES but the patients say NO. Data from UK BILAG-BR in moderate to severe #lupus showed ~half patients who met clinical response did not improve their psychological wellbeing. Factors of discordant: ancestry, damage, SLEDAI-2K @RheumNow https://t.co/9cqcPripA2
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2024 OP0180 Can we safely taper GC in #lupus patients who are in remission? Single study in Italy showed in pts with SLEDAI=0 + pred =<5mg/d + stable IS/HCQ, GC discontinuation after proper tapering appeared safe and was associated with a low risk of flare @RheumNow https://t.co/8IIgPuZUrF
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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2024 OP0187 Can we identify a subgroup of #lupus patients at the outset who may benefit from early intensive therapies inc biologics? Data from an inception cohort showed low complement & cSLEDAI=>9 were assoc w increased risk of intensive therapy need/Tx failure @RheumNow https://t.co/jmahjcqom3
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
New targets and new treatments in #Sjogren’s disease:
Long term outcomes of repeat cycles of RTX
#EULAR2024
CB https://t.co/6fL3e33i8N
Annals of the Rheumatic Diseases ARD_BMJ ( View Tweet)