All News
EULAR 2023 – Day 2 Report
Day 2 at the international EULAR Congress meeting is always bigger and busier. There were sessions on JIA therapies, crystal arthritis, novel drugs for SLE and Sjogren's, early RA and preclinical RA interventions, IgG4 disease, osteoporosis and the growth and application of artificial intelligence in medicine and rheumatology.
Read Article
Better at Predicting RA from MRI: Humans or Computers?
An artificial intelligence model to assess pre-RA hand MRIs has confirmed what human readers have known before: that bone marrow edema and tenosynovitis are objectively the best predictors of future RA development in patients with clinically suspect arthralgias or undiffer
Read Article
Would you rather have Erosive hands OA or RA?
130+ EHOA and 370+ RA, dis duration > 10 yrs for both cohorts
📍EHOA associated w/ > pain & functional impairment
📍RA associated w/ > comorbidities
@RheumNow #EULAR23 POS0103 https://t.co/KdDG7E6PZw
Aurelie Najm AurelieRheumo ( View Tweet)
The risk of osteoarticular infection following Staph aureus bacteremia is twice higher in RA (1/4) than non RA pop (1/8)
Use of TNFi & orthopedic implants associated w/ OAI risk
Mortality however similar in RA and non RA groups
@RheumNow #EULAR23 POS0033 https://t.co/H6JYkbNu0B
Aurelie Najm AurelieRheumo ( View Tweet)
Can combined US examination of nail-enthesis complex & nailfold videocapillaroscopy differentiate PsA from PSO RA and HC?
Brief answer is no, but:
-PsA > tortuous capillaries vs. PSO & HC
-Abnormalities in PSO to be used as predictor of PsA?
TBC...
@RheumNow #EULAR23 POS0025 https://t.co/RNbpht8QGh
Aurelie Najm AurelieRheumo ( View Tweet)
Fluorescence optical imaging in early arthritis?
Nice images but not ready for clinics yet
Can not differentiate OA from RA & PsA
SLE/SSc associated arthritis display a specific pattern, but usually auto-antibody profiles help w/ diagnosis
OP0173 #EULAR23 @Rheunow https://t.co/bAMi9kDKS5
Aurelie Najm AurelieRheumo ( View Tweet)
🛑Doing Hands and feet Xray in undifferentiated arthritis?
Retro study 700+pts shows:
✔️only few patients w/ UA present w/ RA-associated erosions at presentation
✔️Rarely leads to change in diagnosis or prognosis.
Will you stop? I probably won't 👀
@RheumNow #EULAR23 OP0172 https://t.co/BRpmDqaN0r
Aurelie Najm AurelieRheumo ( View Tweet)
In Brazil, if you’re in the early RA clinic (yellow bars) you do a lot better than other academic clinics, even w bDMARD access.
Maybe it’s early Rx, or love & care, or other patient factors
- but it’s a reminder that RA isn’t a level playing field.
POS0055 #EULAR2023 @RheumNow https://t.co/jI2dvuIHWP
David Liew drdavidliew ( View Tweet)
Tapering pred in RA - this just rings true from everyday clinic life.
Some patients just seem to hit a wall at PNL 2.5. Sometimes it’s GC withdrawal arthralgias/tertiary adrenal insufficiency, but often it’s genuine inflammation.
I still wonder why?
POS0050 #EULAR2023 @RheumNow https://t.co/JBh26VqPuM
David Liew drdavidliew ( View Tweet)
Can machine learning help bDMARD selection in RA?
Early days limited by the data available, so not great yet, but efforts underway are a good start for an area where we need to do better than our status quo guessing.
Watch this space
POS0641 #EULAR2023 @RheumNow https://t.co/2j8H40iFWo
David Liew drdavidliew ( View Tweet)
TNFi & Disease activity-guided dose optimization in RA⬇️prog of ADA or ETA daily dose (100%66%50%0%)
10yrs followup in 170pts
⭐️74% tapered until full discontinuation
⭐️Median time to restart 8 mo
⭐️21% never restarted!
What's lacking? % of recovery
@Rheumnow OP0131 #EULAR23 https://t.co/Ms6lqQ7cWf
Aurelie Najm AurelieRheumo ( View Tweet)
Rituximab in RA - do you need to maintain B cell depletion?
Well, in this Paris cohort, if you divide up patients by B cell depletion (at time of next infusion) - no diff in efficacy.
Bias possible but B cell depletion in RA isn’t the hill to die on POS0636 #EULAR2023 @RheumNow https://t.co/GLdu9YkL7g
David Liew drdavidliew ( View Tweet)
CareRA trial:
3 months addition of LEF vs. ETA in pts resistant to COBRA-Slim regimen (MTX 15 mg/w + step-down prednisone):
After 2 years, no difference in dis control but those who received ETA early were treated more frequently w/ csDMARD monotherapy #EULAR23 @RheumNow OP0129 https://t.co/YwSoZWi375
Aurelie Najm AurelieRheumo ( View Tweet)
Don’t be ‘rash’, get adult immune compromised Pts vaccinated against #shingles #varicella #zoster K Winthrop has research re #HZ #vaccination with #Shingrix in #Upadacitinib at #EULAR2023 #OP0225 Bottom line-get #immunecompromised Pts with #rheumatoidarthritis jabbed! @RheumNow
Janet Pope Janetbirdope ( View Tweet)
“You don’t need MTX with TCZ for RA”
Err, well:
- just like TNFi, you def can get ADAb to TCZ
- they definitely lead to lower response rates
- MTX co-admin reduces ADAb
Seems like a good idea to me, but your call 🤷♂️
Bitoun, Mariette et al POS0630 #EULAR2023 @RheumNow https://t.co/2jOAqA6YZ3
David Liew drdavidliew ( View Tweet)
The risk of demyelination with TNFi is low but real. Slight increase of risk was found in male RA patients. The small number of events is reassuring. Careful consideration is recommended in individuals at highest risk of demyelinating diseases Abst#OP0135 #EULAR2023 @RheumNow https://t.co/YT6ZrJTjU0
Dr. Antoni Chan synovialjoints ( View Tweet)
In polyrefractory RA patients, half did not have any PDUS change on ultrasound and/or had normal CRP levels, showing that in the other half, new mechanisms of action for treatment is required by David P, Abst#OP0134 ##EULAR2023 @RheumNow https://t.co/TaY7uGU0bg
Dr. Antoni Chan synovialjoints ( View Tweet)
No relationship between MTX-PG levels in terms of efficacy by SDAI remission but higher MTX-PG levels related to adverse events by Tamai H, Abstr #OP0128 #EULAR2023 @RheumNow https://t.co/TiO5eeYlnS
Dr. Antoni Chan synovialjoints ( View Tweet)
We’re getting better at understanding different types of refractory RA (D2T RA)
We see differences with refractory RA subtypes:
PIRRA (persistently inflamm on USS), and
NIRRA (non-inflamm)
hopefully moving to data-driven Rx approaches for D2T RA?
OP0134 #EULAR2023 @RheumNow https://t.co/vX5IK5O9Wm
David Liew drdavidliew ( View Tweet)
Difficult to treat #rheumatoid #arthritis is a grab bag of multi drug failures or intolerant with high or LOW disease activity 3 groups and diff reasons for failure and diff risk factors. ? Sunset the D2T Pts? OP0117 #EULAR2023 @RheumNow @eular_org https://t.co/1qPMq32kVz
Janet Pope Janetbirdope ( View Tweet)
