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2019 EULAR Recommendations for the Management of Rheumatoid Arthritis

Jack Cush, MD

The 2019 update to the EULAR recommendations on the use of synthetic and biological disease-modifying antirheumatic drugs in rheumatoid arthritis (RA) have been published in Annals of Rheumatic Disease - highlighting the efforts of an international consensus committee effort.

In the end, the task force put forth 5 overarching principles and 12 recommendations concerning use of conventional synthetic DMARDs, glucocorticoids, biological DMARDs, biosimilar DMARDs, and targeted synthetic DMARDs (the Janus kinase (JAK) inhibitors tofacitinib, baricitinib, filgotinib, upadacitinib).

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"Few men are willing to brave the disapproval of their fellows, the censure of their colleagues, the wrath of their society. Moral courage is ... the one essential, vital quality for those who seek to change the world which yields most painfully to change" -Robert F. Kennedy
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A good coach can change a game. A great coach can change a life. —JOHN WOODEN
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“People don’t buy what you do; they buy why you do it. And what you do simply proves what you believe”. —SIMON SINEK
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New EULAR 2019 Rheumatoid Arthritis Treatment recommendations are out. Rheumatologists are the specialists who should care for RA; decisions are based on disease activity, safety issues and other patient factors (comorbidities) https://t.co/4NwYcR8l8G
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#MLK - "No person has the right to rain on your dreams" Martin Luther King, Jr.
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Health Care Utilization prior to the Dx of Psoriatic Arthritis #PsA is significantly 2 fold higher. Study of 462 PsA & 2310 comparators shows more visits to PCP for MSK issues in 1-5 yrs prior, as well as use of other MSK specialists in 5 yrs preceding Dx. https://t.co/5729ya9Ahr
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CSROAdvocacy
Fantastic article from @HealioRheum detailing the history and the hard work of CSRO. With phenomenal leaders like Dr. Michael Schweitz and @MattieRheumMD, CSRO will continue to effectively advocate for high-quality rheumatology care at an affordable rate! https://t.co/ImA9aeaXqh
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#UTSW Dr Nicole Bittencourt on fever and autoinflammatory workup. Here are sources for genetic testing. I rec the Invitae autoinflammatory panel (or cash pay ~$100) https://t.co/XsJ0k7q0ex

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60% The percentage of patients at @NIH's autoinflammatory disease cohort that are undifferentiated and do not have a specific disease diagnosis -Dr. Amanda Ombrello. #ACR19 @rheumnow https://t.co/d85OtnEA8o
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#UTSW Dr Lauren Nassi on JIA - enthesitis related arthropathy or ERA. 80% are B27+. May develop AS or SpA much later. They respond very well to TNF inhibitors
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#UTSW Dr Lauren Nassi on JIA - long term outcomes in Oligoarticular jia is not so benign. Half go on to polyarticular disease https://t.co/eRv52dtyZY
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#UTSW Dr Lauren Nassi on JIA- red flags with Oligoarticular JIA Painful joint Hip involvement High acute phase reactants
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#UTSW Rheum GR Rounds Dr Lauren Nassi on JIA - JIA accounts for 50-70% of all cases in a pediatric rheum clinic
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