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Difficult-to-treat RA: are we any closer to predicting who is at risk?
It is almost four years since EULAR published its definition of difficult-to-treat (D2T) rheumatoid arthritis (RA) (1). This marked a formal recognition of the group of patients who, despite the advances in pharmacological therapy for RA, remain symptomatic.
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Summary of #EULAR2024 #ClinicalPearls
JAKi have expanding disease data
✅ #GCA w #UPA
✅ Awaiting data in #SLE w #UPA & #Deucravacitinib
✅Use in #JIA
✅No new safety signals
@rheumnow
@eular_org
Janet Pope Janetbirdope ( View Tweet)
EULAR 2024: New drugs for RA?
Abiprubart is an Abatacept distant relative, targeting T cell activation through a different target/molecular interaction (CD40/CD154).
https://t.co/3wAGjfCdcN https://t.co/2YK2OeIVZK
Dr. John Cush RheumNow ( View Tweet)
EULAR 2024 - Day 1 Report
https://t.co/LpYxUP8d7e https://t.co/5zwc0HsZZ8
Dr. John Cush RheumNow ( View Tweet)
RheumNow’s expanded coverage of the #EULAR2024 annual meeting is sponsored in part by Bristol Myers Squibb & UCB. All content is chosen by RheumNow & its faculty.
Dr. John Cush RheumNow ( View Tweet)
RheumNow’s expanded coverage of the #EULAR2024 annual meeting is sponsored in part by Bristol Myers Squibb and UCB. All content is chosen by RheumNow & its faculty.
Dr. John Cush RheumNow ( View Tweet)
How many #autoantibodies
Does one need in
#rheumatoid #arthritis
Need 4 citrullinated peptides
Covers off
97% of IgG CVP2 ACPAs
#EULAR2024 @RheumNow @eular_org https://t.co/LNFGuFXGrC
Janet Pope Janetbirdope ( View Tweet)
Once in remission with
#rituximab in #GPA
How long to resize
500 mg q6 mo for
4 years?
?longer
?less
#EULAR2024 @eular_org @RheumNow https://t.co/G4kU3v81je
Janet Pope Janetbirdope ( View Tweet)
Telespa - telemonitoring in AxSpA « minimal impact on disease control « never examine a patient again , never find any pathology outside of joints, remote SpAologists, no longer physicians - easy to train rheumatology nurses to do our jobs @RheumNow #EULAR2024
Peter Nash drpnash ( View Tweet)
PMR has distinct patterns on MRI shoulder, possibly helping diagnosis.
#EULAR2024 OP0248 @RheumNow
also @bmj_rmdopen https://t.co/pS5kO5OQRW where they say:
"Similar to our prior findings... the target of inflammation in PMR is the outer covering of a tendon, the peritendineum" https://t.co/5pu1Xiku3h
Links:
David Liew drdavidliew ( View Tweet)
EULAR 2024 Highlights: Saturday’s Recap with RheumNow https://t.co/BlOsbr9lYB
Links:
Dr. John Cush RheumNow ( View Tweet)
#EULARBEST
RCT of #upadacitinib in #GCA
It works to steroid spare
15 mg > 7.5 mg in outcomes
Both >>placebo
Ethically PBO had slower #prednisone taper
Similar to #TCZ data
What to choose in GCA
IL6i
IL17i
JAKi
@eular_org @RheumNow LBA0001 https://t.co/gy0TEiHxjo
Janet Pope Janetbirdope ( View Tweet)
Does B Cell Depletion Matter?
Dr. Yuz Yusof interviews Dr. Ed Vital regarding abstract OP0077 at Eular 2024 in Vienna, Austria.
https://t.co/IjxGWWjoGD https://t.co/GwLjB4Z7ub
Dr. John Cush RheumNow ( View Tweet)
Telespa - telemonitoring in AxSpA « minimal impact on disease control « never examine a patient again , never find any pathology outside of joints, remote SpAologists, no longer physicians - easy to train rheumatology nurses to do our jobs @RheumNow #EULAR2025
Peter Nash drpnash ( View Tweet)
#Scleroderma #recommendations
#Rayanud’s
#vasculopathy
#digital #ulcers
CCB
PDE5i
IV iloprost
Bosentan for Digital ulcer prevention <not approved in NA>
#EULAR2024 @EUSTAR_org @RheumNow #SSc https://t.co/9c2cHAptIC
Links:
Janet Pope Janetbirdope ( View Tweet)
SHR032 chinese JAK1 inhib AS and PsA - typical efficacy and safety - looks like smells like tastes like JAK1 inhib but no zoster listed or acne, or anaemia with higher dose, 1 mace 1 vte @RheumNow #EULAR2024
Peter Nash drpnash ( View Tweet)
Duo IL17A,F #SONELOKIMAB
RCT in active #PsA
ACR50 around 46%
Nanobody
to me it looks like #Bimekizumab results
So far low #fungal infections
OP0195
We are over run with + IL17i RCTs in
#psoriatic #arthritis
Impt~market /access/risk/benefit?
#EULAR2024 @eular_org @RheumNow
Janet Pope Janetbirdope ( View Tweet)
Ixokibep a small IL17Ai works in #PsA
16 wks ▶️50% had PASI 100
Fast
40-42% ACR50
Same rate of MDA
Helped enthesitis also
⬆️injection site rx’n
Wow! But where to use vs
2 other IL17Ai and IL17AEi
LB0005
#EULAR24 @eular_org @RheumNow
Janet Pope Janetbirdope ( View Tweet)
The electronic nose, knows?
Exhaled breath volatile organic compounds do surprisingly well in diagnosing RA. Really… takes your breath away
(as seen in @rheuma_doktorin’s highlights)
#EULAR2024 POS0652 @RheumNow https://t.co/OCRHdZZS3Q
David Liew drdavidliew ( View Tweet)
Periodontal disease is a major factor in the development of RA - and that’s the tooth!
in ACPA+ clinically suspect arthralgias,
tooth extraction: adjusted HR 3.10
Population-level dental care?
(as seen in @rheuma_doktorin’s highlights)
#EULAR2024 POS0467 @RheumNow https://t.co/wN8bvBtv40
David Liew drdavidliew ( View Tweet)