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EULAR 2023 – Day 2 Report

Jack Cush, MD Jun 01, 2023

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.

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Promising new therapies in SLE

Md Yuzaiful Md Yusof, MRCP(UK), PhD May 31, 2023

The pharmacology treatment in SLE is a rapidly expanding field of research that provides excitement and optimism to both the patients and the clinicians. We now have three licensed targeted therapies (belimumab and voclosporin in active lupus nephritis and anifrolumab in non-renal SLE) over the last 3 years compared to one therapy (belimumab in non-renal SLE) in the previous 50 years. What are other promising therapies on the horizon?

Factors related to having a flare of arthritis during COVID-19 include female gender, higher disease activity, no DMARD at time of vaccination. Stopping DMARDs need to be weighed up against risk of flares, Pedro Machado, COVID-19 #EULAR2023 @RheumNow https://t.co/3sd32tF2kW

Study on folylPG synthétase (FPGS) activity and MTX-PG measured in sperm showed low bio active form of MTX-PG, low FPGS activity resulting in lower capacity to form MTX-PG, Perez-Garcia LF, Abst#OP0224 #EULAR2023 @RheumNow https://t.co/8sGQOBxn8r

Herpes Zoster vaccination in RA patients treated with Upadacitinib and MTX showed a satisfactory response, slight reduction in response compared to general population in both antibody and cell mediated responses Winthrop K, Abst#OP0225 #EULAR2023 @RheumNow https://t.co/wxwbOYsn5K

For our rheum patients who have had cancer previously - the default can’t be to not have DMARDs. @eular_org points to consider SLR: no clear risk, across b/tsDMARDs For too long these patients were unnecessarily asked to ride it out. No more please POS1069 #EULAR2023 @RheumNow https://t.co/7m4Yh0h7rd

Retro French database study shows reassuring data. Overall mortality after IRAEs =similar between pts receiving b/tsDMARDs vs. those who don't 70000+ pts treated w/ ICI, 7800+ IRAEs (most frequent colitis) & 330 treated w/ b/tsDMARDs, 10% Rheum IRAE OP0270 @RheumNow #EULAR23 https://t.co/OFNaIU4kzt

Can’t escape ORAL Surveillance RCT talk Lots of real world data on CV risk & JAKi here (with all the selection, measurement bias) First up: multinational JAK-pot study (n=>50k) Even if you mirror the high-risk RCT cohort - not much there for MACE OP0219 #EULAR2023 @RheumNow https://t.co/FfNspdivri

JAKi use did not increase CV risk compared to TNF, no difference between Bari and Tofa, non significant increased IRR in patients >65 years, Merel Opdam, Abst#OP0221 #EULAR2023 @RheumNow https://t.co/Pu5X8RHJOY

Malignancy in real world datasets: do we see differences between DMARDs - particularly JAKi, with ORAL Surveillance in mind? RABBIT German data (limited risk window): Point estimates slightly up vs TNFi, esp in high CV risk pts but magnitude not big OP0218 #EULAR2023 @RheumNow https://t.co/Ou7TgWvf3b

Men trying to conceive were prev told to avoid MTX. Another myth busted Why? Spermatozoa lack the FPGS enzyme responsible for MTX-PG metabolism, the tiny amount of MTX-PG in sperm isn’t active. No quality issues! OP0224 #EULAR2023 @RheumNow (& @ARD_BMJ https://t.co/SDdoNP12oR)

Is methotrexate safe for men with an immune-mediated inflammatory disease and a…

ANSWER cohort Retrospective study 6600+ bio/tsDMARDs ttmt courses, 20 yrs ✔️IL-6Ri is the lowest discontinued for lack of efficacy ✔️CTLA4-Ig is the lowest discontinued due to AEs ✔️Concomitant GC ⬆️30% drug discontinuation due to AEs @Rheumnow #EULAR23 POS0051 https://t.co/8e6U5KHmX4

Always great to have @EMA_News to come and to talk to us at #EULAR2023 Our meds are very important to us, and the more we can understand how decisions are made and RWE is collected, the better 👍 @RheumNow https://t.co/hSutraUsFD

You need to see this! Albert with a Left V1 distribution of #shingles is a ‘bot’ who interacts with #rheumatologists at #EULAR2023 ⁦@RheumNow⁩ ⁦@eular_org⁩ #artificial #intelligence https://t.co/gDwzc3NX7v

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

The overall risk of cancer and cardiovascular disease were decreased in RA treated with JAKi but there was no comparison with TNFi, Sung Soo Ahn, Abst#00132 #EULAR2023 @RheumNow https://t.co/9Bi6t6uuig

JAKi are NOT associated w worse safety vs bDMARDs when adjusting for confounding. Did regulators get it wrong? #EULAR2023 @RheumNow #OP0116 https://t.co/ZNk0NI7Ky5

#EULAR2023 #OP0137 Most impressive Delta difference vs Control in #lupus! In Phase 3 RCT in China, more patients in Telitacicept, BAFF/APRIL-i met SRI-4 (delta 44% if data imputed; 34% without) vs placebo. No major safety. Global Phase 3 RCT is in progress @RheumNow https://t.co/DUFRQ7pNUA

#JAKi May decrease #cancers - age, male, #diabetes had more #cancer but NOT associated w drug prescribed AND LESS #malignancy & LESS #CVE in JAKi vs csDMARDs in huge admin database. Diff from other results OP0140 @RheumNow #EULAR2023 EFFECTIVE Rx of RA LOWERS CVE & cancer w JAKi! https://t.co/oQ3QeUZz3E

@RheumNow Safety is pretty good too - this is abatacept we are talking about here. Cost is a different question, as is the pharmacoeconomics, but at least it’s safe. One other thing about the study ⬇️ #EULAR2023 @RheumNow https://t.co/H3AdBsK8t9

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EULAR 2023 – Day 2 Report

Promising new therapies in SLE

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