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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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Better at Predicting RA from MRI: Humans or Computers?

David Liew, FRACP Jun 01, 2023

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

So what kind of changes do we see in ACPA+ arthralgia patients, in the 6 months prior to them developing inflamm arthritis? - ACPA titre up, RF pos - EMS, pain up - ESR up Good things to keep an eye on in pre-RA Emery group POS1046 #EULAR2023 @RheumNow https://t.co/cSKPb5SbVH

‘Where have all the rheumatoid nodules gone?’ (Fantastic poster title @MayoClinic) Don’t get to see them much in clinic anymore. Almost surprised when I do Smoking is down Therapies are better RA is changing (a fact worth remembering!) POS1066 #EULAR2023 @RheumNow https://t.co/VxDNusIjOa

#EULAR2023 #POS1069 SLR & meta-analysis to inform EULAR Points to Consider which included 15 studies showed that targeted therapies were not associated with increased risk of cancer recurrence in patients with inflammatory arthritis AND a historyof cancer (85% had RA) @RheumNow https://t.co/uK2XHLjpj8

‘Clinically suspect arthralgias: fact or myth’ - a great debate topic #EULAR2023 First, the argument for. And we start with a reminder as to what we really mean by CSA @RheumNow https://t.co/e1CdxKi69m

To treat or not? Clinically suspect arthralgia does affect QoL including function. Both premises of treating with a DMARD are valid. OverRx v missing the very early window of opportunity @RheumNow #EULAR2023 @eular_org https://t.co/86CVZ2IjEf

Use of antîmalarials in RA reduced the risk of bacterial infection in RA, smaller number of viral and fungal to study impact on systematic infections Bredemeier M, Abst#OP223 #EULAR2023 @RheumNow https://t.co/RXuFi3LdZC

Natural sequence of events happening in a subclinically inflamed joint, serial MRI study When progressing to clinical RA First osteitis then synovitis & tenosynovitis 🦴➡️✋ During resolution tenosynovitis reduces first then synovitis & osteitis @RheumNow #EULAR23 OP0261 https://t.co/ic94htYv6T

We know HCQ adherence is poor in both RA and SLE >50% in this BC 🇨🇦 cohort All despite being such an important medicine What’s super interesting are the trajectories of adherence - and we’d like to understand more about what motivates each group OP0222 #EULAR2023 @RheumNow https://t.co/rbx1l9T36C

Antimalarial adherence in RA and SLE showed 4 patterns of adherence over time, with 53% drop off in 1 year, with higher adherence with age, SLE and socioeconomic class, Hoque MR, Abst#0222 #EULAR2023 @RheumNow https://t.co/Bld5kWVQxE

#EULAR2023 #POS1075 Which biologics have the lowest retention rate in Elderly patients (=>65 yrs) in Rheumatoid Arthritis? Data from Italian registry showed 1/3 discontinued biologics at 2 yrs. IL6-i: lowest persistence; Abatacept: highest @RheumNow https://t.co/28n4qzR3aM

So we need protocolized extra steroids in new RA? A debate as old as time Individual patient data metaanalysis - slight gains early on, not sustained - fewer DMARD changes - but a heap more PNL, well after the protocol ends Life is about trade-offs😐 OP0220 #EULAR2023 @RheumNow https://t.co/M8SBKjGncv

#EULAR2023 #POS1066 “Diagnosis: Seropositive Nodular Rheumatoid Arthritis” - I can probably get rid of Nodular soon in my letter. Trends of Nodules have decreased over time. Could be because we are getting better at preventing erosion and smoking cessation @RheumNow https://t.co/fmQvyNHCUJ

Impact of menopause & on function in RA HAQ increases slightly after menopause Premature menopause = worse function Slightly better HAQ (but moderate & no effects on other PROs) in THR group vs. non THR No safety data @RheumNow OP0268 #EULAR23 https://t.co/7KJScF8O2X

Initial use of glucocorticoids GC as bridging treatment in RA resulted in increase use of GC later, fewer DMARD changes later, van Ouwerkek L, Abst#OP220 #EULAR2023 @RheumNow https://t.co/IjxgQTZ8SE

We need to assess CV risk in IA but how? Performances of QRisk3, Framingham & Reynolds scores for prediction of CV event in OA RA PsA AS PSO Bummer: these 3 prediction tools are less accurate in IA but also OA. We need a dedicated tool. @Rheumnow OP0267 #EULAR23 https://t.co/O73cETXXoe

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

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

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

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EULAR 2023 – Day 2 Report

Better at Predicting RA from MRI: Humans or Computers?

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