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EULAR 2022 – Day 3 Report
By now, those of us attending the meeting know how to find a free coffee or sprite, have found comfortable meeting nooks and know our way around! PAnd congrats to you virtual Rheums for mastering the multi-screen, multitask simultaneous consumption posters, tweets and oral abstract presentations.
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Talking about tapering studies in inflammatory arthritis, but true throughout all of rheumatology:
Not all flares are equal.
This area is full of nuance, we need to think more closely about how we study them.
#EULAR2022 @RheumNow https://t.co/tzqqNZv5Ct
David Liew drdavidliew ( View Tweet)
Everything's better with MTX
Controlled RA on b/tsDMARDs: can we taper MTX?
maintaining remission pooled OR 0.81 (0.68-0.97)
Unless I'm reading it wrong:
it's true many will be fine, but
keeping MTX adds benefit (even in short term, before ADAb)
POS0286 #EULAR2022 @RheumNow https://t.co/ZlwXHgACWd
David Liew drdavidliew ( View Tweet)
Charles-Schoeman et al. ORAL Surveillance, post-hoc analysis of risk factor combinations. 65+ ever smokers appear at particular risk @RheumNow #EULAR2022 POS0674 https://t.co/UyTOITBTX9
Richard Conway RichardPAConway ( View Tweet)
If rheumatoid arthritis comes and goes before a rheumatologist lays their hands on it, is it really RA?
We're born skeptical on this. Ronald van Vollenhoven poses questions on what it means for studying drug-free remission in established RA disease #EULAR2022 @RheumNow https://t.co/9GJoqYtVBP
David Liew drdavidliew ( View Tweet)
So what diet to follow with autoimmunity in mind?
So many, all with different instructions.
Let’s concentrate on where they agree:
yes to fruits & vegetables
no to emulsifiers & processed foods
#EULAR2022 @RheumNow https://t.co/I9abweQOyZ
David Liew drdavidliew ( View Tweet)
#ClinicalPearl? #METEOR is a multi-country ~40K database of #rheumatoid arthritis. @eular_org #EULAR2022- found YOUNGER age of onset of RA close to equator, opposite to low Vitamin D if more NORTH /less sun and MORE #multiple #sclerosis. ?From low age at equator OP0035 @RheumNow
Janet Pope Janetbirdope ( View Tweet)
Looks like I’m not the only one who doesn’t let the absence of synovitis stop me from sometimes treating high-risk clinically suspect arthralgias i.e. ‘very early early RA’
The truth comes out in anonymous surveys!
#EULAR2022 @RheumNow https://t.co/BqTLy4HBWR
David Liew drdavidliew ( View Tweet)
Difficult to Treat RA (D2TRA): Jacob van Laar
#EULAR2022 Points to consider @RheumNow
1. Consider the diagnosis! Misdiagnosis or mimic?
2. U/s when in doubt
3. Caution in comorbidities (obesity, fm) which can overestimate inflamm markers, disease activity https://t.co/YT9NRv7EA0
Eric Dein ericdeinmd ( View Tweet)
These findings suggest a pathogenic link between airway inflammation in bronchiectasis and RA-related autoantibodies
Jeffrey Sparks MD MMSc jeffsparks ( View Tweet)
Prof van Lear noted 5-10% of pts have D2T RA; the highest risk factor is low socieconomic status. D2T RA have higher comorbidities and healthcare utilization #EULAR2022 @rheumnow https://t.co/PhPjhksyI4 https://t.co/JCByho4ubk
TheDaoIndex KDAO2011 ( View Tweet)
Associations with RA-BR (n=57 cases) compared to RA-no lung disease controls (n=36)
⬆️⬆️⬆️RF level (OR 4.4)
⬆️⬆️ ACPA level (OR 3.5)
⬆️older age at RA onset (OR 1.37 per 10 years)
⬇️ BMI (OR 0.94 per kg/m2) (i.e., higher risk in underweight)
🚫 associations: sex, smoking pk-yrs
Jeffrey Sparks MD MMSc jeffsparks ( View Tweet)
Watch: New 2022 EULAR RA Treatment Guidelines
https://t.co/mF4cKJLtbr
#EULAR2022 https://t.co/oI8p6gL0Tf
Links:
Dr. John Cush RheumNow ( View Tweet)
Nossent et al Hospitalisation with opportunistic infection twice as high in RA vs AxSpA/PsA. Has IMPROVED over biologic era. To me, suggests benefits of proper disease control on infection risk
@RheumNow
#EULAR2022 OP0274 https://t.co/cqUoRti4We https://t.co/Ozz7jH3z4N
Links:
Richard Conway RichardPAConway ( View Tweet)
More from GLORIA. Tapering pred 5mg after 2 years. Some minor increase in disease activity (DAS28 0.26) with no evidence of adrenal insufficiency. Can successfully withdraw long term steroids! @RheumNow #EULAR2022 OP0270 https://t.co/IV9iJLY22v https://t.co/ZXdwxlXorK
Links:
Richard Conway RichardPAConway ( View Tweet)
van der Pol et al from BeST study. No association with diabetes for pred use HR 0.588 (95%CI 0.285; 1.21) nor cumulative pred dose OR 1.04 (95% CI 0.978; 1.13). Higher DAS assoc with diabetes. @RheumNow #EULAR2022 OP0272 https://t.co/QVjphcD7MG https://t.co/Buj8VAIJ5x
Links:
Richard Conway RichardPAConway ( View Tweet)
Alsing et al. Dutch study. Persistent excess stroke risk in RA in biologic era. @RheumNow #EULAR2022 OP0277 https://t.co/oLmsrniKw6 https://t.co/2zDkuUzq0S
Links:
Richard Conway RichardPAConway ( View Tweet)
Are JAKi fulfilling their promises in RA? H Schulz-Koops said a survey showed rheumatologists wanted effective fast acting Rx that could be used as monotherapy. @eular_org #EULAR2022 @RheumNow https://t.co/Gdel9YnAzA
Janet Pope Janetbirdope ( View Tweet)
VIGIBASE registry RA
39000+ pts JAKi and 231000+ pts TNFi
*No increase in MACEs with JAKi 1.4% vs. 0.9%
*JAKi Increase in DVT RR 3.99
and PE RR 3.5
adjusted on age and sex
@RheumNow #OP0268 #EULAR2022 #Lupus https://t.co/hiAvKctgky
Aurelie Najm AurelieRheumo ( View Tweet)
Gilbert et al. RA assoc increased risk hospitalisation or death from COVID-19 1.53 (1.20, 1.94). RA-ILD assoc even greater risk hospitalisation or death multivariable HR 2.84 [95% CI 1.64-4.91] @RheumNow #EULAR2022 OP0251 https://t.co/h1jzAV6xNR https://t.co/7E1EzAKCDv
Links:
Richard Conway RichardPAConway ( View Tweet)
