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Hilarious debate #EULAR2022 between Christian Dejaco and Robert Landewe on whether telemedicine is the future of rheumatology. In amongst the trash talking, here are some highlights @RheumNow
David Liew drdavidliew ( View Tweet)
#ClinicalPearl. Why do doctors prescribe #JAKi in RA? Efficacy, fast onset, X-ray inhibition, can work as monotherapy, remission - in order of diminishing frequency BUT I will add access and oral (convenience). POS0680 @RheumNow @eular_org #EULAR2022 https://t.co/XHtNqguqvh
Janet Pope Janetbirdope ( View Tweet)
Boers et al. GLORIA trial of long term 5mg pred in RA. Titled as "favourable balance of benefit and harm". I cannot agree. 24% increase adverse events, NNH 9, for DAS28 0.37 better at 1 year, and really no difference after that. @RheumNow #EULAR2022 OP0263 https://t.co/eO4f1CjH5q https://t.co/VyyZm1QvYy
Links:
Richard Conway RichardPAConway ( View Tweet)
Deep learning can be used to distinguish seropositive RA from seronegative RA and PsA based on MRI.
Early changes in PsO may suggest a PsA-like MRI pattern may be present!
Is this how we predict which PsO -> PsA?
@RheumNow #EULAR2022 ABST#OP0292 https://t.co/NGfFkSqlaM
Robert B Chao, MD doctorRBC ( View Tweet)
#EULAR2022 POS0213
Beware of paradoxical low lipids in RA!
⭐️ETN+MTX vs MTX T2T:
Early ETN: increased in HLD, lesser LDL, differs from MTX. Correlates with clinical disease activity
@RheumNow https://t.co/c6GXadVwYN
Eric Dein ericdeinmd ( View Tweet)
#EULAR2022 POS0207
Fatigue in early RA:
⭐️Does not show direct effect between inflammation on fatigue
⭐️Suggests broader indirect effect of psychosocial aspects of wellbeing (pain, mental health, sleep, disease perception) plays larger role
@Rheumnow https://t.co/zTxk7kZRIX
Eric Dein ericdeinmd ( View Tweet)
Szekanecz et al. ORAL Surveillance. Geographic differences in MACE largely driven by history CVD and high baseline risk in North America and ROW. @RheumNow #EULAR2022 POS0110 https://t.co/cR6a7N2KP5
Richard Conway RichardPAConway ( View Tweet)
The third SARS-CoV-2 vaccine in IMID (RA, SpA, PsA, UC, CD) patients on immunosuppression improves the serologic response follow the first two vaccine doses and allowed them to close the gap compared to the two-dose vaccinated controls #EULAR2022 @RheumNow OP0192 Jyssum et al
Dr. Antoni Chan synovialjoints ( View Tweet)
#EULAR2022 POS0210
RNA sequencing in 11 RA-ILD patients vs 9 RA pts
⭐️Distinct gene expression in RA-ILD with type 1 IFN response, neutrophil activation, and degranulation and CCR1 chemokine interactions
@RheumNow
@fahidalghanim https://t.co/FIrZfzZV1C
Eric Dein ericdeinmd ( View Tweet)
#EULAR2022 OP0278:
Increase in risk of CVA compared to general population ~1.2x risk
⭐️This is unchanged between the pre-biologic (1972-1998) and the post-biologic treatment era
⭐️Interesting finding: smoking rate same over time in RA, despite decr in Norway in gen pop
@Rheumnow https://t.co/r8QsJABfvx
Eric Dein ericdeinmd ( View Tweet)
Charles-Schoeman et al. ORAL Surveillance. PE risk factors - History VTE, antidepressant use, obesity, steroids, male, age, OCP/HRT. PPI protective @RheumNow #EULAR2022 POS0239 https://t.co/fDLKrpvpgI
Richard Conway RichardPAConway ( View Tweet)
Can we predict VTEs from JAKi for RA at all?
Baseline elevated D-dimer pts who go on to develop VTE
(but not baseline CRP, so not just general inflamm)
Questions raised about effect modification for VTE following JAKi too. This story not yet done
OP0269 #EULAR2022 @RheumNow https://t.co/ErDcFpXXUl
David Liew drdavidliew ( View Tweet)
Leng et al. Tocilizumab biosimilar BAT1806/BIIB800 vs originator in MTX-IR RA. Not surprisingly they look the same. Great to see given negative clinical impact of recent supply problems with originator. @RheumNow #EULAR2022 POS0287 https://t.co/EqwINwcm7M
Richard Conway RichardPAConway ( View Tweet)
Long-term low-dose steroids for RA: can it be weaned?
Weaning after 2y of blinded add-on in RA:
either PNL 5mg/d or placebo
No substantial evidence of adrenal insufficiency
- symptoms same
- cortisol/ACTH same
It's never too late to wean the pred!
OP0270 #EULAR2022 @RheumNow https://t.co/jp2ZOlAEnb
David Liew drdavidliew ( View Tweet)
#EULAR2022 OP0274
Hospitalization for TB and other opportunistic infxn (OI) w inflamm joint disease:
⭐️9% with RA, 6% with PsA and AS in Western Australia
⭐️Decrease overall since 1985, but recent increase
⭐️Sharp rise of mycotic infections
⭐️No PJP, likely due to ppx
@Rheumnow
Eric Dein ericdeinmd ( View Tweet)
Yoshimura et al. 10 year findings of TOMORROW study. Glucocorticoid use of even 2mg/day is fracture risk in RA! @RheumNow #EULAR2022 POS0631 https://t.co/c8uCdPzUiE
Richard Conway RichardPAConway ( View Tweet)
RA & dementia - it's getting more damning
RA dementia risk: HR 1.25
from Korean nationwide data: RA n=138,592
this follows @MyasoedovaElena's data
RA systemic inflamm leading to dementia (AD, vascular)?
Need to understand if any DMARD protective
OP0271 #EULAR2022 @RheumNow https://t.co/4V7fOtVlnj
David Liew drdavidliew ( View Tweet)
#EULAR2022 OP0275: RA-ILD after transplant by @AARazmjou
⭐️UIP #1 cause RA-ILD, worst prognosis - 68% of transplanted pts
⭐️UIP seen in 88% of deceased patients, 56% of living
⭐️Median survival 5.3 years
@RheumNow https://t.co/tGBQ5GBlVg
Eric Dein ericdeinmd ( View Tweet)
#EULAR2022 OP0273
Difficult to treat RA (D2TRA):
⭐️Lower socioeconomic treatment
⭐️RF positivity
⭐️Higher inflammatory markers
⭐️ILD
⭐️Lower proportion on MTX, better response to JAKi and RTX
@RheumNow
Eric Dein ericdeinmd ( View Tweet)
GLORIA trial presented by Martin Boxers. 2 yr RCT, 5mg Pred vs. PBO shows DAS28 benefit (-0.37 to -0.62) & -1.7 better X-ray (vs PBO) at 2yrs. BUT signif more harm (AE) RR 1.24; mostly infx. Is this a good trade off? Abst# OP0263 #EULAR2022 https://t.co/kBiRYxXXZe
Dr. John Cush RheumNow ( View Tweet)
