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EULAR 2023 – Day 2 Report

Jack Cush, MD

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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Stills,continuum

AOSD: Young vs. Elderly Onset

Bella Mehta, MBBS, MS

Adult onset still's disease (AOSD) is an autoinflammatory condition characterized by fevers, arthritis, and rash. It is considered an orphan disease because of its low prevalence - it is reported anywhere between 16 to 40 per ten million.

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PSS.scleroderma.arthritis.contractures

Juvenile and Adult-onset Scleroderma Differ

Jack Cush, MD

A retrospecitve cohort comparision of juvenile (jSSc) and adult-onset (aSSc) systemic sclerosis (SSc) are both rare but present differently.  

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National Population Insights (4.28.2023)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports and addresses 3 viewer case questions.

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scale decision balance question

Female Force

Susan Shenoi, MD, MS

In medicine, a field where burnout is becoming the norm, there is much promotion of the idea of work-life balance. In reality, the scales between work and life aren’t really balanced. Is the potential for change on the horizon?

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Higher Rehospitalization Rates in Younger SLE Patients

Jack Cush, MD

A Medicare study shows that young adults with systemic lupus erythematosus (SLE) exhibit very high 30-day rehospitalization rates (36%) that are significantly higher than older SLE patients and age matched non-SLE patients.

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dental,periodontal

Periodontal Mucosal Breaks Trigger RA Disease Activity

Jack Cush, MD

Periodontal disease (PD) is more common in rheumatoid arthritis (RA), especially those with anti-citrullinated protein antibodies (ACPAs).  RA activity has been linked to the severity of PD and mucosal inflammation.

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@eular_org recommendation for AOSD/sJIA: An IL-1 or IL-6 inhibitor should be initiated as early as possible when the diagnosis is established #EULAR2023 @RheumNow https://t.co/xNUdpGDxb9
David Liew drdavidliew ( View Tweet)
Evaluation of diagnostic performance of ACR 1997, SLICC 2012 and EULAR /ACR diagnostic crieteria in childhood onset #SLE - SLICC highest sensitivity early in the disease, ACR1997 has the highest specificity both at diagnosis ans over time. @RheumNow #EULAR2023 abst#POS0136

Bella Mehta bella_mehta ( View Tweet)

Pearls in AOSD – from #EULAR2023 Italian study of 64 patients – AOSD/sJIA pts who achieved drug-free remission more often had white blood cells count >15.000/uL at baseline, however those who were treated with cyclosporine likely failed drug free remission. Abst#AB1484 @rheumnow

Bella Mehta bella_mehta ( View Tweet)

An interesting biomarker in #sJIA- helps differentiate it from other diseases, including infections and other inflammatory diseases! - kids with fever! serum calprotectin (MRP8/14) particle enhanced immuno-turbidimeteic assay (sCAL Turbi). 650 pts @rheumnow #EULAR2023 abst#OP0034

Bella Mehta bella_mehta ( View Tweet)

Juvenile and Adult-onset Scleroderma Differ A retrospecitve cohort comparision of juvenile (jSSc) and adult-onset (aSSc) systemic sclerosis (SSc) are both rare but present differently. https://t.co/57OrgaUNqj https://t.co/Y2puN18ux0

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Dr. John Cush RheumNow ( View Tweet)
Downs Syndrome (1/700) & autoimmune mechanisms - Downs has a 4-6 fold higher risk of JIA, type 1 diabetes, autoimmune thyroid disease and coeliac disease. https://t.co/wVUDRCS96I https://t.co/RosPAkRnPA

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Dr. John Cush RheumNow ( View Tweet)
Brazil study of 1,528 kid lupus (cSLE) shows low mortality (4.1%, n=63); 84%F, age 12 yrs w/ time to death=3.2yrs post-Dx. Cause?1) Sepsis (43%), 2) opportunistic infx(11%), & 3) Pulm hemorrhage (9.5%). Predictors: CNS lupus (HR 2.6) & CKD (HR 4.3) https://t.co/mocrJ2b8Mz https://t.co/TdJ7tFYr1r

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Dr. John Cush RheumNow ( View Tweet)
Finnish population study involving 4180 #JIA patients followed for 6+ years (betw mean ages of 8.3 to 14.8 years), finds that 13% of the JIA patients prescribed psychotropic drugs (vs 10% in controls; p<0.001). Antidepressant use most freq, esp in females https://t.co/PcFhGz291J https://t.co/Ss9NzgC8vp

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Dr. John Cush RheumNow ( View Tweet)
2023 NRMP Match: 365 applicants for Rheum; 97.8% (265 of 271 avail) of Adult Rheum fellow positions matched (only 4/127 programs did not fill their match). Pediatric Rheum 27/41 positions (62.8%)were filled (14/32 programs not filling). https://t.co/VECH6rMHBV https://t.co/MC1jhLCQBk

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Dr. John Cush RheumNow ( View Tweet)
@RheumNow's review of new drug approvals during 2022 at #RNL2023 https://t.co/IgndlG6lOI
Dr. Rachel Tate uptoTate ( View Tweet)
Without head-to-head trials, do we look to metanalyses? 13 trials of TNF inhibitors in JIA pts - Results at 12-14 weeks. While it ADA looks possibly better, that would be an over-interpretation and misuse of trial data that isnt truly comparable https://t.co/k6QcPZZj67 https://t.co/SwwND1VFfT

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Dr. John Cush RheumNow ( View Tweet)
51 Juvenile SLE (j-SLE) studied for neuropsychiatric Dz (j-NPSLE)- 39% presented with jNPSLE. While no clear biomarker/imaging of j-NPSLE identified, they found CSF neopterin (& IFN-α) levels signif higher w/ active j-NPSLE & CNS involvement (p=0.0008) https://t.co/QM8yJGrBJu https://t.co/4hj1eE2JIC

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Dr. John Cush RheumNow ( View Tweet)
Comparison of MIS-C dz in kids and adults>21 (MISC - A). By Dr Susan Shenoi @RWCSmtg #rwcs23 https://t.co/jvsMLARkCA
Dr. John Cush RheumNow ( View Tweet)
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