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JAK Inhibitors in Giant Cell Arteritis
Trials are underway evaluating the potential benefits of JAK inhibitors (JAKi) in giant cell arteritis (GCA) patients who are refractory to standards of care.
EULAR 2024 Rheumatology Roundup (6.21.2024)
Drs. Artie Kavanaugh and Jack Cush discuss highlights from the EULAR 2024 meeting in Vienna
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EULAR 2024 – Day 4 Report
The final day of EULAR 2024 was rich in posters, Late-breaking oral presentations and EULAR updates and recommendations. Below is a synopsis of the half-day's action.
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Update on low-dose glucocorticoids in SLE
Glucocorticoids (GC) have been the mainstay of treatment in SLE for nearly three quarters of a century. GC induce a range of anti-inflammatory effects, quickly relieve some symptoms and lower mortality in some life-threatening flares. However, they also have multiple side effects that limit the duration of treatment, as well as the dose used. Accordingly, the 2023 EULAR recommendations for SLE set a target dose of ≤5mg/day. Is low dose GC an achievable target?
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192 RA pts on MTX: GI Sxs studied w/ MISS (MTX intolerance severity score). GI intolerance seen in 56%, Nausea & pain post-MTX most common. More in afro-descendants, w/ FM, Steroids, or JAKi. MISS results unrelated to Route, Gi Dz, age, MTX dose https://t.co/EROmZQo1Zs https://t.co/SOMzzXXj0b
Links:
Dr. John Cush RheumNow ( View Tweet)
RT @yuz6yusof
#EULAR2024 OP0180 Can we safely taper GC in #lupus patients who are in remission? Single study in Italy showed in pts with SLEDAI=0 + pred =<5mg/d + stable IS/HCQ, GC discontinuation after proper tapering appeared safe and was associated with a low risk of flare
Dr. John Cush RheumNow ( View Tweet)
RT @drminidey
OP0165- incidence & risk factors of D2T RA in an early RA cohort
Factors assoc with D2T RA:
🩸 Seropositivity
🦴 Erosions
📈 Disease activity
📊 D2T pts have higher steroid doses & more commonly develop iatrogenic-related #comorbidities, e.g. osteoporosis
Dr. John Cush RheumNow ( View Tweet)
Update on low-dose glucocorticoids in SLE
GC have been the mainstay of treatment in SLE for nearly 75 yrs. GC induce anti-inflammatory effects, quickly relieve symptoms, and reduce mortality in life-threatening flares through various actions.
https://t.co/uEtWftvwEz https://t.co/nJlpELMj5W
Dr. John Cush RheumNow ( View Tweet)
Voclosporin and Steroids in Lupus Nephritis
Dr. Jack Cush reports on abstract OP0059 presented at Eular 2024 in Vienna, Austria.
https://t.co/y9QPieV0py https://t.co/GzwntEJLve
Dr. John Cush RheumNow ( View Tweet)
PMR patients get too much steroid.
Data across 27 million people in England, n=39,438 with PMR.
The blue are getting more pred than guidelines.
Like everything in rheum: we need to be giving less pred, not more. Lumping PMR in with GCA won’t help.
#EULAR2024 POS0411 @RheumNow https://t.co/bsi3lrAafm
David Liew drdavidliew ( View Tweet)
Steroids are often started before pts see a rheumatologist
This associates with long-term low-dose steroid use
Need better collaboration between referrers and rheum to reduce this avoidable steroid burden
POS0137 @RheumNow #EULAR2024
Mrinalini Dey DrMiniDey ( View Tweet)
« Glucocorticoids are such old drugs and we still use them so much » says Josef Smolen
Summary slide from « 75th anniversary of GCd, what have we learnt? »
@RheumNow #EULAR2024 https://t.co/XSRt44zupw
Aurelie Najm AurelieRheumo ( View Tweet)
EULAR guidelines for screening for TB in rheumatic disease patients
#EULAR2024 https://t.co/jaixl8lGkY
Jilaine Bolek Berquist BolekBerqui ( View Tweet)
POS0277: proof of concept: Prophlx with canakinumab x 1 dose rather than steroids/colch/NSAIDS when starting pegloticase with MTX in pts with active, refractory gout: 11 pts: #gout flares 0 (compared 54% in MIRROR-C), infusion rxn 0, no safety signal @rheumnow https://t.co/4qFnQTOuq0
TheDaoIndex KDAO2011 ( View Tweet)
The fracture risk with glucocorticoids is dose dependent. Lems W #EULAR2024 @RheumNow https://t.co/TGjKu1vfXx
Dr. Antoni Chan synovialjoints ( View Tweet)
I was allocated to bring down the warning, & I did apologise up front to both the EMA and Janet #EULAR2024. It's a tough gig regulating impactful medicines with risk-benefit, especially when our world is full of other medicines with risk-benefit trade-offs (like prednisolone). 2/ https://t.co/6YPhYHbhg8
Links:
David Liew drdavidliew ( View Tweet)
#EULAR2024 OP0124 EULAR recommended target oral Pred =<5mg/d. Should the threshold of LLDAS be changed to LLDAS5? Multicentre study showed the protection gained from mortality, irreversible organ damage accrual and flare was no different btw the two targets @RheumNow #EULARBEST https://t.co/GbP25tTmX8
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2024 OP0180 Can we safely taper GC in #lupus patients who are in remission? Single study in Italy showed in pts with SLEDAI=0 + pred =<5mg/d + stable IS/HCQ, GC discontinuation after proper tapering appeared safe and was associated with a low risk of flare @RheumNow https://t.co/8IIgPuZUrF
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
OP0165- incidence & risk factors of D2T RA in an early RA cohort
Factors assoc with D2T RA:
🩸 Seropositivity
🦴 Erosions
📈 Disease activity
📊 D2T pts have higher steroid doses & more commonly develop iatrogenic-related #comorbidities, e.g. osteoporosis
#EULAR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
Can you ⬇️
#Glucocorticoids or #immunesuppressive in #SLE & change am’t of damage
From Asia Pacific #lupus collab
(Biologics not included)
Compared 7.5 mg #prednisone or less
Or DMARD
1/2 flared after LLDAS
⬇️dose didn’t prevent damage
#EULAR2024
@eular_org @RheumNow https://t.co/QmjEz87Cvw
Janet Pope Janetbirdope ( View Tweet)
