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For patients on bDMARDs having surgery, we worry about post-op delayed wound healing.
In this Japanese cohort, TCZ use was a risk factor.
Unclear if meds withheld, but given IL-6 upreg in wound healing, it's plausible TCZ might have worse outcomes??
SAT0047 #EULAR2020 @RheumNow https://t.co/HVIKPplwiA
David Liew drdavidliew ( View Tweet)
Hand OA Rx strikes out. HCQ Rx neg and colchicine Trial negative. I wouldn’t put hand OA as same category of no Rx as for SSc and Sjogrens but agree though nuts to crack @eular_org @CRASCRRheum @earlyarthritis #EULAR2020 https://t.co/QRe3UpKpbz
Janet Pope Janetbirdope ( View Tweet)
Awesome colchicine data from @CatherineL_Hill @samwhittle and others: Colchicine is not effective for reducing osteoarthritic hand pain compared to placebo: a randomised, placebo-controlled trial (COLAH) Abstract FRI0399 #EULAR2020 @RheumNow https://t.co/NVw9fo55dc https://t.co/LfHZVQTwIf
Links:
Dr Philip Robinson philipcrobinson ( View Tweet)
#EULAR2020 THU0260 LESS IS BEST when it comes to steroids: Singapore 10 yr retrospect SLE study noted GCs dose is an independent predictor of mortality for hospitalized infection even when adjusted for disease activity.
k dao KDAO2011 ( View Tweet)
#tacrolimus #prograf is non inferior to #MMF #cellcept in #lupus #nephritis induction. We’ve been doing it for years but great to see some solid RCT data behind this. #rheumatology #SLE #autoimmune https://t.co/CblD4GaXCp
Mohammad A. Ursani MD, RhMSUS DrMAUrsani ( View Tweet)
#EULAR2020 Dr. V Ritschl:EULAR Task Force on Patient Adherance: 30-80% of pts do not adhere to Rx. resulting in ⬆️dz severity, pain, fatigue, depression, decreased in function, physical activity. HCPs should discuss adherance reg. & explore factors affecting adherance. @RheumNow
k dao KDAO2011 ( View Tweet)
Your #RA patients in low disease or remission, do you maintain, reduce or stop DMARDs #EULAR2020
Dr. John Cush RheumNow ( View Tweet)
#EULAR2020 Updated RA Mgmt Recc
Main points:
1. MTX 1st line (if contraind, then SSZ/LEF; NOT HCQ)
2. Add bDMARD/JAKi if 1st csDMARD doesn't work + poor Px
3. Use IL-6i or JAKi for pts who can only take monoRx and failed csDMARD
@RheumNow
https://t.co/AIXz2dEOrX
k dao KDAO2011 ( View Tweet)
Do not be tempted to stop MTX or other DMARDs perioperatively! They probably help rather than harm #EULAR2020 https://t.co/jb4ZuZlqSu
Christos Koutsianas Dr_C_Koutsianas ( View Tweet)
#EULAR2020 #op0225 sub study of OPAL Balance: withdrawal of MTxdoes not negatively impact Tofa efficacy in PsA. At 6 mo deltaPASDAS 0.229 (0.079) for tofa mono & 0.q138 (0.081) for tofa+mtx. LFT elevation more common in combination arm @RheumNow https://t.co/NO1agViScD
Olga Petryna DrPetryna ( View Tweet)
Don’t forget significant fibrosis with ILD has +RCT with nintedanib INBUILD study. Lots of buzz of RA ILD where MTX is OK, TNFi may have more ILD than other bDMARDs, biomatkers KL-6 @eular_org OP0038 #EULAR2020 @CRASCRRheum https://t.co/OihF3LmNYQ
Janet Pope Janetbirdope ( View Tweet)
#guselkumab #axialdisease - who would have thunk it - IL23 p19 works in axial involvement PsA with radiology! https://t.co/TaSFBJFRnx
Peter Nash drpnash ( View Tweet)
MTX in GCA (+/- TCZ): can GiACTA data provide insights?
MTX didn't add anything from data provided, but channelling bias a definite issue (note PNL numerically higher in non-MTX).
MTX as adjunct/cover post-TCZ? We'll need to test for it properly
FRI0220 #EULAR2020 @RheumNow https://t.co/BCsEKqqaMh
David Liew drdavidliew ( View Tweet)
Primary Sjogren’s syndrome showed benefit of leflunomide + #Hydroxychloroquine vs placebo - past neg RCT of HCQ for PSS Sicca (dry eyes/mouth) so is it just leflunomide that works or combo? Likely pt selection - arthritis and rash likely respond to either @RheumNow @CRASCRRheum https://t.co/lsIeG2uv2H
Janet Pope Janetbirdope ( View Tweet)
For a drug that everything in RA has been built on, we're not great at predicting who will respond to methotrexate.
It's probably because we don't have all the info. Adding pharmacogenomics increased optimal AI prediction from 55% to 76%
@MayoClinic FRI0046 #EULAR2020 @RheumNow https://t.co/bwpSYQIBLG
David Liew drdavidliew ( View Tweet)
Filgo reduces PsA markers OP0224. ? Unique to filgo, a JAK1 effect , class effect or part of any effective PsA Rx or some of the above? @eular_org @RheumNow @CRASCRRheum @earlyarthritis #EULAR2020 https://t.co/2O5wsLPNl2
Janet Pope Janetbirdope ( View Tweet)
Analysis of the UK THIN database shows that delays in receiving followup Denosumab injx results in higher fracture risk (vertebral & Maj OP Fx). 6144 infusions in 2594 pts, shows risk if delay is >16wks (long delay), but not if 4-16wks #EULAR20 SAT0453 https://t.co/DkJK3dHeRN https://t.co/r7ckpSF6PA
Links:
Dr. John Cush RheumNow ( View Tweet)
H2H UPA vs ABA RCT; UPA is clinically superior to ABA in DAS-CRP remission, ACR50, ACR70 at wk 12/24 (NOT diff in Pain, FACIT, Boolean remission); But UPA has more serious AE (vs ABA) - esp hepatic, OI, SIE, SAE, CPK (but not zoster VTE) #EULAR20 SAT0151 https://t.co/K96lybdg7L https://t.co/vQM2MSCNzD
Links:
Dr. John Cush RheumNow ( View Tweet)
Dr Mariette summarizes the evidence for using cytokine-targeted therapies in #COVIDー19
Several studies with favorable results with #Tocilizumab and #Anakinra, however, almost all with methodological limitations (e.g., historical groups)
#EULAR2020 #EULAR20 #EULAR2020goesvirtual https://t.co/cMUKoeGfK9
Juan Camilo Sarmiento-Monroy jcsam25 ( View Tweet)
Do certain TNFi get more affected by obesity in RA? I have colleagues convinced infliximab is better for obese pts (weight-based dosing).
It actually seems obese RA pts might do as well as other RA pts w etanercept, but not w infliximab!
@DrMiniDey OP0220 #EULAR2020 @RheumNow https://t.co/EsaLTqINpd
David Liew drdavidliew ( View Tweet)
