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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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There are a number of diseases where new biologic and targeted synthetic therapeutic options are coming online, and the temptation will be to consider them all equally. GCA is one of those diseases.
Dr. John Cush
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Giant Cell Arteritis and Polymyalgia Rheumatica Update
Dr. Janet Pope discusses abstracts LBA0001, OP0233, OP0261 and POS0280 at Eular 2024 in Vienna, Austria.
https://t.co/0V9Sle0GMU https://t.co/ixeT8L562C
Dr. John Cush
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Dr. John Cush
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#POS0234 The effect of prophylactic Septrin in ANCA #vasculitis pts treated with RTX/CyC need further characterisation. Multicentre study in Korea showed protective effect on Serious Infection btw those treated vs not. Effect was seen in the 1st 3mths only
#EULAR2024 @Yuz6Yusof https://t.co/tOOvvVynKA
Dr. John Cush
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RCT of #upadacitinib in #GCA
It works to steroid spare
15 mg > 7.5 mg in outcomes
Both >>placebo
Ethically PBO had slower #prednisone taper
Similar to #TCZ data
What to choose in GCA
IL6i?
IL17i?
JAKi?
@eular_org
# LBA0001 @Janetbirdope https://t.co/DGOltriVYF
Janet Pope
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Summary of #EULAR2024 #ClinicalPearls
JAKi have expanding disease data
✅ #GCA w #UPA
✅ Awaiting data in #SLE w #UPA & #Deucravacitinib
✅Use in #JIA
✅No new safety signals
@rheumnow
@eular_org
Janet Pope
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Once in remission with
#rituximab in #GPA
How long to resize
500 mg q6 mo for
4 years?
?longer
?less
#EULAR2024 @eular_org @RheumNow https://t.co/G4kU3v81je
Janet Pope
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#EULARBEST
RCT of #upadacitinib in #GCA
It works to steroid spare
15 mg > 7.5 mg in outcomes
Both >>placebo
Ethically PBO had slower #prednisone taper
Similar to #TCZ data
What to choose in GCA
IL6i
IL17i
JAKi
@eular_org @RheumNow LBA0001 https://t.co/gy0TEiHxjo
David Liew
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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
Md Yuzaiful Md Yusof
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#EULAR2024 POS0234 The effect of prophylactic Septrin in ANCA #vasculitis pts treated with RTX/CyC need further characterisation. Multicentre study in Korea showed protective effect on Serious Infection btw those treated vs not. Effect was seen in the first 3mths only @RheumNow https://t.co/dCzD21589S
Peter Nash
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EULAR Abstract Archive
OP0283 (2024)
LONG-TERM EFFICACY TOCILIZUMAB AFTER ULTRA-SHORT GC TO TREAT GCA: 3 Yr FOLLOW-UP OF THE GUSTO TRIAL
3 day GC pulse immediate 12 mths Toci 85% drug free remission at 4 yrs! https://t.co/XWnzuVMlbn @RheumNow #EULAR2024
Md Yuzaiful Md Yusof
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#EULAR2024 LBA0001 New Steroid-sparring therapy for #GCA. Phase 3 RCT showed Upadacitinib 15mg met primary endpoint (sustained clin remission frm Wks 12-52 & adherence to 26Wk GC taper) vs PBO [46% vs 29%] & multiple secondary endpoints. No new safety signals @RheumNow https://t.co/edfSZkMuy2
Mrinalini Dey
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LBA0001 UPA in GCA- Phase 2 RCT
15mg UPA with 26w steroid taper showed
⬆️ efficacy
⬇️ steroid use
vs placebo with 52w steroid taper
Potential new target on the horizon for #GCA??
@RheumNow #EULAR2024
Rheumatology & Rheumatology Advances in Practice
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Enjoyed the #PolymyalgiaRheumatica session at #EULAR2024? Make sure to download our first atlas imaging article, where @drceowen, @drdavidliew et al. characterise PMR using whole-body PET/CT 👀
➡️ https://t.co/tbu0DgAFIS https://t.co/W06YbYyjRx
Nouf Al hemmadi
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Maintenance of remission in GPA/MPA.
RTX for 48 months sounds good to me.
#EULAR2024 https://t.co/5YGwOHhCuX
Janet Pope
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#wasup in #GCA?
#upadacitinib +RCT in #temporal #arteritis LBA0001
Residual #inflammation in 1/3 of pts at 6 mo #Rx w #TCZ on repeat TA Bx
OP0621
#PMR cases
#Leflunomide beats #MTX for
#pred sparing
⬇️relapses
But MTX dose was low
POS0280
#EULAR2024 @RheumNow @eular_org
Md Yuzaiful Md Yusof
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#EULAR2024 POS1420 A cohort study with 1/3 each with GCA, PMR and GCA+PMR found that at 6mth, 16% of patients had new diabetes/diabetes worsened. Worse in GCA+PMR group with the greatest GC accumulation. Call for better GC-sparing strategy @RheumNow https://t.co/ex7u83bVfj
Md Yuzaiful Md Yusof
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#EULAR2024 POS0742 A single cohort study showed for non-criteria #APS, cardiac manifestation (valvular dysfunction & regurgitation) was more common in Triple Ab+ vs Non-Triple Ab. We should monitor and consider an echocardiogram for this group of patient @RheumNow https://t.co/VxFUSpjaG1
David Liew
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If your GCA flares, do you get the same features as you did at diagnosis?
20% of the time it can be new, so keep on doing the checklist!
(also, visual flares uncommon - the power of pred)
#EULAR2024 POS0110 @MayoClinic @MdWarrington @RheumNow https://t.co/hkF8vJT6HI
