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Turning the Corner on CV Risk in Rheumatoid Arthritis
Cardiovascular (CV) disease remains the leading cause of mortality in rheumatoid arthritis (RA). A number of studies progressed our knowledge in the session Rheumatoid arthritis - comorbidity and clinical aspects – I on Thursday at EULAR 2021.
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Pregnancy is a minefield for RA pts:
dx activity➡️preg risk
PNL➡️preg risk, but dx activity proxy?
bring on Swedish/Danish linked data:
1739 RA preg matched 1:10
⬆️pre-term/SGA risk with bDMARDs/PNL
adj for dx activity: less bad, but still concern?
OP0210 #EULAR2021 @RheumNow https://t.co/AlwFtmGcZH
David Liew drdavidliew ( View Tweet)
In the ESPOIR cohort of 813 RA followed for 10 years, polypharmacy associated w/ less DAS28 ESR Remission at 5 (45.0% in vs. 56.3% (p=0.03)) and 10 yrs (32.5% vs. 67.5% (p=0.06)) BUT no longer significant when adjusted for comorbidities!
#EULAR2021 @Rheumnow #OP0098 https://t.co/pSrr1dzKFP
Aurelie Najm AurelieRheumo ( View Tweet)
Acute Coronary Syndrom incidence in > 24,000 RA from Nordic registers followed up to 5 yrs = 5.5/1000 pyrs. After 5yrs RTX show > risk of ACS compared to ETA. In patient with >= 2 previous DMARDs ABA, INF and RTX > risk of ACS compared to ETA.
#EULAR2021 @Rheumnow #OP0114 https://t.co/MjW9LI2cjt
Aurelie Najm AurelieRheumo ( View Tweet)
Patients with RA > 70yo and risk of severe infection: which therapeutic strategy is the safest?
#EULAR2021 @Rheumnow #OP0116
Aurelie Najm AurelieRheumo ( View Tweet)
Dr Yoshida analyze data from US registry 40,721 RA patients. High 2.11 [1.13, 3.96] and moderate 1.97 [1.13, 3.43] CDAI associated w/ > HR of major adverse CV events. HRs decrease during follow up.
Tight and early disease control reduces CV burden!
#EULAR2021 @Rheumnow #OP0101 https://t.co/A0ZYE4v8uf
Aurelie Najm AurelieRheumo ( View Tweet)
In 16,448 RA from ACR’s RISE registry: no difference in disease activity TNFi and non-TNFi at 12 months. Stratified analysis: ⬆️disease activity for TNFi vs. non TNFi in patients of Black and Asian ethnicity. To be confirmed in independent cohorts.
#EULAR2021 @Rheumnow #OP0117 https://t.co/7bFnOKR9uz
Aurelie Najm AurelieRheumo ( View Tweet)
MTX or ETA which one withdraw first? @RADoctor SEAM-RA trial: PROs following withdrawal of MTX or ETN in RA patients with sustained SDAI remission receiving combination ETN+MTX. ETA > MTX for maintaining SDAI remission at W48 (49.5%-28.7% P=0.004)
#EULAR2021 @Rheumnow #OP0118 https://t.co/MSOclXGMEK
Aurelie Najm AurelieRheumo ( View Tweet)
Can we predict pre-clinical RA-ILD?
@Juge_P_A ESPOIR cohort. model w/ 4 variables: male gender, older age @ diag, mean DAS-28 over follow-up and MUC5B variant ▶️ preclinical ILD after 13 years of RA w/ AUC=0.82 CI 95% (0.72-0.91) (Sens 80%, Spe 56%)
#POS0095 @Rheumnow #EULAR2021 https://t.co/bPyidNhNuO
Aurelie Najm AurelieRheumo ( View Tweet)
Can machine learning show JAKi effects for safety? Off target binding predicted in #tofacitinib 58, #baricitinib 41 but NO pathway for thrombosis or viral infection. Could have repurposing for + effects on lung vasculature & antifibrotic effects POS0091 #EULAR2021 @RheumNow
Janet Pope Janetbirdope ( View Tweet)
MACE events with #JAKi is as clear as mud! You voted >50% NOT Sure 1/3 only some Jakis vs MACE in #TNFi! Dunno #EULAR2021 @RheumNow @eular_org https://t.co/vWUgKSwAap
Janet Pope Janetbirdope ( View Tweet)
Poorer outcomes with #JAKi in pts who get #SARSCoV2 but ? related to line of therapy - worse off if 2nd line advanced Rx in RA vs 1st line? JAKi has short half life so it washes out? And..#baricitinib added to #remdesivir improves outcomes NEJM @RheumNow #EULAR2021 #OP0006 Dunno! https://t.co/583z6Mlw3y
Janet Pope Janetbirdope ( View Tweet)
News Feature: EULAR 2021 – Day 1 Report #EULAR2021
https://t.co/igpQYMkf9l https://t.co/qESsN3meJe
Links:
Dr. John Cush RheumNow ( View Tweet)
How common is RA ILD? @RheumNow #EULAR2021 @eular_org
Janet Pope Janetbirdope ( View Tweet)
RA ILD is NOT a needle in a haystack! Older age& makes & COPD is a risk MUC5B gene SNIP are risks NOT ACPA. 7-10% will have relevant RA ILD. Are you ready to identity & treat it? @RheumNow #EULAR2021 BI RA ILD symposium @eular_org https://t.co/4mS6Jejjqk
Janet Pope Janetbirdope ( View Tweet)
Leave my MTX alone says pt & #rheumatologist if pt has chronic ILD. Acute pneumonia from MTX is NOT chronic ILD in RA @RheumNow @eular_org #EULAR2021 #BoehringerIngelheim RA ILD silent killer symposium https://t.co/IQTINuUpVq
Janet Pope Janetbirdope ( View Tweet)
Great talks on comorbidities in RA at #EULAR2021 today. What do we struggle most with in RA management? @RheumNow
Richard Conway RichardPAConway ( View Tweet)
RA ILD will kill pts esp UIP pattern and extent & presence of honeycombing on HRCT. Think about it esp if older pt #EULAR2021 #BoehringerIngelheim symposium @RheumNow @eular_org https://t.co/be2Z7KMqpg
Janet Pope Janetbirdope ( View Tweet)
#POS0093 Collaborative registry studies are to be encouraged! BUT
@k_lauper outlines the heterogenity between registries concerning #AE reporting - Jak-pot study - 18 registries with #RA patients on #tofacitinib - Rates of discontinuation vary across registry
#EULAR2021 @RheumNow https://t.co/oczJAG8hzv
Paul Studenic Stiddyo ( View Tweet)
An original way of differentiating RA from PsA!
The shape of the second MCP in HR-pQCT is enough to train a neural network with high accuracy for recognition of
-HC 94%
-RA 84%
-PsA 89%
and an AUC of 91%. #EULAR2021 @RheumNow #OP0145 https://t.co/BrwFQpX310
Aurelie Najm AurelieRheumo ( View Tweet)
