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EULAR and ACR COVID19 Guidelines: Similarities Provide Reassurance
In difficult times, it's reassuring to reflect on the similarities that bring us together. In the case of the EULAR and ACR COVID19 guidelines as discussed at #EULAR2020 by Drs.
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Hydroxychloroquine Postexposure Prophylaxis for COVID-19 Fails
NEJM has reported that the use of hydroxychloroquine did not prevent symptomatic COVID-19 infection when used within 4 days after SARS-CoV-2 exposure.
Currently for persons who are COVID exposed, the standard of care is quarantine and there is no known preventative therapy.
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#EULAR2020 OP0160 Prospective study of Hopkins Lupus Cohort: HCQ blood levels can predict risk for thrombotic events in SLE. Dr. M Petri advocates this is another reason for monitoring HCQ whole blood levels. Goal HCQ whole blood level should be 1000-1500 ng/mL @rheumnow https://t.co/mM6jsJ2Qmf
k dao KDAO2011 ( View Tweet)
#EULAR2020 OP0163 Updated Lupus Nephritis EULAR/ERA-EDTA Recc:
1. T2T:⬇️proteinuria 50%@6 mo,UPCR<700 mg/g@12mo
2. Class III/IV:MMF, Euro-CYP; MMF+CNI
3. goal pred < 7.5 mg/day@6 mo
4.Class IV: MMF, CNI, CTX
5. Maintain w/MMF, AZP
6.🔃renal Bx w/refract. dz @RheumNow https://t.co/tGaSIDG1ji
k dao KDAO2011 ( View Tweet)
How long should you keep pts on TCZ for GCA after remission has been achieved? @RheumNow #eular2020
k dao KDAO2011 ( View Tweet)
#EULAR2020 Dr. Kimme Hyrich reviews the EULAR #COVID19 Registry "Most individuals with rheumatic diseases receiving immunosuppressive therapies recover from COVID19" @rheumnow https://t.co/EdVLUMyHhF
k dao KDAO2011 ( View Tweet)
SELECT-PSA-2 results: UPA15 & UPA30 showed improvement across PsA domains vs PBO through Wk 24. No new safety signals were identified. Check out abstract #OP0223 for the MDA/ACR50/ACR70 responses. #EULAR2020 @RheumNow https://t.co/UAx2tkKSZI
Dr. Rachel Tate uptoTate ( View Tweet)
Study out of Switzerland finds lower response rates to TNFi in women with nr-axSpA vs men. Poster #THU0383 #EULAR2020 @RheumNow https://t.co/uWNqwqamQM https://t.co/pgnhCaw9f6
Links:
Dr. Rachel Tate uptoTate ( View Tweet)
This Spanish study of 255 SpA pts found that acute unilateral anterior uveitis was the most common pattern, primarily in HLA B27+. NO difference in incidence between SEC and TNFi treated pts. #EULAR2020 @RheumNow Poster #THU0388 https://t.co/OMfG8atfE4
Dr. Rachel Tate uptoTate ( View Tweet)
nr-axSpA pts with active inflammation improved with IXE. Drug efficacy did not change in pts with elevated CRP or sacroiliitis or both. #EULAR2020 @RheumNow poster #THU0395 https://t.co/ap6Wy2eNBL https://t.co/zLoNHuSVV5
Links:
Dr. Rachel Tate uptoTate ( View Tweet)
COAST-V and COAST-X trial results: Both TNFi experienced and naive AS pts had better work productivity compared to PBO. #EULAR2020 @RheumNow poster #THU0396
https://t.co/UPDpLqCSkG https://t.co/UTLzxxTG8K
Links:
Dr. Rachel Tate uptoTate ( View Tweet)
10 ReA pt study out of India reviewing ETN-b found that all pts (previously on ETN) responded to biosimilar med without new safety signals. Further details are here on abstract #AB0632 https://t.co/lRA2IDvU4H #EULAR2020 @RheumNow https://t.co/QyhwBzBBH3
Links:
Dr. Rachel Tate uptoTate ( View Tweet)
Interesting observation: obese patients seem to respond better to etanercept than to mAb TNFi @RheumNow https://t.co/WrjwE4jUNI
k dao KDAO2011 ( View Tweet)
Big one from plenary, new option in ANCA-associated vasculitis:
avacopan (anti-C5a) vs prednisolone in patients receiving CYC/RTX: non-inf at 26w, superior at 52w in the phase III ADVOCATE trial with reduction in steroid toxicity
Merkel, Jayne et al OP0011 #EULAR2020 @RheumNow
David Liew drdavidliew ( View Tweet)
#eular2020 #op0302 Ianalumab (VAY736) dual action BAFFreceptor inhibitor/B cell depletion meets primary end point in p2b for pSS: EESDAI⬇️1.92 pts over PBO at wk24. Dis not meet 2ry endpoint ESSPRI&FACIT-F. Good side effect profile w/mild inj site reactions mostly @RheumNow https://t.co/9qsfUNho9h
Olga Petryna DrPetryna ( View Tweet)
You might think that steroid exposure in PMR patients wouldn't lead to new comorbidities.
These data beg to differ. New steroid-related comorbidities ++ across domains vs matched controls in real-world US claims data.
We need steroid-sparing in PMR.
OP0271 #EULAR2020 @RheumNow https://t.co/mSzWcJSpfV
David Liew drdavidliew ( View Tweet)
Does TCZ actually fix GCA?
@nihrheumatology cohort w serial PET/CT q6m:
FDG uptake (PETVAS) reduces longitudinally over 2y but does not normalise, w rebound on TCZ cessation
Ongoing reductions in year 2? GCA doesn't sleep.
@KQuinnRheum @petercgrayson OP0144 #EULAR2020 @RheumNow https://t.co/aczQbONcNc
David Liew drdavidliew ( View Tweet)
Our study shows that HCQ retinopathy virtually never occurs in first 5 yrs, SLE has more risk than other diseases such as RA and chloroquine has a far higher risk of retinal toxicity OP0333 #EULAR2020 @RheumNow @CRASCRRheum @earlyarthritis https://t.co/ZzRy3po4yw
Janet Pope Janetbirdope ( View Tweet)
#EULAR2020 OP0167 Results are finally in!!
MMF can be safely w/drawn in quiescent SLE: prospect RCT (nonblinded) 102 pts. MMF tapered over 12 weeks, f/u 60 weeks; no sig diff for flares in pts who stopped MMF vs. maintained; pts who cont MMF had ⬆️ minor infections. @rheumnow https://t.co/bOnuEBLis9
k dao KDAO2011 ( View Tweet)
When starting IV Pegloticase in #Gout, Do you start a DMARD too? #EULAR2020
Dr. John Cush RheumNow ( View Tweet)
