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ICYMI: 2023 EULAR Psoriatic Arthritis Recommendations
EULAR has updated its treatment recommendations from the prior 2019 guidelines, since there have been several newly developed agents. The updated guidance includes 7 overarching principles and 11 recommendations regarding treatment strategy and pharmacological therapies.
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RA: update for women of child bearing potential (and men!)
Fertility in the context of RMDs is a daily concern for a lot of rheumatologists and patients.
EULAR this year proposed new fertility data, especially in Rheumatoid Arthritis, along with an update of the EULAR points to consider for use of antirheumatic drugs in reproduction, pregnancy and lactation.
Abbvie announced upadacitinib (Rinvoq) is approved for use in polyarticular JIA and Psoriatic Arthritis (in children 2 years of age and older who have had an inadequate response or intolerance to 1 or more tumor necrosis factor (TNF) blockers) https://t.co/gvRzYpFl5i https://t.co/uSISWG3foy
Dr. John Cush RheumNow ( View Tweet)
RT: @synovialjoints In a Swedish-Danish cohort study on patients with PsA, treatment with TNFi was associated with a small increased risk of NMSC and with non-significant numeric risk increases for both BCC and SCC compared with bDMARD naïve #EULAR2024 Abstract 0150
Dr. John Cush RheumNow ( View Tweet)
RT: @aurelierheumo
TOLERA trial in RA
RTX/ABA sequence versus RTX alone
10pts each group
Primary outcome was ambitious: ACPA seroconversion
No difference between ttmts (and also no seroconversion)
No diff in disease activity
No diff in ACPA change wt wk52
OP0069 #EULAR2024
Dr. John Cush RheumNow ( View Tweet)
TARGET compared triple DMARD to TNFi in 122 RA pts and association with CV risk. In a subanalysis they found no correlation between change in lipid measurements and change in vascular inflammation by FDG-PET. https://t.co/0HKogmdRGH https://t.co/cD7UVTgTQ3
Dr. John Cush RheumNow ( View Tweet)
Swap or Cycle? Study OP0081 show after failure to a first TNFi in patients with axSpA, the drug retention rate was higher in the cycle strategy compared to the swap (IL-17i) strategy. No difference in the disease activity between cycle and swap strategy #EULAR2024
Dr. John Cush RheumNow ( View Tweet)
Potential of Radiomics to Predict TNF Therapy Outcomes in axSpA
Dr. Bella Mehta interviews Dr. Vincenzo Venerito about abstract POS0236 at Eular 2024 in Vienna, Austria.
https://t.co/mv9DeZ9cez https://t.co/1OpT3MomO8
Dr. John Cush RheumNow ( View Tweet)
RISK OF NON-MELANOMA SKIN CANCER WITH TNFi AND OTHER bDMARDs IN PATIENTS WITH PSORIATIC ARTHRITIS: A SWEDISH AND DANISH COHORT STUDY- despite having minimal sun 25% increase NMSC TNFis vs other bDMARDs - skin checks ! @RheumNow #EULAR2024
Peter Nash drpnash ( View Tweet)
EULAR Abstract Archive
OP0031 (2024)
COMPARATIVE ANALYSIS OF TNF INHIBITORS & IL17 INHIBITORS IN PSORIATIC ARTHRITIS: CARDIOVASCULAR OUTCOMES signif absolute risk diff 3 % ischaemic heart disease 2 % heart failure TNFi vs IL17i https://t.co/fNIiMt4caL. @RheumNow #EULAR2024
Links:
Peter Nash drpnash ( View Tweet)
Points to consider in pregnancy in
#rheumatic diseases
3 points
✅TNFi all OK 👍
? Only if you can’t control disease use other #bDMARDs
Baby #vaccinations if exposed to #biologics while present
#rotovirus ok
other live vaccines >6 mos
#EULAR2024 @eular_org @RheumNow https://t.co/MyJdA7p7zh
Links:
Janet Pope Janetbirdope ( View Tweet)
500+ pts AxSPA
No difference in drug discontinuation between IL-17i, TNFi, IL23i over time
Adjusted for CRP, co-medication w/ MTX + classic covariates
IL-17i and IL-23i had experienced a higher number bDMARD failures
#EULAR2024 POS0259 @RheumNow https://t.co/F3B6uXyAca
Aurelie Najm AurelieRheumo ( View Tweet)
Cohort from Netherlands 400+ PsA pts IR first bioDMARD
300+ switched TNFi->IL-17i, 99 cycled TNFi->TNFi
3year retention rates
12 mo 75% cyclers 80% swappers
24mo 60% cyclers 56% swappers
No difference in treatment failure or DAS28 CRP
#EULAR2024 @RheumNow POS0278 https://t.co/J8ONjVAFqG
Aurelie Najm AurelieRheumo ( View Tweet)
more evidence in PsA - switch MOA rather than cycle within class failed first TNF @RheumNow #EULAR2024 https://t.co/hf2UB5MXEy
Peter Nash drpnash ( View Tweet)
important session worth reading the full recommendations - TNF tick of approval @RheumNow #EULAR2024 https://t.co/ORDocVie11
Peter Nash drpnash ( View Tweet)
#opportunistic inf in #autoimmune dz
🎤 @khyrich
👉#herpes zost is ⬆️⬆️,esp😳#lupus (💉 >18yo🇺🇸)
👉#HBV react ⬆️⬆️ w/ RTX (9.1%) >>TNFi, JAKi, IL-6
👉 🙅♂️ #TB repeat 🧪 on #DMARD if 🚫new risk fact/gap⚠️
🔗#eular 2022 guide:
https://t.co/PIpGpTrH28
#eular2024
#rheumx
@RheumNow https://t.co/kouXvradiC
Links:
- https://ard.bmj.com/content/annrheumdis/82/6/742.full.pdf
- https://twitter.com/AMinalyan/status/1801606024576565284/photo/1
- https://twitter.com/AMinalyan/status/1801606024576565284/photo/1
- https://twitter.com/AMinalyan/status/1801606024576565284/photo/1
- https://twitter.com/AMinalyan/status/1801606024576565284/photo/1
Artem Minalyan, MD, DABOM AMinalyan ( View Tweet)
Cycle or swap 2? Post failure to a first TNFi in patients with PsA, there was no difference in cycle versus swap to IL17i for drug retention rate or disease activity. In male PsA patients a cycle strategy had a longer drug retention rate compared to a swap (IL-17i) strategy.… https://t.co/5BykvDwFWV https://t.co/GfcnIltV2A
Links:
Dr. Antoni Chan synovialjoints ( View Tweet)
What is better in #PsA
#psoriatic #arthritis
#TNFi or #apremilast #PDE4i
#COREVITAS database study in #PsA
YOU can guess the answer!
1st line advanced RxTNFi lasts longer - retention
Vs PDE4i
#EULAR2024 @RheumNow @eular_org
POS0990 https://t.co/VmYG6Rj87c
Janet Pope Janetbirdope ( View Tweet)
Cycle or Swap? The swap strategy (SG) (i.e. from TNFi to IL17i) had higher retention rates compared to the change strategy (CG) choice in PsA patients who failed the first line of advanced treatment. The 5 years retention rate in SG was higher than in CG (57,8% vs 45,2%; p=0.1).… https://t.co/pH5rFI00vK https://t.co/XqTHO1tIr3
Links:
Dr. Antoni Chan synovialjoints ( View Tweet)
The age old question in #inflammatory #arthritis
Should you cycle within TNFi class or move on to another MOA in
#PsA #psoriatic #arthritis
Better retention to go to a IL17i vs another TNFi in observational study comparing the 2
POS0266
#EULAR2024 @RheumNow @eular_org https://t.co/CXcmYAG4m9
Links:
Janet Pope Janetbirdope ( View Tweet)
