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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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TNR Grand Rounds - Update on Biosimilars
This week's Tuesday Nite Rheumatology featured Dr Jonathan Kay (U Mass) who gave an update on Biosimilars and took questions the subject. The program was moderated by Dr. Jack Cush.
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Noninflammatory Pain Persists in RA Despite Treatment
Almost one-third of patients with new-onset rheumatoid arthritis (RA) reported persistent unacceptable pain after 21 months of combination therapy, according to a study by Swedish researchers.A total of 29% of patients continued to have unacceptable pain.
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RA pts are at risk of pneumonia, & inflamed lung mucosa can produce RF/CCP. Are these linked via subclinical lung injury?
Seropos RA pts @BrighamWomens have double the pneumonia risk post-adjustment.
We're still learning more about RF...
@jeffsparks OP0111 #EULAR2020 @RheumNow https://t.co/C3CYpXABGc
David Liew drdavidliew ( View Tweet)
Tenosynovitis is underrated in RA.
A nice reminder from an Argentinian group, who USS scanned 90 RA pts in clinical remission >3m and followed them for 12m. Subclinical synovitis did not predict flares, but subclinical tenosynovitis did (adj OR 9.8)
THU0119 #EULAR2020 @RheumNow https://t.co/kcle8qyQbI
David Liew drdavidliew ( View Tweet)
Physician global assessment in RA is a murky beast, which we should standardise better (especially interrater).
Portuguese cross-sectional (n = 392): SJC/CRP/HAQ/PGA did not fully explain it.
What are we capturing, and does it matter?
THU0111 #EULAR2020 @Janetbirdope @RheumNow https://t.co/krL2yFIl8a
David Liew drdavidliew ( 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)
RA isn't just a disease of joints & tendons: muscle is abnormal even at diagnosis. Changes throughout disease seen on MRI: T2, fatty infiltration, muscle volume all vary at different stages. Plenty more to understand/optimise! @LeedsBRC @DrAiLynTan OP0332 #EULAR2020 @RheumNow https://t.co/PwjLuZ1wcL https://t.co/QSYZALfi29
David Liew drdavidliew ( View Tweet)
I mean, the EULAR recommendations for management of early arthritis are tough:
"1. Patients presenting arthritis... should be referred to, and seen by, a rheumatologist, within 6 weeks after the onset of symptoms"
Does it matter though?
https://t.co/wJkVHQZqjs
David Liew drdavidliew ( View Tweet)
Integrated safety analysis of filgotinib treatment for RA from 7 clinical trials: 4,057 patients, VTE risk looks very reassuring #EULAR2020 @RheumNow https://t.co/Ld2tpu7UT5 https://t.co/sZqadeUTh8
Links:
Dr Philip Robinson philipcrobinson ( View Tweet)
And another one! No association of MTX with worsening of ILD in this study by Men-Vazquez et al. #EULAR2020 https://t.co/X7C6KyC29L
Richard Conway RichardPAConway ( View Tweet)
#EULAR2020 ABST#OP0012 German RABBIT registry show TNFi has less risk for venothrombolic events HR 0.53 (95% CI 0.33-0.86) compared to csDMARD in RA. Age > 65 years, CRP > 5 mg/L increases risk for VTE, no differences with steroids or smoking status.
@RheumNow https://t.co/Hkv6T7pl9f
k dao KDAO2011 ( View Tweet)
#EULAR2020 Plenary Abstr#OP0016 Brilliant study showed how gut microbiota dysbiosis may trigger RA in high risk people (+CCP w/o Sx) using fecal transplantation in a mouse model to trigger collagen induced arthritis @rheumnow
Healthy vs. preclin RA vs. RA microbiota specimen: https://t.co/ZITCAcmuXh
k dao KDAO2011 ( View Tweet)
After seeing the results of the NORD-STAR early RA trial, would you start a newly diagnosed, treatment naive RA patient on: #EULAR2020 @RheumNow
k dao KDAO2011 ( View Tweet)
#EULAR2020 OP0020: RABBIT 5500 pt study of all DMARDS/biologics, IL-6 inh may be the best to improve fatigue seen in RA patients @rheumnow https://t.co/VJW8MwMamM
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)
#EULAR2020 panel on #COVID19 spec. situatns:
1. German regtry: very few preg rheum pts w/CV19; cases mild.
2. No info how CV19 affects APS
3. Very few ped rheum cases of CV19- cases mild; outcomes sim to gen peds pop
4. Most rheum pts w/CV19 good prognosis @rheumnow https://t.co/LQVdzJKCgu
k dao KDAO2011 ( 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)
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)
