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Impact of regulatory warning on JAK inhibitors
The development of JAK inhibitors represents an advance for the treatment of inflammatory rheumatic diseases. However, the enthusiasm in using this target has waned since the publication of the ORAL surveillance clinical trial in 2022. Subsequently, both the FDA and EMA issued a warning on using JAKi in patients with certain risk factors, e.g., ≥65 years, at increased risk of MACE, current smoker or past smoker and at increased risk of cancer, should other alternative treatment be available. So, how has this warning impacted on JAKi development and use?
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Is a Biomarker for Adverse Pregnancy Outcomes on the Horizon?
With a better understanding of pathophysiology, improved management guidelines, available medications, and a multidisciplinary approach, pregnancy for lupus patients has become more feasible. Despite these improvements, some patients still experience poor outcomes, highlighting the need for biomarkers that can predict these risks. An abstract presented at #EULAR2024 (POS1393) explored this possibility.
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BARI reduces nociplastic pain, small cohort RA n=13
-wk 12 ACR FM score 14 vs 10.5 p=0.03
-fMRI data: reduction connectivity between DMN and posterior insula & between IPL & anterior/middle insular regions
Directs mechanims yet to be investigated
@RheumNow POS0310 #EULAR2024 https://t.co/jGgvS5qqV6
Aurelie Najm AurelieRheumo ( View Tweet)
Is RA always preceded by clinically suspect arthralgia? Cohort 650+ pts CSA = 83 pts no CSA = 616 pts
Pts w/ no CSA: -older -more frequent acute onset of symptoms -higher SJC -increased CRP -less ACPA+ No sure how accounted for memory bias
#EULAR2024 @RheumNow POS1030 https://t.co/dJeN41ax5P
Aurelie Najm AurelieRheumo ( View Tweet)
🗓️ Our abstract on psychosocial determinants of health in #RheumatoidArthritis will be presented at #EULAR2024
📹 Watch my video on @RheumNow for a sneak preview!
📍 Join me to hear more on #PARE Poster Tour IV, Friday 14th June, 12:00 - 13:00 CEST
https://t.co/rDTJVukD6j
Mrinalini Dey DrMiniDey ( View Tweet)
➡️POS0591 Are there sex differences in risk & outcomes of stroke in patients with #RA?
📈Stroke risk in RA increased compared to general population
🫀Not fully explained by traditional risk factors or AF
📊Stroke-related mortality differs in women vs men
@RheumNow #EULAR2024
Mrinalini Dey DrMiniDey ( View Tweet)
POS0592 Increased overall & cause-specific mortality in population-based cohort of people with incident #RA
Higher mortality in RA vs gen pop but this has decreased after 2000 & better 10-year survival
Severe causes of mortality incl cardiac higher in RA
EULAR2024 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
POS1035 FVC & risk of lung transplant & mortality in #RAILD
50% pts had FVC % predicted decline in ~6.5yrs
2/3 identified groups more strongly assoc w transplant or ILD-related death than INBUILD definition ➡️marked heterogeneity in ILD progression
#EULAR2024 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
📄 You can now read my article on #CardiovascularDisease, #Stroke & #Mortality @RheumNow!
🌟 Featuring 2 cohort studies from @MayoClinic, presented at #EULAR2024
🔗 https://t.co/b639vE5hSA
@MyasoedovaElena
Mrinalini Dey DrMiniDey ( View Tweet)
#EULAR2024 OP0193 Watch out, blinatumomab will BiTE! Bi-specific T-cell engagers (BiTEs), kill Bcells by engaging Tcells. In 6 refractory #RA patients (failed 3 x ts/bDMARDs), deep blood & tissue depletion were met, good response. Brief raised temp but no cytokine storm @RheumNow https://t.co/OmxSbTXfZq
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Fascinating - @ndb_org installed an app to measure smartphone usage, and texting less and moving less were associated with more flares.
The pseudo-wearable in our pockets??
#EULAR2024 POS0678 @RheumNow https://t.co/ZA0hd3Q10d
David Liew drdavidliew ( View Tweet)
Is muscle US useful in RA?
100+ pts 1yr followup
BL muscle thickness correlated w/ grip strength improvement
HAQ improv correlated w/ pennation angle vastus lateralis
No diff between muscle morphology & DAS
I'd say it's still easier to US joints!
@RheumNow #EULAR2024 POS1033
Aurelie Najm AurelieRheumo ( View Tweet)
RA patients on abatacept have an appalling immunogenic response to Shingrix. Humoral fades away in the first year, and an absence of cellular responses.
Alarming and need strategies to combat this #EULAR2024 POS0620 Winthrop/@RADoctor @RheumNow https://t.co/8gY9ocLBDp
David Liew drdavidliew ( View Tweet)
#EULAR2024 POS0390 What impact of regulatory warning on JAK-i on access to therapy? Data from UK BSSR-BR reported 4 in 5 #RA patients would have been considered ‘high-risk’. Of these, 28% had failed ≥3 biologics; so no suitable alternatives. Enormously impacted @RheumNow https://t.co/XeS9qHXSpH
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
What psychosocial factors drive treatment outcomes and disease activity for people living with rheumatoid arthritis?
#EULAR2024 POS0309-PARE @DrMiniDey @ElenaNikiUK @RheumNow https://t.co/q0tTLSL044
David Liew drdavidliew ( View Tweet)
Do we give enough attention to pts mental health?
2 cohort 400+ RA tREACH & DEPAR 500+ PsA
RA 20% depression 30% anxiety
PsA 19% depression 22% anxiety
2 yrs no remission
RA OR 2.5 depression OR 1.7 anxiety
PsA OR 6.10 depression OR 4.67 anxiety
@RheumNow #EULAR2024 POS0946 https://t.co/ok4HRNJqgY
Aurelie Najm AurelieRheumo ( 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
Artem Minalyan, MD, DABOM AMinalyan ( 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
Artem Minalyan, MD, DABOM AMinalyan ( View Tweet)
How good are we at picking up depressing in RA patients?
In this Polish registry:
- 1.8% had a depression diagnosis
- 21% had low mood on HAQ
& depression has real correlates with disease activity.
Plenty to think about with truly holistic RA care!
#EULAR2024 POS1045 @RheumNow https://t.co/ZNbMVo8TGk
David Liew drdavidliew ( View Tweet)
Bold conclusion from Japan:
laughter improves function in RA.
I like it
Feel like it might be partially a correlation/causation link but if an hour of laughter can push down IL-6 levels in RA patients, time for reimbursement for stand up comedy?
#EULAR2024 POS1029 @RheumNow https://t.co/EpHnX50PgF
David Liew drdavidliew ( View Tweet)