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To treat or not? Clinically suspect arthralgia does affect QoL including function. Both premises of treating with a DMARD are valid. OverRx v missing the very early window of opportunity @RheumNow #EULAR2023 @eular_org https://t.co/86CVZ2IjEf
Janet Pope Janetbirdope ( View Tweet)
Use of antîmalarials in RA reduced the risk of bacterial infection in RA, smaller number of viral and fungal to study impact on systematic infections Bredemeier M, Abst#OP223 #EULAR2023 @RheumNow https://t.co/RXuFi3LdZC
Dr. Antoni Chan synovialjoints ( View Tweet)
Should we use #immunesuppression EARLY in #scleroderma to prevent #ILD? Answer from a study comparing Y vs N immune suppression- there was no difference in FVC decline. Maybe not a long enough study, ? Chanelling bias scleroderma #lung #disease OP0239 @RheumNow #EULAR2023
Janet Pope Janetbirdope ( View Tweet)
#EULAR2023 #POS1128 Promising new therapy on the block for #lupus nephritis. A single arm Phase 2a study showed Zetomipozomib, selective immunoproteosome-i + MMF showed about 2/3 pts met =>50% reduction in uPCR at WK24. No safety signal including low IgG or infection @RheumNow https://t.co/0A8cCW5GVV
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
50% reduction of RF levels
& Complete seroconversion at M3 predicts LDA and Remission at M6 to M24 period after treatment initiation.
RF responders reach LDA/Rem faster.
Exciting data but... SDAI remains the stronger predictor of response at M3
@Rheumnow #EULAR23 OP0272 https://t.co/td1MZEzqag
Aurelie Najm AurelieRheumo ( View Tweet)
We worried that JAKi + MTX might impair Shingrix efficacy, esp given JAKi HZ risk
Shingrix nested in upa RCT:
Response (seroconversion rate, titres, cellular response) less than gen pop, but still very good
+ only 2/95 had RA flares
Vaccinate away!
OP0225 #EULAR2023 @RheumNow https://t.co/i4ObRSyYh9
David Liew drdavidliew ( View Tweet)
#ClinicalPearl Rx of #scleroderma #ILD -add another drug. MMF, then Cyclo, Rituximab, ?tocilizumab; if progressive fibrosis then #Nintedanib ?Pirfenidone Small RCT of MMF v Tacrolimus - looked the same -helpful if MMF fails, future pregnancy OP0240 @RheumNow #EULAR2023 @eular_org https://t.co/XWphyEO2JJ
Janet Pope Janetbirdope ( View Tweet)
Natural sequence of events happening in a subclinically inflamed joint, serial MRI study
When progressing to clinical RA
First osteitis then synovitis & tenosynovitis
🦴➡️✋
During resolution tenosynovitis reduces first then synovitis & osteitis
@RheumNow #EULAR23 OP0261 https://t.co/ic94htYv6T
Aurelie Najm AurelieRheumo ( View Tweet)
#EULAR2023 #POS1133 Consistent with clinical response in Phase 2 RCT, therapy with Updacitinib alone and ABV599-HD (Elsubrutinib + Upadacitinib) modulated IFN-I signalling pathways (IFN gene expression & proteomics). Assuring therapeutic evidence @RheumNowNews https://t.co/27mtCNg76X
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Long term data on Canakinumab - IL-1B antibody in #AOSD @EULAR2023 25 pts with persistent disease activity, f/u 12 mths, remission in all but 2 pts. Improved parameters as below :-
@rheumnow abst#OP0257 https://t.co/7jKTp87FlX
Bella Mehta bella_mehta ( View Tweet)
#EULAR2023 #OP0226 DORIS remission in #SLE is a goal but may be slight tricky to achieve. Multicentre cohort study showed attainment of LLDAS protected against subsequent Flare and Damage @RheumNow https://t.co/MIypIDW6aE
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
For our rheum patients who have had cancer previously - the default can’t be to not have DMARDs.
@eular_org points to consider SLR:
no clear risk, across b/tsDMARDs
For too long these patients were unnecessarily asked to ride it out. No more please
POS1069 #EULAR2023 @RheumNow https://t.co/7m4Yh0h7rd
David Liew drdavidliew ( View Tweet)
We know HCQ adherence is poor in both RA and SLE
>50% in this BC 🇨🇦 cohort
All despite being such an important medicine
What’s super interesting are the trajectories of adherence - and we’d like to understand more about what motivates each group
OP0222 #EULAR2023 @RheumNow https://t.co/rbx1l9T36C
David Liew drdavidliew ( View Tweet)
Should immunosuppression be used to improve #PAH in #SSc added to PAH Rx (85%) Morbidity or mortality outcomes >700 pts - half had a DMARD after dx RheumNow #EULAR2023 OP0238 Targeted Rx improved esp RTX\TCZ findings V interesting results #GameChanger May change my Rx practice!
Janet Pope Janetbirdope ( View Tweet)
Retro French database study shows reassuring data.
Overall mortality after IRAEs =similar between pts receiving b/tsDMARDs vs. those who don't
70000+ pts treated w/ ICI, 7800+ IRAEs (most frequent colitis) & 330 treated w/ b/tsDMARDs, 10% Rheum IRAE
OP0270 @RheumNow #EULAR23 https://t.co/OFNaIU4kzt
Aurelie Najm AurelieRheumo ( View Tweet)
Antimalarial adherence in RA and SLE showed 4 patterns of adherence over time, with 53% drop off in 1 year, with higher adherence with age, SLE and socioeconomic class, Hoque MR, Abst#0222 #EULAR2023 @RheumNow https://t.co/Bld5kWVQxE
Dr. Antoni Chan synovialjoints ( View Tweet)
Fatigue in SLE remains a challenge!
Online digital tool - LEAF - Lupus Expert System for Assessment of Fatigue - assement of fatigue PROMs in 1250pts - 80% reported fatigue, 93% found tool helpful @rheumnow #EULAR2023
Need more tools to assess and manage fatigue!
abst#OP0230
Bella Mehta bella_mehta ( View Tweet)
#EULAR2023 #POS1075 Which biologics have the lowest retention rate in Elderly patients (=>65 yrs) in Rheumatoid Arthritis? Data from Italian registry showed 1/3 discontinued biologics at 2 yrs. IL6-i: lowest persistence; Abatacept: highest @RheumNow https://t.co/28n4qzR3aM
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Can’t escape ORAL Surveillance RCT talk
Lots of real world data on CV risk & JAKi here
(with all the selection, measurement bias)
First up: multinational JAK-pot study (n=>50k)
Even if you mirror the high-risk RCT cohort - not much there for MACE
OP0219 #EULAR2023 @RheumNow https://t.co/FfNspdivri
David Liew drdavidliew ( View Tweet)
No new predictors for decline in #SSc lung function in ILD Progression of #scleroderma Lung disease is common - risks male, dcSSc, low FVC, Topo1 @RheumNow #EULAR2023, OP0236 @eular_org https://t.co/bTxTyLE8dZ
Janet Pope Janetbirdope ( View Tweet)