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EULAR 2022 – Day 3 Report

Jack Cush, MD

By now, those of us attending the meeting know how to find a free coffee or sprite, have found comfortable meeting nooks and know our way around! PAnd congrats to you virtual Rheums for mastering the multi-screen, multitask simultaneous consumption posters, tweets and oral abstract presentations.

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Babies! Safety and Outcomes Data on Pregnancies

Kathryn H. Dao, M.D.

EULAR Congress 2022 highlighted several posters on pregnancy, an important subject as most rheumatic diseases afflicts women during their childbearing years.

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RNL22 RA Best Management

RNL 2022: Rheumatoid Arthritis - Best Management

Jack Cush, MD

This week's Tuesday Night Rheumatology, hosted by Dr. Jack Cush, featured highlights from the 2022 RheumNow Live Rheumatoid Arthritis - Best Management Pod, followed by a lively audience Q & A. Lectures featured:

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coronavirus,COVID,Mask,red

Increasing Corticosteroid Use in Non-Hospitalized COVID-19

Jack Cush, MD

JAMA reports that despite NIH recommendations (that corticosteroids only be used in hospitalized COVID-19 patients), nonhospitalized COVID infected patients were oftent prescribed systemic corticosteroids.

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Can SGLT2 Inhibitors Be Protective in Lupus and Vasculitis?

Jack Cush, MD

SGLT2 inhibitors are all the buzz in the renal world with reports of a renal protective and mortality lowering effects. Maybe these agents should be considered and studied in lupus nephritis and ANCA- associated vasculitis.

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#LB0006 #EULAR2022 Therapy for relapsing polymyalgia rheumatica. 118/280 recruited re:COVID impact. Phase 3 RCT of Sarilumab+14Wk Steroid taper showed more pts had sustained remission at Wk52 vs PBO+52Wk Steroid Taper(28% vs 10%) even if CRP excluded. PRO improved too! @RheumNow https://t.co/P11iXIAfGn
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
SAPHYR phase 3 RDBPCT study: #sarilumab vs PCB for relapsing #PMR on pred 7.5+ mg/d. Study met endpoints (whether of or not CRP was included). Time to first flare was longer w/SARI, less steroid use, and also better PROs. AE: #EULAR2022 LB0006 @rheumnow 1/2 https://t.co/lIspLKlveb
TheDaoIndex KDAO2011 ( View Tweet)
Novel ePROMS use. Use of ePROMS RAPID3/PASS and asking patients if they had a flare had high diagnostic accuracy identifying those not needing DMARD or steroid intensification up and eligible to skip their next outpatient clinic visit. Seppen et al #EULAR2022 @RheumNow POS0381

Dr. Antoni Chan synovialjoints ( View Tweet)

Palmowski et al. Glucocorticoids and bone density in GCA/PMR/other vasculitis from Rh-GIOP. Weird one, no increase in osteoporosis, no association with current or cumulative steroid dose and osteoporosis. Low BMI, vert #, PPIs were assoc osteoporosis. @RheumNow #EULAR2022 POS1139 https://t.co/n3d6YArXmU
Richard Conway RichardPAConway ( View Tweet)
More from GLORIA. Tapering pred 5mg after 2 years. Some minor increase in disease activity (DAS28 0.26) with no evidence of adrenal insufficiency. Can successfully withdraw long term steroids! @RheumNow #EULAR2022 OP0270 https://t.co/IV9iJLY22v https://t.co/ZXdwxlXorK

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Richard Conway RichardPAConway ( View Tweet)
In case there was doubt: - steroid toxicity is real in GCA - giving steroid-sparing therapies (TCZ, MTX) early makes a difference just something to not forget when your next new GCA patient rolls in the door? POS0805 #EULAR2022 @RheumNow https://t.co/2wGV3M8wZD
David Liew drdavidliew ( View Tweet)
Boers et al. GLORIA trial of long term 5mg pred in RA. Titled as "favourable balance of benefit and harm". I cannot agree. 24% increase adverse events, NNH 9, for DAS28 0.37 better at 1 year, and really no difference after that. @RheumNow #EULAR2022 OP0263 https://t.co/eO4f1CjH5q https://t.co/VyyZm1QvYy

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Richard Conway RichardPAConway ( View Tweet)
Long-term low-dose steroids for RA: can it be weaned? Weaning after 2y of blinded add-on in RA: either PNL 5mg/d or placebo No substantial evidence of adrenal insufficiency - symptoms same - cortisol/ACTH same It's never too late to wean the pred! OP0270 #EULAR2022 @RheumNow https://t.co/jp2ZOlAEnb
David Liew drdavidliew ( View Tweet)
Yoshimura et al. 10 year findings of TOMORROW study. Glucocorticoid use of even 2mg/day is fracture risk in RA! @RheumNow #EULAR2022 POS0631 https://t.co/c8uCdPzUiE
Richard Conway RichardPAConway ( View Tweet)
Unizony et al. Case series of tocilizumab + 8 weeks steroid in GCA. 30 patients, 50% new 50% relapsing. 77% in sustained remission at week 52! No vision loss. Exciting, needs an RCT @RheumNow #EULAR2022 OP0185 https://t.co/ohBYIWYxBC https://t.co/fsn4x17Hwv

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Richard Conway RichardPAConway ( View Tweet)
#Behcets. If topical oracort / steroids don’t work for Mucosal ulcers consider topical #tacrolimus https://t.co/7ZiLfdwZoP

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Janet Pope Janetbirdope ( View Tweet)

Continue with PJP prophylaxis during the 6 months of induction Rx and until B cells repleted and if prednisone > = 20 mg/day #EULAR2022 AAV reccs @rheumnow

TheDaoIndex KDAO2011 ( View Tweet)

#EULAR2022 TREAT-EARLIER OP0700 Arthralgia + subclinical inflammation in MRI without RA, treated with MTX + depo steroid injection ▶️In High risk patients, delayed development of synovitis, but does not prevent in long-term ▶️Reduction in disease burden on MTX Rx @RheumNow https://t.co/SKlqMQQTui
Eric Dein ericdeinmd ( View Tweet)
ACR21: conditionally recommends against steroids with starting csDMARD #EULAR2022 recommends with rapid GC dose reduction and discontinuation Which is better recommendation? @RheumNow

Eric Dein ericdeinmd ( View Tweet)

And now the paper that no one can find even if they are looking for it. On the relationship between disease activity and glucocorticoid disease. https://t.co/aT8I0jwQOJ @rheum_covid @ARD_BMJ https://t.co/7ntGLPdypJ

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The COVID-19 Global Rheumatology Alliance rheum_covid ( View Tweet)
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