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The interface between cutaneous lymphoma and lupus panniculitis, characteristic differences and diagnostic algorithm, Eviatar T, #EULAR2023 @RheumNow https://t.co/HRTQWS4Ctq
Dr. Antoni Chan synovialjoints ( View Tweet)
Do we use too much PNL in GCA (when not using TCZ)? Could we wean quicker?
Salvarini group n=22
26w PNL weaning protocol from GiACTA, but no TCZ
10/26 in relapse free remission at 1y
Much less PNL, still some steroid AEs
Way of the future for some?
POS0728 #EULAR2023 @RheumNow https://t.co/qeZHeCi9vq
David Liew drdavidliew ( View Tweet)
Tapering pred in RA - this just rings true from everyday clinic life.
Some patients just seem to hit a wall at PNL 2.5. Sometimes it’s GC withdrawal arthralgias/tertiary adrenal insufficiency, but often it’s genuine inflammation.
I still wonder why?
POS0050 #EULAR2023 @RheumNow https://t.co/JBh26VqPuM
David Liew drdavidliew ( View Tweet)
#EULAR2023 #POS0120 From Sjogren to SLE. Interim analysis of Phase 2 RCT showed primary endpoint, SRI-4 + ability to sustain pred dose to ≤5 mg/d or ≤ BL from Wk16 to 28 was achieved more in Ianalumab (Bcell depletion & BAFF-R-i) vs PBO (44% vs 9%). Advance to Phase 3 @RheumNow https://t.co/Wg29uj5yqv
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Can machine learning help bDMARD selection in RA?
Early days limited by the data available, so not great yet, but efforts underway are a good start for an area where we need to do better than our status quo guessing.
Watch this space
POS0641 #EULAR2023 @RheumNow https://t.co/2j8H40iFWo
David Liew drdavidliew ( View Tweet)
You need to see this! Albert with a Left V1 distribution of #shingles is a ‘bot’ who interacts with #rheumatologists at #EULAR2023 @RheumNow @eular_org #artificial #intelligence https://t.co/gDwzc3NX7v
Janet Pope Janetbirdope ( View Tweet)
#EULAR2023 #POS0116 How does Voclosporin fare in #lupus pts with heavy proteinuria (=>2g/day)? Pooled Analyses from Phase 2&3 RCTs showed consistent improvement in renal response regardless of demographics or clinical characteristics. An option this resistant group @RheumNow https://t.co/AmZ0fStJrW
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
TNFi & Disease activity-guided dose optimization in RA⬇️prog of ADA or ETA daily dose (100%66%50%0%)
10yrs followup in 170pts
⭐️74% tapered until full discontinuation
⭐️Median time to restart 8 mo
⭐️21% never restarted!
What's lacking? % of recovery
@Rheumnow OP0131 #EULAR23 https://t.co/Ms6lqQ7cWf
Aurelie Najm AurelieRheumo ( View Tweet)
Rituximab in RA - do you need to maintain B cell depletion?
Well, in this Paris cohort, if you divide up patients by B cell depletion (at time of next infusion) - no diff in efficacy.
Bias possible but B cell depletion in RA isn’t the hill to die on POS0636 #EULAR2023 @RheumNow https://t.co/GLdu9YkL7g
David Liew drdavidliew ( View Tweet)
CareRA trial:
3 months addition of LEF vs. ETA in pts resistant to COBRA-Slim regimen (MTX 15 mg/w + step-down prednisone):
After 2 years, no difference in dis control but those who received ETA early were treated more frequently w/ csDMARD monotherapy #EULAR23 @RheumNow OP0129 https://t.co/YwSoZWi375
Aurelie Najm AurelieRheumo ( View Tweet)
Don’t be ‘rash’, get adult immune compromised Pts vaccinated against #shingles #varicella #zoster K Winthrop has research re #HZ #vaccination with #Shingrix in #Upadacitinib at #EULAR2023 #OP0225 Bottom line-get #immunecompromised Pts with #rheumatoidarthritis jabbed! @RheumNow
Janet Pope Janetbirdope ( View Tweet)
#EULAR2023 #POS0115 Can we minimise placebo response in #lupus trials? Post-hoc analysis of Phase 2 RCT Dapirolizumab (CD40-CD40L-i) showed greater response in acute flare with Normal Complement levels in the PBO group. Could Low Complement be used for trial entry? @RheumNow https://t.co/8aRq5tWi97
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
“You don’t need MTX with TCZ for RA”
Err, well:
- just like TNFi, you def can get ADAb to TCZ
- they definitely lead to lower response rates
- MTX co-admin reduces ADAb
Seems like a good idea to me, but your call 🤷♂️
Bitoun, Mariette et al POS0630 #EULAR2023 @RheumNow https://t.co/2jOAqA6YZ3
David Liew drdavidliew ( View Tweet)
The risk of demyelination with TNFi is low but real. Slight increase of risk was found in male RA patients. The small number of events is reassuring. Careful consideration is recommended in individuals at highest risk of demyelinating diseases Abst#OP0135 #EULAR2023 @RheumNow https://t.co/YT6ZrJTjU0
Dr. Antoni Chan synovialjoints ( View Tweet)
In polyrefractory RA patients, half did not have any PDUS change on ultrasound and/or had normal CRP levels, showing that in the other half, new mechanisms of action for treatment is required by David P, Abst#OP0134 ##EULAR2023 @RheumNow https://t.co/TaY7uGU0bg
Dr. Antoni Chan synovialjoints ( View Tweet)
#EULAR2023 #OP0142 From #Lupus to #Sjogren. A phase 2 RCT in China showed more patients on Telitacicept (BAFF/APRIL-i) achieved significant reduction in ESSDAI at Wk24 vs PBO. Trend to improvement in glandular function. Intriguing option & will await Phase 3 global RCT @RheumNow https://t.co/BCiohuAfP3
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
No relationship between MTX-PG levels in terms of efficacy by SDAI remission but higher MTX-PG levels related to adverse events by Tamai H, Abstr #OP0128 #EULAR2023 @RheumNow https://t.co/TiO5eeYlnS
Dr. Antoni Chan synovialjoints ( View Tweet)
JAKi have superior effectiveness at 6 months compared to TNFi and the efficacy was similar in those with and and without safety risk (increased age, CV risk, smoker) by Hannah Bower, Abst#0133 #EULAR2023 @RheumNow https://t.co/Pt6EoN6323
Dr. Antoni Chan synovialjoints ( View Tweet)
#EULAR2023 #OP0143 Promising therapy. A Phase 2 RCT of Dazodalidep (CD40L-i) in #Sjogren showed significantly more patients on DAZ group met reduction in ESSDAI vs placebo. Interesting to see higher hurdle ESSDAI favoured DAZ Group. Phase 3 RCTs are underway @RheumNow https://t.co/I9uHxvRlnr
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
We’re getting better at understanding different types of refractory RA (D2T RA)
We see differences with refractory RA subtypes:
PIRRA (persistently inflamm on USS), and
NIRRA (non-inflamm)
hopefully moving to data-driven Rx approaches for D2T RA?
OP0134 #EULAR2023 @RheumNow https://t.co/vX5IK5O9Wm
David Liew drdavidliew ( View Tweet)