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EULAR 2023 – Day 1 Report
EULAR 2023 launched today to crowds of attendees. The opening Plenary session and presidential address by Dr.
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Promising new therapies in SLE
The pharmacology treatment in SLE is a rapidly expanding field of research that provides excitement and optimism to both the patients and the clinicians. We now have three licensed targeted therapies (belimumab and voclosporin in active lupus nephritis and anifrolumab in non-renal SLE) over the last 3 years compared to one therapy (belimumab in non-renal SLE) in the previous 50 years. What are other promising therapies on the horizon?
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An update on JAK inhibitors and cardiovascular risks
In the last 2 years, there has been more caution and vigilance with the use of JAK inhibitors in the treatment of rheumatoid arthritis due to the risk of CV events, including MACE and VTE. The ORAL surveillance study, a post-approval safety study conducted in RA patients aged ≥50 years with ≥1 CV risk factor, has resulted in increased caution and greater emphasis on assessment of MACE and VTE risks in patients starting JAK inhibitors.
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Is Interferon Type1 Impt in #scleroderma? #EULAR2023 OP#0114 Interferon accelerated skin fibrosis in mouse model- 61 pts 1/3 dcSSc, 2/3 lcSSc had markers of INF-1 in blood vessels &skin - more in #diffuse #SSc ?Rx opportunity w available drugs? RCT needed @RheumNow @eular_org https://t.co/vZWjSY8jKg
Janet Pope Janetbirdope ( View Tweet)
What would you do? A middle aged woman has pain and impaired hand function with her PIP&DIP erosive hand #osteoarthritis? Exam - jts are tender w soft tissue swelling? #NSAIDs, #denosumab, #methotrexate? 🤷♀️ A +RCT of #MTX in #erosive #hand #OA at #EULAR2023 @RheumNow @eular_org https://t.co/7rp3nReTPd
Janet Pope Janetbirdope ( View Tweet)
Are we going to treat hands OA with MTX?
Moderate effect on VAS pain at 6 and 12 months in a small RCT vs. PBO in hands OA WITH MRI detected synovitis.
Thoughts
1) Is it really OA?
2) Benefit Risk balance remains debatable
@RheumNow OP0070 #EULAR23 https://t.co/WLlX48NtGT
Aurelie Najm AurelieRheumo ( View Tweet)
#EULAR2023 OP0083-HPR Stretch & Strength training is key! An RCT in Brazil shows: Pilates x 3/week is more effective in reducing pain, HRQoL, psychological effects & analgaesic consumption VS Aerobic walking on treadmill x 3/week for 12 weeks in women with Fibromyalgia @RheumNow https://t.co/CzIH9Xd8Ku
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
An interesting biomarker in #sJIA- helps differentiate it from other diseases, including infections and other inflammatory diseases! - kids with fever! serum calprotectin (MRP8/14) particle enhanced immuno-turbidimeteic assay (sCAL Turbi). 650 pts @rheumnow
#EULAR2023 abst#OP0034
Bella Mehta bella_mehta ( View Tweet)
#CPPD and #cervical involvement. Several clinical presentations
A-asymptomatic deposition
B-crowned dens syndrome
C-retro-odontoid pseudotumor
D-inflammatory discitis
Good teaching points in the supplements! @RheumNow #EULAR2023 Abst#AB1859 https://t.co/LJe7Gk1oZX
Bella Mehta bella_mehta ( View Tweet)
Remember to discuss bone density in your pts with #gout! Bone mineral density was significantly lower in pts with hyperuricemia, more so in males and elderly. Large cohort wirh 9017 pts from China! @EULAR2023 @rheumnow abst#AB1639 https://t.co/BGscJxMZno
Bella Mehta bella_mehta ( View Tweet)
Gut microbiome studies are implicated in all disease we study! 5 gut microbiota are suggested to have a causal relationship in #gout.
68k controls and 2k gout pts.
Can experts comment if it's just data mining or discovery? #EULAR2023 @rheumnow abst#ab1237 https://t.co/d1AkDPG8QR
Bella Mehta bella_mehta ( View Tweet)
#EULAR2023 #OP0046 With more effective therapies in #lupus, we should aim for bare minimum/cessation of steroid. A study using French database showed:
>12% were on =>5mg Pred/d, this associated with comorbidities & increased costs
14% on high dose Pred weren’t on HCQ
@RheumNow https://t.co/x99Jt9yf1g
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2023 #OP0007 What are the recent trends of autoimmune disease (AID)? A database study (22m) in UK showed:
- 1 in 10 people had AID in the last 20yrs
- socioeconomic, seasonal & regional disparities cd influence pathogenesis
- CTD (SLE,pSS,SSc) tended to co-occur @RheumNow https://t.co/3DDPR2K5NC
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Medication adherence in #lupus - assessed using Optum administrative database 14 yrs. 12510 pts. Median copays were less than $ 10. Black and hispanics had significantly lower odds of adherence after adjusting for several SDOH! @rheumnow #EULAR2023 abst#AB0579 https://t.co/pO5tjzTPbz
Bella Mehta bella_mehta ( View Tweet)
Chinese study 43 axSpA pts Rx w/ Secukinumab-37 pts had HBV & 16% (6) reactivated HBV after mean 9 mos of SEC (5 w/ chronic HBV, 1 occult HBV). 2 pts chronic HBV reactivated despite anti-HBV prophylaxis. 6 axSpA w/ LTBI - none had TB on SEC https://t.co/o4gA9mcD2R https://t.co/XKwp2z9U3K
Links:
Dr. John Cush RheumNow ( View Tweet)
Randomized double blind, placebo controlled MTX trial in inflammatory #handOA - pts with MrI detected synovitis. 97 pts 20mg MTX helped reduce pain and stiffness at 6 months. @rheumnow
#EULAR2023 abst#OP0070
Early work with some promise!
Bella Mehta bella_mehta ( View Tweet)
Interesting newer potential theraputics in #handOA discussed at #EULAR2023 - denosumab had clear structure modifying effects in erosive habd OA compared to placebo. Monocentric, placebo controlled, doubke blind phase 2 study of 100 pts. @rheumnow abst#OP0071
Bella Mehta bella_mehta ( View Tweet)
Recruitment in clinical trials is tough in #lupus and #CTD. A #EULAR2023 study of 49 trials, 1909 records- in an unselected, real world cohort of #CTD pts, upto 50% would be excluded due to classification criteria or overlapping features etc! Abst#op0013 @RheumNow https://t.co/X3YuvgSVzo
Bella Mehta bella_mehta ( View Tweet)
Colchicine 0.5mg BID for 12 weeks in #HandOA did not relieve pain. Results from 186 pts- double blind placebo controlled, randomized. MCID on VAS of 15 was not achieved. Presented at #EULAR2023 today abst#op0073
@RheumNow
Bella Mehta bella_mehta ( View Tweet)
Metanalysis of 62 RCTs, 16 LTEs, 82 366 Pt-Yrs JAK exposure. JAKi malignancy incid rate = 1.15/100 PYs in RCTs (1.26/100PYs overall). Network meta-analyses show no diff betw JAK & PBO or MTX in NMSC, but signif increased malignancy risk (IRR 1.50) https://t.co/kk12pa17Nn https://t.co/qEcRatKRSf
Links:
Dr. John Cush RheumNow ( View Tweet)