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ILD in RA and PsA
Interstitial lung disease (ILD) is a severe extra articular manifestation of RA, with limited treatment strategies and poor prognosis.
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Swiss Clinical Quality Management cohort
1200+ PsA pts:
Overweight 27% & Obesity 37% PsA > 11% vs. 30% general pop
Obesity ⬆️ over time in males only
Socio economic status NOT associated w/ risk in PsA population vs. general pop
https://t.co/wLkZUuskZl OP0064 #EULAR23 @Rheumnow https://t.co/dYg0iGmLCy
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Diagnosing spondylitis is a pain in the ‘butt’! #EULAR2023 OP0005 studied an inception cohort of incident chronic low back pain followed for 2 yrs. Of pts referred to #rheumatologist, 1/3 had dx of axSpA, but clinical features alone didn’t; imaging did. @RheumNow OP0005
Janet Pope Janetbirdope ( View Tweet)
ICYMI: The Biosimilar "Buy In"
In 2023, we are expecting 17 biosimilars in rheumatology. While some pharmaceutical company and payer contracts are still under negotiation, we need to start preparing ourselves and our patients.
https://t.co/U7YTH0Uodf https://t.co/PZelN4G5Jb
Links:
Dr. John Cush RheumNow ( View Tweet)
A highlight at #EULAR2023 AI in predicting RA from MRI scans of hands and feet in patients with early onset arthritis or clinically suspect arthralgia. From 1,974 people, 651 went on to develop RA. The accuracies were close to expert level prediction, Li Y, Abst#OP0002 @RheumNow https://t.co/MP8yn18PWI
Dr. Antoni Chan synovialjoints ( View Tweet)
#EULAR2023 #OP0052 Could we predict renal flares in #lupus patients treated with Belimumab for non-renal purpose? Post-hoc analyses of 3 x RCTs showed predictors were:
- Current/former renal involvement
- high baseline proteinuria
- hypoalbuminaemia
- low C3
@RheumNow https://t.co/vylWCf0XNy
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
RheumNow’s expanded coverage of the #EULAR2023 annual meeting is sponsored in part by Bristol Myers Squibb. All content is chosen by RheumNow and its faculty.
Dr. John Cush RheumNow ( View Tweet)
Beydon et al., french registry study 255000+ RA patients 2010-2020
Increase ⬆️ overall malignancy by 20% vs. general pop
⬆️lung 40%, ENT 40%, cervix 80%, prostate 8%, melanoma 37%
Pancreatic cancer 10% less frequent in ♂
Breast 9% & Uterine body 23% less frequent in ♀
Aurelie Najm AurelieRheumo ( View Tweet)
So can computers beat humans in predicting RA from pre-RA arthralgia MRIs?
No, for now… but unsupervised they pick up the same culpable features we look for: bone marrow edema & tenosynovitis. Sometimes it’s nice when the machines tell us we’re right
#EULAR2023 OP0002 @RheumNow https://t.co/71Zo2JyC8d
David Liew drdavidliew ( View Tweet)
I swear it is muscle, Doctor!
GLORIA trial substudy
Pred 5 mg/day 2 years in RA pts >65yo:
Weight gain 1kg vs. PBO, no increase or redistribution of fat mass but augmentation in lean mass 💪
Probably explained by better disease control (although NS in study, small sample size)
Aurelie Najm AurelieRheumo ( View Tweet)
Mild correlation between fine motor hand skills and synovitis score grey scale and PD
However no correlation w/ TJC68/SJC66 https://t.co/ryCs21KRcB
Aurelie Najm AurelieRheumo ( View Tweet)
#EULAR2023 #OP0053 Baricitinib in non-renal #lupus were inconclusive. How about Renal #SLE?An RCT showed primary endpoint (=>50% reduction in proteinuria) was met more in Bari vs Cyclo at Wks12 & 24. Intriguing but need longer-term, composite endpoint and larger size! @RheumNow https://t.co/z3YJog6gTy
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Loss of grip strength in PsA is NOT correlated w/ clinical parameters but US features
US study of 100+ pts w/ Pso or PsA
Strong correlation grip strength & grey scale tenosynovitis score (digit 2) r=-0.6
https://t.co/qClfMrhqhI OP0069 #EULAR23 @Rheumnow
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
EULAR imaging recommendations in gout - ultrasound and DECT are recommended, double contour sign useful, by Peter Mandl, Abstr#0008 @RheumNow https://t.co/BNd1S3AJpB
Dr. Antoni Chan synovialjoints ( View Tweet)
EULAR PtoC management of targeted therapies in pts w/ IA & Hx cancer
1) If remission, initiate targeted therapy w/out delay
2) Prefer anti-cytokine bDMARDs if Hx solid cancer
3) B cell depleting therapy if Hx lymphoma
4) Use JAK inhibitors and abatacept with caution 🛑 https://t.co/cKhQVZwGh1
Aurelie Najm AurelieRheumo ( View Tweet)
#EULAR2023 Could we predict renal flares in #lupus patients treated with Belimumab for non-renal purpose? Post-hoc analyses of 3 x RCTs showed predictors were:
- Current/former renal involvement
- high baseline proteinuria
- hypoalbuminaemia
- low C3
@RheumNow https://t.co/bBtBm1olcr
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Belimumab in Lupus Nephritis
Belimumab is a BLyS-specific inhibitor that is FDA approved for the treatment of active lupus and lupus nephritis, based on a few pivotal trials; and now a metanalysis supports its use in active lupus nephritis.
https://t.co/f2odJWlyR2 https://t.co/y5exJIFzht
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Dr. John Cush RheumNow ( View Tweet)
Nathalie Conrad, Abstr#OP0007 @RheumNow presenting on the incidence, prevalence and co-occurrence of autoimmune disease - no evidence of overall increase in conditions. Environmental and socioeconomic factors involved in the presentation of the conditions https://t.co/3jy9NoltkG
Dr. Antoni Chan synovialjoints ( View Tweet)
Prediction of RA early arthritis & clinically suspect arthralgia pts w/ AI analysis of MRIs scans:
✔️Feasible
✔️Accurate AUC 0.683 EA group AUC 0.727 CSA group
✔️Peformance = human experts
✚ Could identify new imaging biomarkers
https://t.co/sVXw9A8NqZ OP0002 #EULAR23 @Rheumnow https://t.co/oq5RJApm9U
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
🚨EULAR PtC clinical & imaging features suspicious for progression to PsA
Main take home messages ⬇️⬇️
Obesity, Nail Disease, Extensive PsO, Arthralgia, US detected synovio-entheseal
involvement/abnormalities in US = risks factors of developing PsA in PsO pts.
@Rheumnow #EULAR23
Aurelie Najm AurelieRheumo ( View Tweet)