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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
Links:
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)
Provan et al. large scandinavian registry study: 🫁ILD risk in RA & PsA initiating b/tsDMARDs
HR ILD RA=10
HR ILD PsA=5
No increase risk w/ MTX and b/tsDMARDs but RA HR ILD 1.7 RTX vs. ETA: confounding by indication?
https://t.co/CF1ysNkQxU OP0006 #EULAR23 @Rheumnow https://t.co/DgDE1uFeUs
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
#EULAR2023 #OP0051 4-year Pooled Analyses of 3 x Anifrolumab RCTs in #lupus (inc. LTE) showed:
- LLDAS was attained earlier & more cumulative time was spent in LLDAS in anifrolumab compared to placebo groups
Assuring longer-term data
*sorry photos weren’t permitted @RheumNow
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Autoimmune disease diagnoses slowly on the rise, despite reduced smoking - but that’s now 10% of the population, & many patients have more than one. Most are lifelong.
Surely this needs more investment??
CPRD data from the UK #EULAR2023 OP0007 @RheumNow https://t.co/7NGF5YaE9z https://t.co/m6SaibqmEq
David Liew drdavidliew ( View Tweet)
https://t.co/0FsCCOP17E OP0044 #EULAR23 @RheumNow https://t.co/pl0AnGUAw1
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Scandinavian RA registry study shows reassuring data on CV risk in RA🫀
Acute Coronary Syndrom incidence rates are similar in RA pts achieving remission & general pop & is similar whether RA pts reach remission using MTX or TNFi.
https://t.co/wBDZtaTVba
OP0038 #EULAR23 @Rheumnow https://t.co/JLdbYF49xF
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Data from combined big Scandinavian population registries looking at both RA and PsA, ILD development, & MTX exposure
Here’s the ILD risk for methotrexate.
Can we stop this MTX misinformation? No more besmirching a really useful drug for our patients #EULAR2023 OP0006 @RheumNow https://t.co/7swqAYchDC
David Liew drdavidliew ( View Tweet)
Interstitial lung disease in RA and PSA in b/tsDMARD treated patients with MTX - there is no increased risk of developing ILD above the background risk of RA and PsA vs general population Sella Aarrestad Provan Abst#OP0006 @RheumNow https://t.co/yJsrmraeZ5
Dr. Antoni Chan synovialjoints ( View Tweet)
Comorbidities and metabolic burden in PsA:
-Occur EARLY
-Early PsA pts > multiple comorbidities & > CV morbidity vs. age-matched early RA pts
Independent of BMI & obesity
Time to address these as part of dis pathogenesis in PsA
https://t.co/qOiGHn2eZT OP0066 #EULAR23 @Rheumnow https://t.co/lK7MbeMybO
Links:
Aurelie Najm AurelieRheumo ( View Tweet)