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The steroid dosing in SAPHYR (sarilumab in PMR):
Bottom two trajectories: sarilumab protocol & actual
Top two trajectories: placebo protocol & actual
Fascinating that with sarilumab, more PNL only really in play at PNL <3mg/d. Def takes the heat out
POS0715 #EULAR2023 @RheumNow https://t.co/aEC8cQaR7O
David Liew drdavidliew ( 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)
• Erdheim-Chester disease (ECD) is associated with Langerhans cell histiocytosis (LCH)
• Bone pain, xanthelasma, hairy kidney
• Differential diagnoses of LCH
• BRAF mutation associated with cardiac and neurological phenotype of ECD
Haroche J, Papo M
#EULAR2023
@RheumNow https://t.co/AzKJKp82nq
Dr. Antoni Chan synovialjoints ( View Tweet)
What do we do with PMR patients with subclinical GCA seen on ultrasound?
Well, in these non-blinded cohorts the subclinical GCA pts got more pred.
Was it warranted? Hard to say. If we’re going to look for it, let’s try and figure out what it means
POS0712 #EULAR2023 @RheumNow https://t.co/KmCcE0Nsu9
David Liew drdavidliew ( View Tweet)
Rx of #lupus #SLE The most challenging seems to be longstanding & residual disease activity - damage accumulates over time - esp if #glucocorticoids are used. Consider only as bridging. How to treat #lupus #EULAR2023 Boumpas @RheumNow #ClinicalPearl @eular_org https://t.co/heBbcRAjxO
Janet Pope Janetbirdope ( View Tweet)
I mean, if proteomics is more your jive for GCA, we’ve got that too here at #EULAR2023. Definite potential for phenotyping a disease with diverse outcomes
POS0694 @RheumNow https://t.co/tSWpZlUPoE
David Liew drdavidliew ( View Tweet)
Could mitochondria play a role in the pathogenesis of Sjogrens disease?!
#Eular2023 https://t.co/XndW4qFf3E
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
Malt lymphoma in Sjogrens disease and role of PET scan.
When is PET scan suggestive?
Follow:
Complement
RF
Focus score
SPEP
#Eular2023 https://t.co/60l8iRNvQN
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
Just a reminder: nr-axSpA isn’t destined to become r-axSpA/AS. Life is more complicated than that.
Between the natural history and TNFi, very small conversion rate post-10y. Of course, whatever the x-rays, it can still disable though
DESIR cohort POS0675 #EULAR2023 @RheumNow https://t.co/29HeJXpK2S
David Liew drdavidliew ( View Tweet)
Very early days, but it’s cool to see transcriptomics in GCA ➡️ in situ spatial profiling ➡️ drug-gene interactions ➡️ new therapeutic targets identified.
Only time will tell if they will work, but very cool nevertheless.
POS0091 (Mayo, La Jolla, & INSERM) #EULAR2023 @RheumNow https://t.co/n7raIENVOT
David Liew drdavidliew ( View Tweet)
I’ve been hearing the term ´Jackies’ used in talks on Jak inhibitors. A shorter form of JAKinibs or JAKi #EULAR2023 @RheumNow
Dr. Antoni Chan synovialjoints ( View Tweet)
In Brazil, if you’re in the early RA clinic (yellow bars) you do a lot better than other academic clinics, even w bDMARD access.
Maybe it’s early Rx, or love & care, or other patient factors
- but it’s a reminder that RA isn’t a level playing field.
POS0055 #EULAR2023 @RheumNow https://t.co/jI2dvuIHWP
David Liew drdavidliew ( View Tweet)
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)