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EULAR 2023 Notes from Milan (6.09.2023)

d Jack Cush, MD

Dr. Jack Cush reviews highlight abstracts and sessions - covering lupus, RA, gout, Still's disease, safety data, AI in medicine and more - from last week's EULAR 2023 Congress held in Milan, Italy.

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ANCA, vasculitis, test

ANCA-associated vasculitis: beyond therapy with rituximab?

d Md Yuzaiful Md Yusof, MRCP(UK), PhD

Following the success of Phase 3 randomised controlled trials of non-renal and renal vasculitis, therapy with rituximab has tremendously improved the outcomes of AAV patients. However, some patients are unable to taper their glucocorticoids during rituximab therapy while others appear to be refractory to therapy, particularly those with EGPA. Hence, what are other current or future approaches beyond rituximab?

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EULAR19.abstract.jpg (keep)

EULAR 2023 – Day 4 Report

d Jack Cush, MD

Day 4 was a half day closeout to the EULAR 2023 Congress.

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Magnifying glass

Clinically suspect arthralgias: justified or artefact?

d David Liew, FRACP

Some subjects in rheumatology seem to create contention the more they get explored, and one of those areas is a traditional crowd favourite for discussion at EULAR - clinically suspect arthralgias.

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#Top #EULAR learnings #SLE #recommendations 1 Limit #prednisone 2 use #biologics early if poor prognosis 3 #lupus #nephritis - treat early with #belimumab or #voclosporin and more Rx in #RCTs #gamechanger https://t.co/JHQHu91tud
Janet Pope Janetbirdope ( View Tweet)
Targeted therapies in Sjogren’s syndrome: are we close? There is a clear unmet need for new and effective therapies in primary Sjogren’s Syndrome (pSS) patients, as there is no current licensed therapies. https://t.co/B4kKDjhuh7 https://t.co/pGWpSNhJe2

Links:

Dr. John Cush RheumNow ( View Tweet)
Puzzle pieces

Are T cells the missing link in pre-clinical RA?

d Aurelie Najm, MD, PhD

T cells are known to play a key role in RA pathogenesis and the diversity of the T cell repertoire is known to be reduced in RA. 

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Target,T2T,bullseye

Targeted therapies in Sjogren’s syndrome: are we close?

d Md Yuzaiful Md Yusof, MRCP(UK), PhD

There is a clear unmet need for new and effective therapies in primary Sjogren’s Syndrome (pSS) patients, as there are no current licensed therapies.

 

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Wasn’t following the SLE stuff #EULAR2023 but heard a lot of talk about both telitacicept & CAR-T, including meeting highlights by Christian Dejaco. Both look pretty exciting - the longer the sustained remission with CAR-T, the more it looks like maybe the real deal @RheumNow https://t.co/oKzb8ojTcz
David Liew drdavidliew ( View Tweet)
New 2023 @eular_org SLE recommendations Key changes, in response to evidence: - more caution re: steroids - biologics earlier - combo therapy (BEL or CNI/VCS) considered for lupus nephritis #EULAR2023 @RheumNow https://t.co/J3Lp8owRyT
David Liew drdavidliew ( View Tweet)
#SLE #EULAR recommendations What is new - use LESS #glucocorticoids, aim for none or 5 mg/d or less, use #biologics early if needed to prevent damage, #lupus #nephritis consider less pulse dose if using, voclosporin vs Belimumab ? it depends @RheumNow #EULAR2023 https://t.co/Ylnnl3pHOK
Janet Pope Janetbirdope ( View Tweet)
Abstracts talking about #RA and JAKs and Biologic comparisons Huge number of pts to analyze this aftrr the initial NEJM study. Abstract summary pics below @RheumNow https://t.co/jl5S4fLq19
Bella Mehta bella_mehta ( View Tweet)
Abatacept in pts at risk of #RA data from clinical trial. 213 pts, 31 centers. Pts with multiple autoantibodies improved the most with abatacept. @rheumnow #EULAR2023 https://t.co/c82jx0cAEq
Bella Mehta bella_mehta ( View Tweet)
Denosumab in hand OA prevented erosions! #eular2023 @RheumNow https://t.co/Ij2CVjh1ET
Bella Mehta bella_mehta ( View Tweet)
Treat early it is also cheaper! 5 yr cost of RA ttmt €11250 ACPA+ > €3526 ACPA- bDMARDS users €44788 ACPA+ > €40896 ACPA- ACPA- "late" ttmt 46% more expensive ACPA+ early vs. late = similar costs @Rheumnow #EULAR23 POS0369 https://t.co/dg9T9fqJDl
Aurelie Najm AurelieRheumo ( View Tweet)
#EULAR2023 Clinical Highlights. SpA: OP0059 H2H RCT of SEC vs ADA Biosimilar in bDMARDs naive showed no difference in imaging progression at 2yrs. OP0061 Pooled analyses of UPA RCTs showed low rates of Extra-articular Manifestation. Numerically lower vs PBO for Uveitis @RheumNow https://t.co/GoUPfpwTLq
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Biosimilars cost less, but do they incur in indirect costs due to less dis control or more AE? DANBIO study (>1,300 pts w/ IA) Costs similar or decreased 9 mo after mandatory switching to ADA biosimilar (GP2017 or SB5) Decrease 15% GP2017 switchers #EULAR23 POS0376 @RheumNow https://t.co/bAeqYhNgf0
Aurelie Najm AurelieRheumo ( View Tweet)
meds for PsA at #EULAR2023 recommendations bDMARD after csDMARD (no order proposed) @RheumNow https://t.co/bHMG4A8nmP
Bella Mehta bella_mehta ( View Tweet)
The thing that can influence bDMARD choice in PsA are the extra-MSK manifestations “A little bit of a paradigm shift here” - Laure Gossec 2023 @eular_org recommendations #EULAR2023 @RheumNow https://t.co/gr9IOg1bbj
David Liew drdavidliew ( View Tweet)
Which bDMARD first in PsA? 2023 @eular_org recommendation: no preferred order. All are equal in its eyes #EULAR2023 @RheumNow https://t.co/6HNNamAj1J
David Liew drdavidliew ( View Tweet)

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