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Should immunosuppression be used to improve #PAH in #SSc added to PAH Rx (85%) Morbidity or mortality outcomes >700 pts - half had a DMARD after dx RheumNow #EULAR2023 OP0238 Targeted Rx improved esp RTX\TCZ findings V interesting results #GameChanger May change my Rx practice!
Janet Pope Janetbirdope ( View Tweet)
Retro French database study shows reassuring data.
Overall mortality after IRAEs =similar between pts receiving b/tsDMARDs vs. those who don't
70000+ pts treated w/ ICI, 7800+ IRAEs (most frequent colitis) & 330 treated w/ b/tsDMARDs, 10% Rheum IRAE
OP0270 @RheumNow #EULAR23 https://t.co/OFNaIU4kzt
Aurelie Najm AurelieRheumo ( View Tweet)
Antimalarial adherence in RA and SLE showed 4 patterns of adherence over time, with 53% drop off in 1 year, with higher adherence with age, SLE and socioeconomic class, Hoque MR, Abst#0222 #EULAR2023 @RheumNow https://t.co/Bld5kWVQxE
Dr. Antoni Chan synovialjoints ( View Tweet)
Fatigue in SLE remains a challenge!
Online digital tool - LEAF - Lupus Expert System for Assessment of Fatigue - assement of fatigue PROMs in 1250pts - 80% reported fatigue, 93% found tool helpful @rheumnow #EULAR2023
Need more tools to assess and manage fatigue!
abst#OP0230
Bella Mehta bella_mehta ( View Tweet)
#EULAR2023 #POS1075 Which biologics have the lowest retention rate in Elderly patients (=>65 yrs) in Rheumatoid Arthritis? Data from Italian registry showed 1/3 discontinued biologics at 2 yrs. IL6-i: lowest persistence; Abatacept: highest @RheumNow https://t.co/28n4qzR3aM
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Can’t escape ORAL Surveillance RCT talk
Lots of real world data on CV risk & JAKi here
(with all the selection, measurement bias)
First up: multinational JAK-pot study (n=>50k)
Even if you mirror the high-risk RCT cohort - not much there for MACE
OP0219 #EULAR2023 @RheumNow https://t.co/FfNspdivri
David Liew drdavidliew ( View Tweet)
No new predictors for decline in #SSc lung function in ILD Progression of #scleroderma Lung disease is common - risks male, dcSSc, low FVC, Topo1 @RheumNow #EULAR2023, OP0236 @eular_org https://t.co/bTxTyLE8dZ
Janet Pope Janetbirdope ( View Tweet)
An AI algorithm to predict opined related deaths
UK database >1000000 pts, 1200+ opioids related deaths
Risk factors:
Substance used disorder
Hx self harm
Alcohol abuse
Oxycodone
Liver disease
Concomitant gabapentinoids & BZD
*no pictures allowed*
@Rheumnow OP0269 #EULAR23 https://t.co/II96fnhqy3
Aurelie Najm AurelieRheumo ( View Tweet)
JAKi use did not increase CV risk compared to TNF, no difference between Bari and Tofa, non significant increased IRR in patients >65 years, Merel Opdam, Abst#OP0221 #EULAR2023 @RheumNow https://t.co/Pu5X8RHJOY
Dr. Antoni Chan synovialjoints ( View Tweet)
#Deeplearning in salivary biopsies in #SjogrensSyndrome - 327 pts - binary focus score (>=1) prediction the AUROC was 0.87 and for primary sjogrens diagnosis prediction it was 0.84
Quicker and cost effective in the future?
@rheumnow #EULAR2023 abst#OP0232 https://t.co/Ec0zuKqpXf
Bella Mehta bella_mehta ( View Tweet)
So we need protocolized extra steroids in new RA? A debate as old as time
Individual patient data metaanalysis
- slight gains early on, not sustained
- fewer DMARD changes
- but a heap more PNL, well after the protocol ends
Life is about trade-offs😐
OP0220 #EULAR2023 @RheumNow https://t.co/M8SBKjGncv
David Liew drdavidliew ( View Tweet)
#EULAR2023 #POS1066 “Diagnosis: Seropositive Nodular Rheumatoid Arthritis” - I can probably get rid of Nodular soon in my letter. Trends of Nodules have decreased over time. Could be because we are getting better at preventing erosion and smoking cessation @RheumNow https://t.co/fmQvyNHCUJ
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Impact of menopause & on function in RA
HAQ increases slightly after menopause
Premature menopause = worse function
Slightly better HAQ (but moderate & no effects on other PROs) in THR group vs. non THR
No safety data
@RheumNow OP0268 #EULAR23 https://t.co/7KJScF8O2X
Aurelie Najm AurelieRheumo ( View Tweet)
Risks for #ILD #SSc lung progression. FVC decline >5% is the gold standard but there are other criteria. OP0236 #EULAR2023 @RheumNow @eular_org #scleroderma Some criteria are stricter - larger PFT changes and/or worsening symptoms or fibrosis, so depends on def’n for % def’n https://t.co/TCuX2KY64w
Janet Pope Janetbirdope ( View Tweet)
#Scleroderma activity index #SCTC has an initial validated tool that is associated with death and organ damage with moderate correlations, so it has some degree of face validity @RheumNow #EULAR2023 @eular_org #OP0235 https://t.co/RDekhr7d2e
Janet Pope Janetbirdope ( View Tweet)
Initial use of glucocorticoids GC as bridging treatment in RA resulted in increase use of GC later, fewer DMARD changes later, van Ouwerkek L, Abst#OP220 #EULAR2023 @RheumNow https://t.co/IjxgQTZ8SE
Dr. Antoni Chan synovialjoints ( View Tweet)
>= 2 tophi and carotid plaque by ultrasound could independently predict major adverse cardiovascular events in addition to conventional CVD risk factors in #gout, data from a single center cohort of 262 pts with 10 yr follow up #EULAR2023 @rheumnow abst#OP0154
Bella Mehta bella_mehta ( View Tweet)
Malignancy in real world datasets:
do we see differences between DMARDs - particularly JAKi, with ORAL Surveillance in mind?
RABBIT German data (limited risk window):
Point estimates slightly up vs TNFi, esp in high CV risk pts
but magnitude not big
OP0218 #EULAR2023 @RheumNow https://t.co/Ou7TgWvf3b
David Liew drdavidliew ( View Tweet)
Scleroderma has an activity index that is associated w future morbidity & mortality. I wonder re the weightings of diff clinical manifestations as scleroderma renal crisis could weigh similarly to ex elevated CRP & a less severe manifestation. OP0235 @RheumNow #EULAR2023 https://t.co/KkimHBDVpg
Janet Pope Janetbirdope ( View Tweet)
#ClinicalPearl Updated #scleroderma Rx recommendations OP0234 New recommendations included ILD, early dcSSc 20 vs prior 16 guidelines. And they recommend ??! Won’t release yet due to importance of wording which will be finalized soon EULAR2023 @RheumNow @eular_org https://t.co/lES6pqkgeT
Janet Pope Janetbirdope ( View Tweet)
