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Getting Real on PMR Dr. David Liew talks polymyalgia rheumatica and how our understanding has evolved over the years. #EULAR2022 https://t.co/j4LJPZFqzY https://t.co/ABAbm3axSG

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Polymyalgia rheumatica immunological puzzle further illustrated Infiltrating macrophages expressing IL-6 and GM-CSF may drive the subacromial bursitis often seen in polymyalgia rheumatica, according to new research presented at #EULAR2022. https://t.co/Miab1eiHZ6 https://t.co/n9IjPwqG2t

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Video: Vessels Glowing in the Dark - Does it Matter? https://t.co/ZM6kmqM9Ap https://t.co/ibqwrE3p1g

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FDG-PET/CTscans were used in 58 for FUO evaluations. Dx was Rheumatic (44.5%), malignancy (34.5%), or infectious (10.3%). Most prevalent Rheum dx was vasculitis (17%), especially LG vessel vasculitis. FDG PET/CT is a useful FUO pts https://t.co/AVQ7lRYoRw

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#good news and bad news. Avacopan works v well for steroid sparing in #GPA. It’s an oral C5a receptor blocker - maintains more remission and less relapses and less total prednisone OP0180 @eular_org #EULAR2022 @RheumNow Bad news $$💰 will limit access.

#Bestinclass. #Giantcellarteritis GCA lots of novel ideas. V short prednisone- 2 months with #Tocilizumab. Not RCT. Looked safe & effective but too small to know if blindness etc are increased. Don’t suggest you try this at home...yet! @RheumNow @eular_org #EULAR2022 OP0185

#Bestinclass Recurrent #PMR RCT of #sarilumab v placebo. Nearly doubles sustained remission but maybe attenuating effect - flare difference over time? N=118. 🤷‍♀️ Dunno who I would use it in yet. LB0006 @RheumNow @eular_org #EULAR2022

Positive study NUT when to use the Rx? PMR RCTof 1 g #rituximab once. Over 1 yr with more steroid free remission - curves separate by 21 weeks (steroids off) POS0269 @RheumNow @eular_org #EULAR2023 when to use it-COVID risk, ?prefer IL6i

ARIAA: saw 18m results #EULAR2022 (alluded to at #ACR21) High-risk ACPA+ clinically suspect arthralgias Didn't progress to arthritis: after 6m abatacept: 92% vs 65% 12m after abatacept stopped: 65% vs 43% (tighter at points) How to pick those that benefit? POS0531 @RheumNow https://t.co/dkf1jU5gx7

David Liew on Twitter: "Can we stop RA developing? Not previously.
&#1…

Sarilumab in pts with relapsing PMR - Phase 3 trial Sarilumab +14 week steroid taper - higher sustained Remission than w/o sarilumab (28% vs 10%) Less flare occurrences Sarilumab noted to have higher incidences of neutropenia, arthralgia @RheumNow #EULAR2022 ABST#LB0006 https://t.co/SeetkBsYI3

PMR on the podium @profbdasgupta, with a positive phase 3! Sarilumab in relapsing PMR (SAPHYR): sari q2w+14w taper vs placebo+52w taper underrecruited 118/280 (COVID) but still hit primary, almost all secondary Better outcome + steroid-sparing: big LB0006 #EULAR2022 @RheumNow https://t.co/nd3TSibYa0

SAPHYR trial of sarilumab for relapsing PMR @profbdasgupta et al. Sarilumab+14 week steroids vs 52 week steroid monotherapy. Sustained remission 28.3% vs 10.3% P=0.0193. Flare after remission 16.7% vs 29.3% HR 0.56 (0.35–0.90) P=0.0158 @RheumNow #EULAR2022 https://t.co/oopWKjciWG https://t.co/xi4ELJiCXa

EULAR Abstract Archive

#LB0006 #EULAR2022 Therapy for relapsing polymyalgia rheumatica. 118/280 recruited re:COVID impact. Phase 3 RCT of Sarilumab+14Wk Steroid taper showed more pts had sustained remission at Wk52 vs PBO+52Wk Steroid Taper(28% vs 10%) even if CRP excluded. PRO improved too! @RheumNow https://t.co/P11iXIAfGn

ECLIPSE UK primary care dataset: 23 million pts @DrMaxYates1 1. in >55yo, PMR prevalence 2.2% (10,000 new dx/y) 2. 1/4 take PNL for >4y (PMR = 18% of all pts on PNL) 3. mean 3.5 comorbid dx (steroids worsen) Now tell me we don't need better PMR therapies. #EULAR2022 @RheumNow

Sarilumab in PMR SAPHYR Phase 3 RCT Underpowered (<50% target recruitment) -% remission sustained from wk12 to wk 52 28% vs 10% PBO -Risk of flare reduced HR 0.56 -Improvement of several PROs No new safety signal LB0006 @RheumNow #EULAR2022 https://t.co/n7WdQxQaHo

SAPHYR phase 3 RDBPCT study: #sarilumab vs PCB for relapsing #PMR on pred 7.5+ mg/d. Study met endpoints (whether of or not CRP was included). Time to first flare was longer w/SARI, less steroid use, and also better PROs. AE: #EULAR2022 LB0006 @rheumnow 1/2 https://t.co/lIspLKlveb

BRIDGE-PMR (rituximab in PMR) routine care extension to 52w (in #PMRGCAJC one big qu asked was ?sustained benefit) sustained benefit (RR 2.5 GC-free remission) steroid-sparing (PNL 1.6g v 2.3g) & ritux ?cheap enough now but COVID calculus difficult POS0269 #EULAR2022 @RheumNow https://t.co/Ln2ArclKO8 https://t.co/OtCwdjIPeL

The Lancet Rheumatology on Twitter: "NEW RESEARCH—Efficacy of #rituximab i…

Therkildsen et al Ocular manifestations GCA in Denmark. Quite low proportion at 7%. Most occur around time diagnosis, with 1/3 pre-diagnosis. Aspirin not assoc reduced risk. @RheumNow #EULAR2022 POS0791 https://t.co/YgailfJ6fI

Cantoni et al. Maladaptive trained immunity in GCA. Aberrant activation of trained immunity programs in myelomonocytic cells leads to sustained and enhanced inflammatory activation and increased expression inflammatory cytokines (esp IL6) @RheumNow #EULAR2022 POS0492 https://t.co/A8t9gV1O3d

Palmowski et al. Glucocorticoids and bone density in GCA/PMR/other vasculitis from Rh-GIOP. Weird one, no increase in osteoporosis, no association with current or cumulative steroid dose and osteoporosis. Low BMI, vert #, PPIs were assoc osteoporosis. @RheumNow #EULAR2022 POS1139 https://t.co/n3d6YArXmU

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