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Tune it at 1pm EST for RheumNow's daily #EULAR23 recaps. You can find us live on Twitter, YouTube and LinkedIn. https://t.co/t531csjXo8
Dr. John Cush RheumNow ( View Tweet)
Study on folylPG synthétase (FPGS) activity and MTX-PG measured in sperm showed low bio active form of MTX-PG, low FPGS activity resulting in lower capacity to form MTX-PG, Perez-Garcia LF, Abst#OP0224 #EULAR2023 @RheumNow https://t.co/8sGQOBxn8r
Dr. Antoni Chan synovialjoints ( View Tweet)
Herpes Zoster vaccination in RA patients treated with Upadacitinib and MTX showed a satisfactory response,
slight reduction in response compared to general population in both antibody and cell mediated responses Winthrop K, Abst#OP0225 #EULAR2023 @RheumNow https://t.co/wxwbOYsn5K
Dr. Antoni Chan synovialjoints ( View Tweet)
To treat or not? Clinically suspect arthralgia does affect QoL including function. Both premises of treating with a DMARD are valid. OverRx v missing the very early window of opportunity @RheumNow #EULAR2023 @eular_org https://t.co/86CVZ2IjEf
Janet Pope Janetbirdope ( View Tweet)
For our rheum patients who have had cancer previously - the default can’t be to not have DMARDs.
@eular_org points to consider SLR:
no clear risk, across b/tsDMARDs
For too long these patients were unnecessarily asked to ride it out. No more please
POS1069 #EULAR2023 @RheumNow https://t.co/7m4Yh0h7rd
David Liew drdavidliew ( View Tweet)
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)
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)
Men trying to conceive were prev told to avoid MTX. Another myth busted
Why? Spermatozoa lack the FPGS enzyme responsible for MTX-PG metabolism, the tiny amount of MTX-PG in sperm isn’t active. No quality issues!
OP0224 #EULAR2023 @RheumNow (& @ARD_BMJ https://t.co/SDdoNP12oR)
David Liew drdavidliew ( View Tweet)
EULAR 2023 – Day 2 Report
Day 2 at the international EULAR Congress meeting is always bigger and busier. There were sessions on JIA therapies, crystal arthritis, novel drugs for SLE and Sjogren's, early RA and preclinical RA interventions, IgG4 disease, osteoporosis and the growth and application of artificial intelligence in medicine and rheumatology.
Read Article
Obesity in #AOSD – predicted the development of a chronic disease course and biologic DMARD failure, 139 pts with AOSD- 19% Obese (BMI>30) observational study. abst#AB1503 #EULAR2023 @rheumnow
Bella Mehta bella_mehta ( View Tweet)
ANSWER cohort
Retrospective study 6600+ bio/tsDMARDs ttmt courses, 20 yrs
✔️IL-6Ri is the lowest discontinued for lack of efficacy
✔️CTLA4-Ig is the lowest discontinued due to AEs
✔️Concomitant GC ⬆️30% drug discontinuation due to AEs
@Rheumnow #EULAR23 POS0051 https://t.co/8e6U5KHmX4
Aurelie Najm AurelieRheumo ( View Tweet)
Treatment of IIM, MTX or AZA or IVIG are 1st line (with steroids). #EULAR2023 https://t.co/TDKWxgrST0
Dr. John Cush RheumNow ( View Tweet)
CareRA trial:
3 months addition of LEF vs. ETA in pts resistant to COBRA-Slim regimen (MTX 15 mg/w + step-down prednisone):
After 2 years, no difference in dis control but those who received ETA early were treated more frequently w/ csDMARD monotherapy #EULAR23 @RheumNow OP0129 https://t.co/YwSoZWi375
Aurelie Najm AurelieRheumo ( View Tweet)
“You don’t need MTX with TCZ for RA”
Err, well:
- just like TNFi, you def can get ADAb to TCZ
- they definitely lead to lower response rates
- MTX co-admin reduces ADAb
Seems like a good idea to me, but your call 🤷♂️
Bitoun, Mariette et al POS0630 #EULAR2023 @RheumNow https://t.co/2jOAqA6YZ3
David Liew drdavidliew ( View Tweet)
No relationship between MTX-PG levels in terms of efficacy by SDAI remission but higher MTX-PG levels related to adverse events by Tamai H, Abstr #OP0128 #EULAR2023 @RheumNow https://t.co/TiO5eeYlnS
Dr. Antoni Chan synovialjoints ( View Tweet)
How much MTX do we need with adalimumab in RA? Can blood concentrations help?
MTX RBC polygluts:
- don’t seem to match to efficacy
- do seem match to safety, a bit
(no ADAb data here)
*One day* we’ll get better at what MTX dose is needed with TNFi #EULAR2023 OP0128 @RheumNow https://t.co/OGM3hxr4fG
David Liew drdavidliew ( View Tweet)
What would you do? A middle aged woman has pain and impaired hand function with her PIP&DIP erosive hand #osteoarthritis? Exam - jts are tender w soft tissue swelling? #NSAIDs, #denosumab, #methotrexate? 🤷♀️ A +RCT of #MTX in #erosive #hand #OA at #EULAR2023 @RheumNow @eular_org https://t.co/7rp3nReTPd
Janet Pope Janetbirdope ( View Tweet)
Are we going to treat hands OA with MTX?
Moderate effect on VAS pain at 6 and 12 months in a small RCT vs. PBO in hands OA WITH MRI detected synovitis.
Thoughts
1) Is it really OA?
2) Benefit Risk balance remains debatable
@RheumNow OP0070 #EULAR23 https://t.co/WLlX48NtGT
Aurelie Najm AurelieRheumo ( View Tweet)
Randomized double blind, placebo controlled MTX trial in inflammatory #handOA - pts with MrI detected synovitis. 97 pts 20mg MTX helped reduce pain and stiffness at 6 months. @rheumnow
#EULAR2023 abst#OP0070
Early work with some promise!
Bella Mehta bella_mehta ( View Tweet)