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Mortality rates among patients with giant cell arteritis (GCA) in Canada's Ontario province rose by 15% from 2000 to 2018, a new study found, even as the general population saw declines in overall mortality.
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Richard Conway
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Germano et al. Temporal artery abnormality on clinical exam predicts biopsy + . Arterial thickening and reduced pulse strongest predictors @RheumNow #EULAR2022 POS0820 https://t.co/Rs36ALSoJb
Dr. John Cush
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Watch: EULAR Recommendations for ANCA Vasculitis
Dr. Eric Dein reviews the session held on updates to recommendations for ANCA Vasculitis, presented at the #EULAR2022 meeting in June.
https://t.co/1nr0tVIJpn https://t.co/kq0Id7PxyW
Richard Conway
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Sanchez-Martin et al. Tocilizumab in newly diagnosed vs refractory GCA. 471 patients. Appears of relatively similar efficacy in both groups. Surprising that the difference is not greater given refractory GCA inherently more complex @RheumNow #EULAR2022 POS0817 https://t.co/HEWzYCz9YD
Richard Conway
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HAS-GCA study @alwinuk @profbdasgupta Southend pretest probability score and Halo score useful in diagnosis and prognosis in GCA. Halo score may be useful for monitoring. @RheumNow #EULAR2022 POS0818 https://t.co/sxYjnQQFA8
Richard Conway
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Unizony et al. Case series of tocilizumab + 8 weeks steroid in GCA. 30 patients, 50% new 50% relapsing. 77% in sustained remission at week 52! No vision loss. Exciting, needs an RCT @RheumNow #EULAR2022 OP0185 https://t.co/ohBYIWYxBC https://t.co/fsn4x17Hwv
David Liew
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What does avacopan mean for sustained remission in AAV?
New post-hoc from ADVOCATE - keeping in mind the avacopan was instead of steroids. Impressive numbers, so increasingly the questions will be about strategy and cost?
#EULAR2022 @RheumNow https://t.co/B4y8jZiHf5
David Liew
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Mortality after PMR:
looking at 35y follow-up of a cohort in Norway,
apparent higher mortality for women (vs men, general population) decades after.
Is this real? Treatment related?
My wild guess: sarcopenia kills.
Thoughts @Sarah_L_Mackie & tagged?
OP0181 #EULAR2022 @RheumNow https://t.co/k7p9jNfW5s
David Liew
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Sometimes hear “GCA associated with PMR is extracranial”
Interesting point:
of the 20% of PMR patients with USS-evident subclinical GCA
- one-quarter had isolated cranial disease
GCA phenotypes not so clear cut
(Proviso: it’s subclinical disease)
OP0184 #EULAR2022 @RheumNow https://t.co/storHFL8aW
Richard Conway
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Sanchez-Bilbao et al. TCZ for large vessel GCA. Has been a concern due to limited LVV/imaging in RCTs 196 patients. Seems to work well. 20% sustained remission month 6, 60% month 12. Clinically significant reduction steroid doses as shown in figure. @RheumNow #EULAR2022 POS0802 https://t.co/Z0HEVal6RI
Janet Pope
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ANCA vasculitis guidelines make sense. Less use of cyclophosphamide was already the case, rituximab can be for induction & maintenance, I am reluctant though in severe disease to stop maintenance Rx at 1 or 2 yrs and go longer as at least 1/3 will relapse beyond 2 yrs. @RheumNow https://t.co/3xRHWya2Uq
Eric Dein
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#EULAR2022 Updated ANCA Vasculitis Recommendations
⭐️Incorporates PEXIVAS and ADVOCATE findings
⭐️EGPA guidelines
⭐️PJP PPx recommendations
https://t.co/CnMnxTlB1D
@Rheumnow
TheDaoIndex
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Continue with PJP prophylaxis during the 6 months of induction Rx and until B cells repleted and if prednisone > = 20 mg/day #EULAR2022 AAV reccs @rheumnow
Richard Conway
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Norwich regimen of steroids for GCA @cmukhtyar et al. Bespoke regime starting at 1mg/kg tapered over 100 weeks. Drug-free relapse free survival 82% at 100 weeks, 69% 150 weeks. @RheumNow #EULAR2022 POS0793 https://t.co/b5smCqCkgg
Richard Conway
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More from the VITAL study Dr Costenbader @karen_kc123 et al. 5 year supplementation followed 2 year follow up. Vit D 2000iu ⬇️incident autoimmune disease 21%. RA, PMR, psoriasis trend towards reduction. No effect omega-3 @RheumNow #EULAR2022 OP0038 https://t.co/kbKqDhtN9z https://t.co/HcFXbweEPm
David Liew
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PMR bursas are filled with macrophage subtypes esp CD68+, expressing IL-6 & GM-CSF.
PMR is now far from just a vibe - real science, real targets for therapy.
Not every day that PMR basic science makes it on stage, lovely from @VasculitisUMCG @jiemy_william
#EULAR2022 @RheumNow https://t.co/zem3JEosQL
Richard Conway
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Jiemy et al. Phenotyping monocytes/macrophages in PMR. Synovial/bursal macrophages have pro-inflammatory phenotype with prominent IL-6 and GM-CSF response. Rationale for tocilizumab/mavrilimumab @RheumNow #EULAR2022 OP0015 https://t.co/53GJkL4BcP
Richard Conway
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Zhao et al. Infection risk is ⬆️ in incident AAV. aHR 3.8 for first infection and 3.8 for infectious mortality. 3.2 fold increase in number infections. @RheumNow #EULAR2022 OP0093 https://t.co/LSe4vJqZym https://t.co/tNqI2m30SD
TheDaoIndex
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More #EULAR2022 Updated Reccs for #AAV
👉use clinical assessments & not just ANCA or CD19+ B-cell testing to inform decision for change in Rx.
👉measure Ig levels w/RTX prior to each course of RTX (to eval for immunodeficiency)
👉use PJP prophylaxis in high risk pts @rheumnow https://t.co/kYPQnLvcCK
TheDaoIndex
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Overarching principles #EULAR2022 AAV Updated reccs are patient centered:
1. Best care w/shared decision making
2. Access to education on AAV
3. Screen pts for Rx side effects/comorbidities
4. Need a multidisciplinary approach w/vasculitis expertise @rheumnow https://t.co/OgE4l4np12
