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What can we learn from Oral Surveillance?
The Oral Surveillance trial has almost become a household word for rheumatologists.
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This week's Tuesday Night Rheumatology, hosted by Dr. Jack Cush, featured highlights from the 2022 RheumNow Live Rheumatoid Arthritis - Best Management Pod, followed by a lively audience Q & A. Lectures featured:
Dr. John Cush
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450 axSpA pts followed 2868 Pt-yrs, 48% on TNFis. TNFi Rx pts had reduced CV risk (HR 0.30; 0.10–0.85), but no longer signif after adjustment for CRP, ESR (HR 0.37, 0.12–1.12, p = 0.077). Reduced CV risk, may not be specifically due to TNFi use https://t.co/mVHYn3PteL https://t.co/bgKWreBL8z
Dr. John Cush
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CV risk factors not equal when considering magnitude of risk
What can we learn from Oral Surveillance?
The Oral Surveillance trial has almost become a household word for rheumatologists.
https://t.co/LHZTVZh4AK https://t.co/2SlxrG7UpQ
Robert B Chao, MD
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New biomarker for atherosclerosis, cardiovascular risk and disease activity in axSpA?
Low Irisin associated with subclinical atherosclerosis, high CV risk and more severe disease activity in axSpA
@RheumNow #EULAR2022 ABST#POS0327
Richard Conway
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Redondo-Rodriguez et al. Abatacept in RA-ILD. Prospective study 38 patients. 73.6% improved/stablised with abatacept at median 17 month follow-up @RheumNow #EULAR2022 POS0654 https://t.co/D2du0hAXIy
Jeffrey Sparks MD MMSc
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Associations with RA-BR (n=57 cases) compared to RA-no lung disease controls (n=36)
⬆️⬆️⬆️RF level (OR 4.4)
⬆️⬆️ ACPA level (OR 3.5)
⬆️older age at RA onset (OR 1.37 per 10 years)
⬇️ BMI (OR 0.94 per kg/m2) (i.e., higher risk in underweight)
🚫 associations: sex, smoking pk-yrs
Richard Conway
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Alsing et al. Dutch study. Persistent excess stroke risk in RA in biologic era. @RheumNow #EULAR2022 OP0277 https://t.co/oLmsrniKw6 https://t.co/2zDkuUzq0S
Richard Conway
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Szekanecz et al. ORAL Surveillance. Geographic differences in MACE largely driven by history CVD and high baseline risk in North America and ROW. @RheumNow #EULAR2022 POS0110 https://t.co/cR6a7N2KP5
David Liew
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Was ORAL Surveillance really a surprise?
Let's look post-hoc at all the other tofacitinib RCTs (ph 1-3b/4 +LTE)
Cardiovascular risk-enriched pts were always in the same MACE ballpark with tofa
ORAL Surveillance was worse, but clues were always there
OP0264 #EULAR2022 @RheumNow https://t.co/rB5SwVX2oc
Md Yuzaiful Md Yusof
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#OP0251 #EULAR2022 Any data to support association of RA-ILD with poor #COVID outcomes? A study is US >500 pts (9% ILD) showed ILD as well as poor RA status (RF+ & erosion) increased risk. Detailed analysis inc Radiographic + PFT cd help stratify risk further @RheumNow https://t.co/E89dd38GQS
Aurelie Najm
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CTD associated ILD 🫁:
lncRNA ENST00000604692 detected in PBMCs is associated with CTD-ILD and can distinguish SSc-
ILD and RA-ILD vs. non ILD patients with AUC 0.79.
As many lncRNA, unknown if biomarker only or has a pathogenic role.
@RheumNow OP0114 #EULAR2022 https://t.co/sR4GmaMkXD
Richard Conway
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Vadillo et al. Clinical course in IPAF (ping @leticiakawano ) . Most frequent females in 60s. Arthritis, raynauds most common features. Most NSIP. 50% PFT deterioration 16 months. UIP, baseline fibrosis, mod/high ANA titre assoc progression @RheumNow #EULAR2022 POS1427 https://t.co/qk9zK90Wuk
Richard Conway
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Rojas-Gimenez et al After adjusting for age, smoking, ACPA. Male sex (OR 4.2) and longer time of having RA (OR 1.08) associated with ILD @RheumNow #EULAR2022 POS0619 https://t.co/kzG76Qwe52
Richard Conway
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Comorbidity in AS from @rheum_cat , Karmacharya et al. Clustering of comorbidities. Depression and hypertension clusters assoc worse disease activity and function @RheumNow #EULAR2022 OP0154 https://t.co/jGQXayAYs9 https://t.co/SnVDhVYQq5
Richard Conway
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RABBIT registry data on CV events with JAKi. Incidence rate low 0.41/100PY. No increase compared to TNFi RR 0.94 (0.39-2.38). No increase in high-risk group RR 0.90 (0.37-2.17). Reassuring with wide CI's. @RheumNow #EULAR2022 OP0135 https://t.co/vBSsnfeBoR https://t.co/iYDZsNwMye
Eric Dein
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#EULAR2022 OP0136:
PROTECT-RA Cohort - 150 pts established RA
Cholesterol loading capacity (CLC) on macrophages
⭐️High CLC correlates with CV events
⭐️bDMARD use affects CLC
@RheumNow https://t.co/9ngaH9yUI7
Eric Dein
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#EULAR2022 OP0071
Association between long-term exposure to air pollution (fine particulate matter) and immune-mediated disease in Italy
⭐️⬆️ risk of autoimmune disease, esp RA as well as CTD, IBD
⭐️Every 10 ug/m3 increase in PM, associated with incremental 7% risk
@RheumNow https://t.co/x57CXUHSHb
Janet Pope
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Cdn cohort of #PsA and CV events - u risk factors were associated with MACE and NSAIDS ⬆️ risk and TNFi ⬇️risk and poor HAQ⬆️ risk. #OP0030 @RheumNow @eular_org Too small events, lipids often absent and spanning 30+ yrs.
Md Yuzaiful Md Yusof
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#POS0065 #EULAR2022 What is the nature of ILD progression in #Sjogren and is it mostly stable? A cohort study in Oslo (N=702) showed after 15 yrs follow-up, 45% had radiographic progression. Hence, need to monitor lung function test @RheumNow https://t.co/ga7qer27ks
