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EULAR 2022 – Day 1 Report
It’s good to be back into full, big meeting mode.
Highlights included a EULAR Recommendation Session, where updated guidelines were presented for the management of a) ANCA-associated Vasculitis, b) ASAS/EULAR recommendations for axSpA and c) RA. Here are a few of my favorites from Day 1.
#OP0144 #EULAR2022 Promising Digital use in monitoring disease activity for clinicians. Researchers in Amsterdam developed the first e-health #SLE T2T. High acceptance rate re: usability. Need more validation and in different languages @RheumNow https://t.co/7LravXhoJ8
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
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
David Liew drdavidliew ( View Tweet)
Farshad et al. 17% of admissions on long-term allopurinol had it held. Reasons - acute gout flare, renal impairment, gastrointestinal issues, cytopenia, drug interactions, NPO status, and always discontinued the medication. @RheumNow #EULAR2022 OP0169 https://t.co/ADOomiOrRi https://t.co/nxAAOMWsJB
Links:
Richard Conway RichardPAConway ( View Tweet)
RABBIT registry and MACE in RA
No difference between
*JAKi (Tofa and Bari) and *TNFi in both unselected and high CV risks patients.
🧨 different than ORAL surveillance
but Observational and overall Low incidence (28 events).
#EULAR2022 @RheumNow OP0135 https://t.co/o8rngHrwQF
Aurelie Najm AurelieRheumo ( View Tweet)
#ClinicalPearl #SLE has ⬆️mortality until v advanced age and if not in remission or v low disease activity Mortality is higher. Ideas: control disease activity, prevent damage, limit prednisone. @RheumNow #EULAR2022 T Dormer Session #Lupus https://t.co/90cpsBVgAb
Janet Pope Janetbirdope ( View Tweet)
Rahman et al. Pooled safety data from IL23i guselkumab clinical trial programme in PsA. 1508 patients 2125 PY. No increase (and generally lower) than PBO. No IBD. @RheumNow #EULAR2022 POS1015 https://t.co/9otcpwW9ni
Richard Conway RichardPAConway ( View Tweet)
#OP0141 #EULAR2022 What do our #lupus patients think about Treat-to-target (T2T) and are they involved? A patient survey showed improvement in QoL as most important. They were open to T2T concept but concerned of more visits + new drugs. 61% felt they were involved @RheumNow https://t.co/rT500lhrih
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Rahman et al shows factors associated with variability of fatigue in PsA are systemic disease 34%, joint disease 16%, skin involvement 12%, accounting for 62% and leaving a residual effeect of 38% that was unexplained and needing further research #EULAR2022 @RheumNow OP0025 https://t.co/RoqjS64Xjy
Dr. Antoni Chan synovialjoints ( View Tweet)
The CONSUL study @ProftDr showed there was no significant difference in Celecoxib(CEL)+Golimumab (GOL) vs GOL alone. The mSASSS change was 1.1 vs 1.7, p=0.79 between the 2 groups. The combination may be clinically relevant in high-risk progressors #EULAR2022 @RheumNow OP0018 https://t.co/AUOL7IDx9L
Dr. Antoni Chan synovialjoints ( View Tweet)
ASRI @Gillianfitzger1 @bososhea @Sineadm15 Current smoking is associated with lower risk of uveitis and arthritis in males with axSpA. I wonder why this would be? @RheumNow #EULAR2022 POS1001 https://t.co/3bKmyvI606
Richard Conway RichardPAConway ( View Tweet)
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
Richard Conway RichardPAConway ( View Tweet)
Dermatologists doing ultrasound (US) for earlier diagnosis of PsA? Grobelski et al showed in this study of 140 PsA patients, pre-US sensitivity/specifity was 81%/55%, post-US this changed to 62%/91%. Targeted US improved accuracy of referrals for PsA #EULAR2022 @RheumNow OP0029 https://t.co/iajqMuPqcd
Dr. Antoni Chan synovialjoints ( View Tweet)
Sex differences may affect the response to first line TNFi in AxSpA. Hellamund et al EuroSpA study showed the TNFi 6/12/24 month retention rate was lower in females (58%) compared to males (72%). Females had lower CRP level and higher PROs at baseline #EULAR2022 @RheumNow OP0020 https://t.co/ANgRYMxpat
Dr. Antoni Chan synovialjoints ( View Tweet)
MIRACLE study: High or Low dose MTX w/ ADA in eRA?
✨ LOWd (6-8mg/w) 38.4% non-inferior to HIGHd (>10mg/w) 44.8%
✨But safety profile looks better 9.1% vs 22.1% 👀
Are you already looking for minimal dose of MTX in patients treated w/ biologics?
#OP0062 @Rheumnow #EULAR2022 https://t.co/dq0EIKSnOe
Aurelie Najm AurelieRheumo ( View Tweet)
RA patients close to the equator (i.e. ‘Global South’) get RA earlier in life than the temperate world.
Is it patient-level characteristics like smoking? No.
It’s country-level factors e.g. socioeconomic status.
Are rich world and poor world RA the same?
#EULAR2022 @RheumNow https://t.co/tAzGHzaZGe
David Liew drdavidliew ( View Tweet)
#POS0114 #EULAR2022 Can we identify #lupus patients better in electronic health records? Barbero et al. used machine learning and developed a model to distinguish SLE diagnosis vs "near-misses". AUC: 0.90. Further validation can help future epidemiological studies @RheumNow https://t.co/vpLH8SWlWm
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Upadacitinib shows promising response in the treatment of nr-AxSpA in the SELECT-AXIS 2 study. Deodhar et al showed the ASAS40 response rate for UPA was twice vs placebo (45% vs 23%). 12/14 of the secondary endpoints were also met #EULAR2022 @RheumNow OP0016 https://t.co/dOWVJdLRtG
Dr. Antoni Chan synovialjoints ( View Tweet)
Updated #EULAR2022 AxSpa Recc: The Algorithm @rheumnow https://t.co/fu46QJ3jmQ
TheDaoIndex KDAO2011 ( View Tweet)
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
Janet Pope Janetbirdope ( View Tweet)