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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
David Liew drdavidliew ( View Tweet)
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
Links:
Richard Conway RichardPAConway ( View Tweet)
Retrospective nation-wide italian study:
Long term exposure to :
🌫 PM10 ⬆️ risk of RA aOR 1.4 but not other AI diseases
🚗PM2.5 ⬆️ risk of RA aOR 1.6 CTDs aOR 1.1 IBDs aOR 1.2
OP0071 #EULAR2022 @Rheumnow https://t.co/HOOEnh7KWW
Aurelie Najm AurelieRheumo ( View Tweet)
Pre-clinical RA TREAT EARLIER Trial: #Plenary OP0070
RDBPCT eval temporary MTX vs PCB in 136 pts with arthralgias >2 weeks at risk for RA (MRI hand/forefoot w/subclinical inflammation) followed for 2 yrs; 1/3 +ACPA. Rx 1 yr can delay but won’t prevent RA. #EULAR2022 @rheumnow https://t.co/v1GWOBFstz
TheDaoIndex KDAO2011 ( View Tweet)
EULAR 2022 Featured Industry Abstracts
Review is a collection of several EULAR 2022 abstracts highlighted in recent press releases from companies sponsoring major clinical trials. You can search the EULAR site for these abstract and others here.
https://t.co/ggnAyuvAbl https://t.co/WjKDb70RkW
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Dr. John Cush RheumNow ( View Tweet)
#OP0002 #EULAR2022 What immune tests to monitor during pregnancy in #lupus? A meta-analysis found:
💠32% had a flare (new IS or Pred>9mg/d)
💠⬇️C3 and/or C4 in 1st Trimester predicted LN or SLE flare
Worth checking C3/C4 in each trimester @RheumNow https://t.co/fPEXwReK7u https://t.co/BX6fzKzfvC
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#POS0183 #EULAR2022 Pooled analyses of 5 Belimumab RCTs showed better response vs PBO in those:
💠SLEDAI=>10
💠dsDNA+ve + ⬇️C3 and/ ⬇️C4
💠⬇️C3 and/ C4 pre-treatment
💠Response high regardless SDI, Steroid, #lupus duration
@RheumNow https://t.co/fLggazbRQu
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
✨Localized #Scleroderma Pearls✨
#EULAR2022
Eosinophilic Fasciitis
👉Contractures wrists/ankles, rarely fingers
👉Mimics- #Lipodermatosclerosis #Panniculitis
👉GCs+MTX 1st line (IV in refractory🧐),MMF 2nd line
✅I add IVIg+/-UVA1 (pending logistics and insurance coverage!) https://t.co/ZErfLxgdxd
Ashima Makol MD AshimaMakol ( View Tweet)
Hellamand et al. Sex differences in first TNFi response in AxSpA. Treatment efficacy (RR 0.85) and retention (58% vs 72% month 24) rates lower in females. @RheumNow #EULAR2022 OP0020 https://t.co/2IL88K7q40 https://t.co/hSJds5EJFK
Links:
Richard Conway RichardPAConway ( View Tweet)
TOFFIFE RCT in colchicine-resistant FMF. Tocilizumab normalises SAA and CRP/ESR with PGA response in 20-25%. Maybe response criteria too strict, or maybe TCZ only effective for subgroup of patients @RheumNow #EULAR2022 OP0043 https://t.co/kNs8DMzXFB https://t.co/QMDk1IUkjx
Links:
Richard Conway RichardPAConway ( View Tweet)
Adami et al on risk of RMDs with air pollution. Mainly RA - OR 1.4 for PM10, 1.6 for PM2.5 @RheumNow #EULAR2022 OP0071 https://t.co/zDr2jMsIWv https://t.co/f0Y2rQxWRD
Links:
Richard Conway RichardPAConway ( View Tweet)
Can you train #dermatologists to do ultrasound to detect #PsA if pt has joint pain. POCUS of up to 3 painful joints. US ⬆️derm suspicion of PsA- but this is not feasible in busy offices and no reimbursement @RheumNow #EULAR2022 @eular_org OP0029 https://t.co/9a3gDgIBp0
Janet Pope Janetbirdope ( View Tweet)
#EULAR2022 TREAT-EARLIER OP0700
Arthralgia + subclinical inflammation in MRI without RA, treated with MTX + depo steroid injection
▶️In High risk patients, delayed development of synovitis, but does not prevent in long-term
▶️Reduction in disease burden on MTX Rx
@RheumNow https://t.co/SKlqMQQTui
Eric Dein ericdeinmd ( View Tweet)
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
Links:
Richard Conway RichardPAConway ( View Tweet)
MIRACLE (love it!) study. High (max tolerated up to 25mg) vs low dose (6-8mg) MTX in combo with ADA in MTX-IR. Low dose non-inferior with better safety. Japanese population so may not be generalisable. @RheumNow #EULAR2022 OP0062 https://t.co/l3CfzzM7mi https://t.co/lkjuoqLY56
Links:
Richard Conway RichardPAConway ( View Tweet)
Krijbolder et al on MTX to prevent RA in clinically suspect arthralgia. No effect on arthritis free survival (80 vs 82%). Some delay in RA onset in high-risk group. But there was a sustained improvement in symptoms in MTX group @RheumNow #EULAR2022 OP0070 https://t.co/0CPIP51yQd https://t.co/kWNmw1YzrH
Links:
Richard Conway RichardPAConway ( View Tweet)
Bimekizumab (dual 17A/17F inhibitor) RCT in AS. ASAS40 45% vs 23% at week 16. All secondary clinical and imaging endpoints also + @RheumNow #EULAR2022 OP0019 https://t.co/RiZ7Divap3 https://t.co/ushogL5TaX
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Richard Conway RichardPAConway ( View Tweet)
How do we treat fatigue in our PsA patients? Guselkumab PsA trials showed systemic disease activity/function, joint manifestations, and skin involvement accounted for 62% of variability in fatigue. How do we account for the other 38%?
@RheumNow #EULAR2022 ABST#OP0025
Robert B Chao, MD doctorRBC ( View Tweet)
Early RA - does the biologic matter?
NORD-STAR: largely seropos, high CRP early RA
Perhaps unsurprising abatacept shone vs TNFi or TCZ
One of the few pt subgroups with plausible rationale & some data for comparative advantage. Shame it’s less & less common?
#EULAR2022 @RheumNow https://t.co/CrOILKVpIp
David Liew drdavidliew ( View Tweet)
Combined Nordic registry data on demyelination and inflammatory neuropathy with TNFi. Demyelination 2-3 times higher in SpA vs RA. No difference between ETN and monoclonals. @RheumNow #EULAR2022 OP0060 https://t.co/SK9s7aVaZk https://t.co/hZ5VaoTe4X
Links:
Richard Conway RichardPAConway ( View Tweet)