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Damien et al on Whipple's Disease presenting as RMD. 73 cases (wow!) Treat Whipples, 93% remission, 94% off DMARD @RheumNow #EULAR2022 OP0066 https://t.co/XQnQq4RNcq
Links:
Richard Conway RichardPAConway ( View Tweet)
#EULAR2022 POS0241 shows JAKi ⬇️ pain catastrophization/central sensitization in RA patient via CSI (Central Sensitization Inventory) and (PCS) Pain Catastrophizing Scale.
No decrease of articular inflammation on ultrasound with JAKi shown, but study had just 22 pts
@RheumNow
Eric Dein ericdeinmd ( View Tweet)
Bimekizumab (dual IL-17F and IL-17A inhibitor) phase 3 study for treatment of active ankylosing spondylitis demonstrated ASAS40 improvement at wk 14 (44% vs. 25%).
#EULAR2022 @RheumNow #ABSTOP0019 https://t.co/eohvNFG3GS
Robert B Chao, MD doctorRBC ( View Tweet)
Sustained benefits #voclosporin in #LupusNephritis AURORA2 - 2 year study POS0186:
👉no unexpected AEs; rate of AEs⬇️over time
👉COVID19 seen in 12 controls, 7 VCS
👉4 deaths w/control arm vs 0 deaths w/ VCS
👉GFR & sCr & reduction in UPCR remained stable #EULAR2022 @rheumnow
TheDaoIndex KDAO2011 ( View Tweet)
10 year study showed NSAIDs associated with slowing radiographic progression in axSpA patients. mSASSS progression numerically lower in COX2i pts compared to non-selective NSAIDs.
@RheumNow #EULAR2022 #ABSTOP0021 https://t.co/dfz3rseikl
Robert B Chao, MD doctorRBC ( View Tweet)
#EULAR2022 OP0066
French retrospective obs study 2019-2021 with 73 cases of Whipples disease treated for rheum disease
▶️M/F ratio 3, middle aged
▶️1/2 met RA criteria
▶️Peripheral jts, 1/3 had axial involvement
▶️Rx: HCQ, Doxi - 80% cured, DMARD stopped in >90% cases
@RheumNow https://t.co/t7zlDrPfJB
Eric Dein ericdeinmd ( View Tweet)
NORD-STAR results. Biologic + MTX combo seemed better than slightly strange "conventional"(ACT) group of MTX + oral steroids or triple therapy + IA injections @RheumNow #EULAR2022 OP0058 https://t.co/tOfTlcplFR https://t.co/CvtvuVn5Xj
Links:
Richard Conway RichardPAConway ( View Tweet)
#EULAR2022 AAV Update Reccs (1/n):
1.Tissue biopsy recommended to establish diagnosis and eval pts w/ possible relapse
@rheumnow https://t.co/qsD2PPfOPU
TheDaoIndex KDAO2011 ( View Tweet)
#EULAR2022 POS0235: Filgotinib Safety in RA for Median 2.2 years:
▶️No new safety concerns from 2020 report with shorter f/u
▶️Adverse events stable, or decreased, from early studies
@Rheumnow https://t.co/DO15Tqim4n
Eric Dein ericdeinmd ( View Tweet)
#EULAR2022 Updated Reccs for EGPA (1/n)
👉 Use high dose GC +CYP or RTX for remission induction of #EGPA @rheumnow https://t.co/2Au5UrNKs3
TheDaoIndex KDAO2011 ( View Tweet)
Secukinumab 300mg at week 52 in ankylosing spondylitis patients (who did not achieve inactive disease with SEC 150mg at week 16) experienced similar clinical response and safety profile regardless of dose escalation.
#EULAR2022 @RheumNow #ABSTOP0023 https://t.co/7LeZMMWeRC
Robert B Chao, MD doctorRBC ( View Tweet)
SELECT-AXIS 2 trial demonstrated efficacy and safety of upadacitinib in treatment of non-radiographic axSpA. ASAS40 at week 14 (45% vs. 23% placebo). No MACE, VTEs, IBD, death.
@RheumNow #EULAR2022 ABST#OP0016 https://t.co/vyky0JJJjS
Robert B Chao, MD doctorRBC ( View Tweet)
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 KDAO2011 ( View Tweet)
Combination tx of NSAIDs and TNFi (celecoxib and golimumab) did not show significant superiority compared to TNFi alone in slowing radiographic progression for treatment of radiographic axSpA. There was a numerical reduction however.
#EULAR2022 @RheumNow #ABSTOP0018 https://t.co/gUZAwd92dK
Robert B Chao, MD doctorRBC ( View Tweet)
@Rheumnow #EULAR2022 POS0240
▶️ In 2021, 73.6% of Belgian RA patients staring a JAKi, started a 2nd generation JAKi (UPA, FIL).
Predictors for 1st generation usage (BAR, TOFA): older age, prior DMARD therapies.
What would you start as a first JAKi?
Eric Dein ericdeinmd ( View Tweet)
Household Cleaning is dirty business at least if you have #rheumatoid #arthritis as silica exposure from laundry and cleaning products were associated with RA ILD. #EULAR opening day. #ClinicalPearl #EULAR2022 @RheumNow #OP0006 https://t.co/OJQMy9Fe9m
Janet Pope Janetbirdope ( View Tweet)
Immune Checkpoint Inhibitor Associated Arthritis
Immune checkpoint inhibitors (ICIs) have dramatically improved outcomes in numerous cancers but have been hampered by a growing spectrum of immune-related adverse events (irAEs).
https://t.co/Eno0TcWlNX https://t.co/XjkBlUEFxk
Links:
Dr. John Cush RheumNow ( View Tweet)
ACR21: conditionally recommends against steroids with starting csDMARD
#EULAR2022 recommends with rapid GC dose reduction and discontinuation
Which is better recommendation?
@RheumNow
Eric Dein ericdeinmd ( View Tweet)
#EULAR2022 RA updated reccs w/ minor changes: start MTX+GC, reduce GC rapidly, JAKi are recc only for pts w/o risk factors for CV or malignant dz (not sure I agree with this last one if the JAKi is the best drug for the pt and there are little options avail) @rheumnow https://t.co/CXyyCi6LVI
TheDaoIndex KDAO2011 ( View Tweet)
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
TheDaoIndex KDAO2011 ( View Tweet)