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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)
Musculoskeletal US used by dermatologists helped increasedspecificity of PsA detection, leading to fewer false suspicions of PsA earlier diagnosis of psoriatic arthritis.
@RheumNow #EULAR2022 ABST#OP0029
Robert B Chao, MD doctorRBC ( View Tweet)
After the #EULAR2022 Recommendations session, it begs the question - Do we follow it?
In Germany, the answer is sometimes
Early bDMARD or JAKi is more frequent in recent years. 1/3 of patients did not receive recommended treatment escalation after 1st csDMARD
POS0234 @Rheumnow https://t.co/0DaP5b7Htc
Eric Dein ericdeinmd ( View Tweet)
Real-world data: #SLE Rx & pt willingness to take risk: 342 pts w/SLE surveyed on hypothetical Rx's based on Sx's. Pts value Sx improvement more than risks & rated most➡️least important: joint pain, rash, & fatigue, risk for infx was least impt #EULAR2022 @Rheumnow POS0086-PARE
TheDaoIndex KDAO2011 ( View Tweet)
#EULAR2022 Update ANCA-associated vasculitis
⭐️Last update 2016
▶️Tissue bx important!
▶️RTX for most for remission, maintenance
▶️Lower steroids (50-75 mg, decrease to 5 mg/d by 4-5 mo), can use avacopan to ⬇️
▶️ No routine PLEX
▶️Maintenance is 24-48 mo, tailor to pt
@RheumNow https://t.co/OmCne2lIIb
Eric Dein ericdeinmd ( View Tweet)
#EULAR2022 EGPA recommendations:
Organ or life-threatening? Y = CYC, N = steroid
Relapsing disease? Mepolizumab
@Rheumnow https://t.co/qh564cAhC2
Eric Dein ericdeinmd ( View Tweet)
#EULAR2022 AAV Reccs summarized for induction remission for GPA/MPA @rheumnow https://t.co/Cbp72bCcik
TheDaoIndex KDAO2011 ( View Tweet)
Do you use PJP prophylaxis on patients with ANCA vasculitis on rituximab without high dose steroids?
#EULAR2022 ANCA-associated recommendations
@RheumNow
Eric Dein ericdeinmd ( View Tweet)
#EULAR2022 AAV Reccs for Steroids: start prednisone 50-75 mg/d prednisone and taper to goal 5 mg/day by 4-5 months based on #PEXIVAS @rheumnow https://t.co/6gIfme4HXH
TheDaoIndex KDAO2011 ( View Tweet)
Overarching principles of #EULAR2022 Ax Spa Updated Reccs @Rheumnow https://t.co/g6Hd9NE1vB
TheDaoIndex KDAO2011 ( View Tweet)
#EULAR2022 updated ASAS-EULAR guidelines for the management of axSpA review with Dr. @sofiaramiro82 @RheumNow https://t.co/SHg4y49auA
Dr. Rachel Tate uptoTate ( View Tweet)
#EULAR2022 ASAS Updated Reccs: Treatment Algorithm @rheumnow https://t.co/YEdhrAX0lT
TheDaoIndex KDAO2011 ( View Tweet)