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EULAR 2021 – Day 2 Report

Jack Cush, MD

During Day 2 there were great sessions devoted to RA, spondylarthritis, fatigue and more.  Here are some of my highlights from Day 2.

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New insights in RA-ILD therapeutics

Aurelie Najm, MD, PhD

RA associated ILD (RA-ILD) is the most common extra-articular manifestation in RA. Its prevalence varies considerably, ranging from 5% to 30%, and is often underestimated since patients only become symptomatic or display abnormalities on chest X-Ray at a late stage of disease, leading to subsequent delay in diagnosis. In this context, several groups advocate for an earlier and more precise detection, using high resolution chest computed tomography (HRCT), which is the most sensitive for pre-clinical RA-ILD diagnosis.
But why would we want to diagnose early a manifestation that we cannot treat?

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EULAR 2021 – Day 1 Report

Jack Cush, MD

After the opening ceremonies and keynote speaker there were several enticing sessions and a plenary session full of great research and presentations.  Here are a few of the highlights that I saw.

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⭐️Deucravacitnib = oral TYK2i w/ downstream inhibitory effects on IL23, IL12 & type I IFN pathways ⭐️Recent studies (POETYK PSO-1/2) show that it outperforms Otezla per PASI75 ⭐️OP0227 shows it is also efficacious for active PsA vs PBO w/ no serious AEs #EULAR2021 @Rheumnow https://t.co/qA1NsLzQsF

Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)

RheumNow’s expanded coverage of the #EULAR2021 Annual meeting is sponsored in part by Novartis, Bristol Myers Squibb, and Janssen. All content chosen by RheumNow and its faculty.

Dr. John Cush RheumNow ( View Tweet)

JAKi to #JAKi cycling is common in #rheumatoidarthritis Rx. Opal registry >53000 pts, 1/4 treated with JAKi (4000) & 44% new starts were Jaki. JAKi to JAKi cycling was >40%! POS0223 #EULAR2021 ⁦@RheumNow⁩ https://t.co/XV7wVJsE9c
Janet Pope Janetbirdope ( View Tweet)

RheumNow’s expanded coverage of the #EULAR2021 Annual meeting is sponsored in part by Novartis, Bristol Myers Squibb, Janssen. All content chosen by RheumNow & its faculty.

Dr. John Cush RheumNow ( View Tweet)

#OP0227 #TYK2 inhibitor deucravacitinib showed good efficacy in #PsA patients vs. placebo in phase 2 16weeks Primary endpoint ACR20 12mg: 62.7% 6mg: 52.9% PLC: 31.8% + well tolarated: no serious adverse events #EULAR2021 @RheumNow https://t.co/6SFqWd79db
Paul Studenic Stiddyo ( View Tweet)
Ever wonder why one drug works in a pt & not another? Study of bio markers in PsA from RCT of #upadacitinib vs #adalimumab shows diff pathways affected by each drug & some overlap too @RheumNow #EULAR2021 @eular_org OP0030 https://t.co/WifrVOIMkW
Janet Pope Janetbirdope ( View Tweet)
Can machine learning show JAKi effects for safety? Off target binding predicted in #tofacitinib 58, #baricitinib 41 but NO pathway for thrombosis or viral infection. Could have repurposing for + effects on lung vasculature & antifibrotic effects POS0091 #EULAR2021 @RheumNow

Janet Pope Janetbirdope ( View Tweet)

MACE events with #JAKi is as clear as mud! You voted >50% NOT Sure 1/3 only some Jakis vs MACE in #TNFi! Dunno #EULAR2021 @RheumNow @eular_org https://t.co/vWUgKSwAap
Janet Pope Janetbirdope ( View Tweet)
Poorer outcomes with #JAKi in pts who get #SARSCoV2 but ? related to line of therapy - worse off if 2nd line advanced Rx in RA vs 1st line? JAKi has short half life so it washes out? And..#baricitinib added to #remdesivir improves outcomes NEJM @RheumNow #EULAR2021 #OP0006 Dunno! https://t.co/583z6Mlw3y

Links:

Janet Pope Janetbirdope ( View Tweet)

⭐️All cancer excluding NMSC - 0.9HR TNFi vs cDMARD ⭐️Squamous cell CA - 1.2HR of TNFi vs cDMARD ⭐️No overall increase in all CA: RTX, TOCI ⭐️Abatacept 1.21HR for all cancer, mainly NMSC ⭐️needs more data on JAKs, IL-17, IL-23 Abs#6916 #EULAR2021 @RheumNow

Robert B Chao, MD doctorRBC ( View Tweet)

Efficacy & Safety of UPA after 1yr from SELECT-AXIS 1 study? ⭐️187 bDMARD-naive, active AS pts w/ inadeq resp to NSAID ⭐️82-85% txed w/ UPA 15mg QD achieved BASDAI50 or ASDAS LDA over 64w 🚫 new safety signal & ZERO VTE, MACE, TB, or deaths w/ UPA. OP0144 #EULAR2021 @RheumNow https://t.co/mFbgQjsD6f
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
➡️5 cases of single-dermatome Herpes Zoster in 4 patients treated w/ UPA 15 mg QD for active AS in SELECT-AXIS 1 ⭐️Do not forgot to vaccinate patients with 1st dose of Shingrix prior to starting a JAK-i. 2nd dose can be given after start of therapy OP0144 #EULAR2021 @RheumNow

Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)

Do you vaccinate ALL patients (even if less than 50 yo) with first dose of Shingrix prior to starting a JAK-i? #EULAR2021. @RheumNow

Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)

News Feature: EULAR 2021 – Day 1 Report #EULAR2021 https://t.co/igpQYMkf9l https://t.co/qESsN3meJe

Links:

Dr. John Cush RheumNow ( View Tweet)

RheumNow’s expanded coverage of the #EULAR2021 meeting is sponsored in part by Novartis, Bristol Myers Squibb, Janssen. All content chosen by RheumNow & its Faculty.

Dr. John Cush RheumNow ( View Tweet)

#POS0093 Collaborative registry studies are to be encouraged! BUT @k_lauper outlines the heterogenity between registries concerning #AE reporting - Jak-pot study - 18 registries with #RA patients on #tofacitinib - Rates of discontinuation vary across registry #EULAR2021 @RheumNow https://t.co/oczJAG8hzv
Paul Studenic Stiddyo ( View Tweet)
You put a pt on a #Jaki What is most likely infection that will occur? #EULAR2021 @RheumNow @eular_org

Janet Pope Janetbirdope ( View Tweet)

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