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Update on Axial SpA at EULAR 2022
This year at EULAR 2022, there were important and interesting topics in Axial Spondyloarthritis (AxSpA). These are my picks of abstracts from the conference.
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Updates on Axial SpA from #EULAR2022 @RheumNow https://t.co/0dGPUpksxT
Dr. Antoni Chan synovialjoints ( View Tweet)
Update on Axial SpA at #EULAR2022
This year at EULAR 2022, there were important and interesting topics in Axial Spondyloarthritis (AxSpA).
Dr Antoni Chan shares his picks of abstracts from the conference.
https://t.co/AhUC7ORrZi https://t.co/1olLoNS5Ey
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Dr. John Cush RheumNow ( View Tweet)
Spondyloarthritis and COVID-19
With the availability of vaccines and new therapeutics, many of our patients are fully vaccinated. We know this can limit their chances of severe COVID all while allowing their rheumatic disease to be treated. #EULAR2022
https://t.co/PmQNKYg1Ao https://t.co/N4DJVYJqrL
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Dr. John Cush RheumNow ( View Tweet)
New biomarker for atherosclerosis, cardiovascular risk and disease activity in axSpA?
Low Irisin associated with subclinical atherosclerosis, high CV risk and more severe disease activity in axSpA
@RheumNow #EULAR2022 ABST#POS0327
Robert B Chao, MD doctorRBC ( View Tweet)
Sex differences in axSpA: we’re continuing to better understand the differences in imaging findings.
Existing MRI scoring may underserve axSpA in women.
Added to therapy differences, a lot to readdress for our female axSpA patients.
from roundup #EULAR2022 @RheumNow https://t.co/8wCKx9AFcM
David Liew drdavidliew ( View Tweet)
Gut microbiome of AS patients different from healthy controls. Different bacteria communities may be associated with disease activity.
So much more to digest....
@RheumNow #EULAR2022 ABST#POS0330 https://t.co/EAvHngd6SD
Robert B Chao, MD doctorRBC ( View Tweet)
Tofacitinib had faster and larger impact on improvement of fatigue compared to placebo in treatment of ankylosing spondylitis pts.
Note 100% fatigue resolution roughly same vs. placebo
@RheumNow #EULAR2022 ABST#POS0305 https://t.co/Doep91QIRa
Robert B Chao, MD doctorRBC ( View Tweet)
Upadacitinib effective in treatment of ankylosing spondylitis pts refractory to biologic tx - phase 3 trial
Primary endpoint (ASAS40) and secondary endpoints met
No malignancy, MACE, VTE, death
@RheumNow #EULAR2022 ABST#POS0306 https://t.co/UL4hUJ0rQV
Robert B Chao, MD doctorRBC ( View Tweet)
Does treating spondyloarthritis early matter?
Systematic review showed in nr-axSpA tx with biologics may lead to better outcomes compared to established axSpA
axSpA - no difference in response between early vs. established disease
@RheumNow #EULAR2022 ABST#POS0302
Robert B Chao, MD doctorRBC ( View Tweet)
What guides treatment decisions in AxSpA? Bolt et al showed patients assessed in clinical remission, 1/3 had BASDAI >3.5. Treatment unchanged as low disease activity, awaiting effects of current Rx, complaints not related to axSpA, patient preference #EULAR2022 @RheumNow POS0303
Dr. Antoni Chan synovialjoints ( View Tweet)
Treatment of active SpA improves depressive symptoms in SpA with HADS-D score reducing. This was greatest for TNFi followed by NSAIDs and csDMARDs. TNFi reduced the proportion of patients (48% to 29%) with depressive symptoms at follow up Webers et al #EULAR2022 @RheumNow POS0304
Dr. Antoni Chan synovialjoints ( View Tweet)
Wetterslev et al showed that almost all of 108 axSpA patients in clinical remission flared during tapering,47% flared at 2/3 to ½ dose and 53% at 1/3 to discontinuation. Higher baseline physician global score was an independent predictor of flare #EULAR2022 @RheumNow POS0298 https://t.co/RELuiB3Enl
Dr. Antoni Chan synovialjoints ( View Tweet)
New in AS. Upadacitinib 15mg od was significantly more effective than placebo over 14 weeks in AS bDMARD-IR (ASAS40 45% vs 18% and the onset of effect seen by week 4), no new safety risks identified in the SELECT-AXIS 2 study by Van de Heijde et al #EULAR2022 @RheumNow POS0306 https://t.co/LCQBf38GWe
Dr. Antoni Chan synovialjoints ( View Tweet)
SELECT-AXIS 1 trial of upadacitinib in active #AS with an inadequate resp to prior biologic - pivotal phase 2/3 RCT of 420 AS pts (Dz dur 7.7 yrs; 83% B27+) showed better ASAS40 at wk 14 w/ UPA vs PBO (45% vs 18%; P<0.0001) #EULAR2022 POS0306 https://t.co/6ZBEvjRjqc https://t.co/GL0vlB34mE
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Dr. John Cush RheumNow ( View Tweet)
So what diet to follow with autoimmunity in mind?
So many, all with different instructions.
Let’s concentrate on where they agree:
yes to fruits & vegetables
no to emulsifiers & processed foods
#EULAR2022 @RheumNow https://t.co/I9abweQOyZ
David Liew drdavidliew ( View Tweet)
Characteristics assoc outcomes PsO/PsA/axSpA @pedrommcmachado @rheum_covid bDMARDS, NSAIDs assoc better outcomes. Usually culprits assoc worse outcomes (age, CVD etc), and also disease activity and steroids @RheumNow #EULAR2022 OP0249 https://t.co/siLdQVj2jb https://t.co/BmdwspDhsG
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Richard Conway RichardPAConway ( View Tweet)
Nossent et al Hospitalisation with opportunistic infection twice as high in RA vs AxSpA/PsA. Has IMPROVED over biologic era. To me, suggests benefits of proper disease control on infection risk
@RheumNow
#EULAR2022 OP0274 https://t.co/cqUoRti4We https://t.co/Ozz7jH3z4N
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Richard Conway RichardPAConway ( View Tweet)
Michielsens et al T2T tapering of TNFi in AxSpA and PsA. 72% tapered, 28% discontinued TNFi. Month 12 LDA 69% vs 73%.Month 12 dose 53% vs 91%. Flares 85% vs 78%. Needed more NSAID 54% vs 24% and steroid 30% vs 17%. @RheumNow #EULAR2022 OP0261 https://t.co/EDBPOgg4sX https://t.co/ckPqaTdm4B
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Richard Conway RichardPAConway ( View Tweet)
Increased risk of aortic regurgitation and atrial fibrillation in radiographic axSpA pts when compared to general population. No significant risk for AV block (II-III). Unclear if treatment affects cardiac risk in these patients.
@RheumNow #EULAR2022 ABST#POST0146
Robert B Chao, MD doctorRBC ( View Tweet)
