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Dr. Jack Cush reviews this week’s news and journal reports featured on RheumNow.com.
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Dr. Jack Cush reviews and highlights his favorite abstracts and presentations from last week's virtual EULAR 2021 meeting.
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Despite being relatively common and frequently severe, RA-ILD has been a neglected area of research and indeed of clinical management in RA. In recent years we finally seem to have started making some progress in this area and this momentum has continued with a several interesting abstracts at EULAR 2021. Here are four selected for review.
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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?
Dr. John Cush
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RA ILD: Stepping out of the shadows
Interstitial lung disease (ILD) is a common complication of rheumatoid arthritis (RA) with up to 8% of patients affected with clinically significant ILD.
https://t.co/BaoqQLKR5C https://t.co/duIqHVfCAa
Dr. John Cush
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Abatacept in RA ILD
Dr. Conway ( @RichardPAConway) discusses abstract POS0595 at the virtual #EULAR2021 meeting.
https://t.co/rpVuHOkS5w https://t.co/7pNzh6sb7a
Dr. John Cush
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Video: The Future of Treatment of RA-ILD: Dr. David Liew ( @drdavidliew )
Dr. David Liew reviews abstract OP0124 presented at #EULAR2021
https://t.co/0dqBPRiwjA https://t.co/XR7cQhPVRw
Richard Conway
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Clive Kelly presents data from INBUILD on nintedanib in progressive fibrosing RA-ILD over 52 weeks FVC decline -82.6 (41.3) mL in nintedanib vs -199.3 (36.2) mL in placebo (p=0.037) @RheumNow #EULAR2021 Abstr#OP0124 https://t.co/MZwzNoq6LC
David Liew
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Just a reminder: RA-ILD doesn't just happen in early disease; risk continues on long after diagnosis.
PS don't smoke if you have RA; smokers have an adj HR 1.92
PPS don't smoke if you don't want to get RA
PPPS don't smoke.
@MayoClinic POS0210 #EULAR2021 @RheumNow https://t.co/elhvJrK7B4
Jeffrey Sparks MD MMSc
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Lots of discussion about RA-ILD, but what about bronchiectasis (BR) in RA? We found a pooled prevalence of RA-BR of 18.7% (some may have been subclinical). POS0522 Prevalence of bronchiectasis in rheumatoid arthritis: A systematic review and meta-analysis #EULAR2021 @Janetbirdope
Robert B Chao, MD
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Metabolomic profiling for PsA showed vLDL, triglycerides; apolipoprotein B, glycoprotein acetylene associated with increased CV events…
Do you monitor cholesterol levels in your PsA pts?
Abs#OP0221
#EULAR2021 @RheumNow
Eric Dein
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#EULAR2021 OP0290: Cluster analysis of APLS
4 Clusters:
⭐️ 2ndary APS, non-criteria
⭐️ ♂️ with CV risks
⭐️OB morbidity
⭐️Isolated LA +
@RheumNow
Dr. John Cush
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Turning the Corner on CV Risk in Rheumatoid Arthritis by Richard Conway ( @RichardPAConway) #EULAR2021
https://t.co/S0ownscRKv https://t.co/PJODe0U6wr
Aurelie Najm
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Dr Yoshida analyze data from US registry 40,721 RA patients. High 2.11 [1.13, 3.96] and moderate 1.97 [1.13, 3.43] CDAI associated w/ > HR of major adverse CV events. HRs decrease during follow up.
Tight and early disease control reduces CV burden!
#EULAR2021 @Rheumnow #OP0101 https://t.co/A0ZYE4v8uf
Aurelie Najm
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In 16,448 RA from ACR’s RISE registry: no difference in disease activity TNFi and non-TNFi at 12 months. Stratified analysis: ⬆️disease activity for TNFi vs. non TNFi in patients of Black and Asian ethnicity. To be confirmed in independent cohorts.
#EULAR2021 @Rheumnow #OP0117 https://t.co/7bFnOKR9uz
Aurelie Najm
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Can we predict pre-clinical RA-ILD?
@Juge_P_A ESPOIR cohort. model w/ 4 variables: male gender, older age @ diag, mean DAS-28 over follow-up and MUC5B variant ▶️ preclinical ILD after 13 years of RA w/ AUC=0.82 CI 95% (0.72-0.91) (Sens 80%, Spe 56%)
#POS0095 @Rheumnow #EULAR2021 https://t.co/bPyidNhNuO
Ashima Makol MD
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Very informative #EULAR2021 WIN session on MIS-C @EULAR_org
👉 Steroids early
👉 IVIg in all
👉 anticoagulant use remains variable
#Coronary aneurysms
✅ occur during acute phase in MIS-C and improve with treatment
✅ occur in the late/convalescent phase of #Kawasaki disease https://t.co/Ff3rX6u5VK
Md Yuzaiful Md Yusof
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Do we need to monitor #ECG in patients on #HCQ and #polypharmacy? Dr Antivalle reported ⬆️QTc interval in HCQ vs controls. Only 3/132 was above ULN in HCQ group though. Importantly,⬆️QTc was noted more in HCQ + co-meds (e.g. PPI) #EULAR2021 #POS0090 @RheumNow https://t.co/1Ui4MghqIk
Janet Pope
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How common is RA ILD? @RheumNow #EULAR2021 @eular_org
