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COVID-19 mostly mild for majority of SpA patients.
Steroid use associated with more severe COVID-19 outcomes (OR 3.15).
TNFi found to be protective! (OR 0.26)
@RheumNow #EULAR2022 ABST#OP0254
Robert B Chao, MD doctorRBC ( View Tweet)
Perrot et al. Factors assoc severe COVID in SpA. corticosteroid intake (3.15 [1.46-6.76]), age (OR=1.06 [1.04-1.08]) while anti-TNF (OR=0.26 [0.09-0.78]) was protective @RheumNow #EULAR2022 OP0254 https://t.co/bIiEW6efQ2
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Richard Conway RichardPAConway ( View Tweet)
#OP0249 #EULAR2022 Dr Machado presented pooled data >5000 pts. Poor #COVID outcomes in Pso, PsA and AxSpa were associated with the usual suspects: Age, male, high disease activity and comorbidities. No specific bDMARDs was associated. Good news for our patients @RheumNow https://t.co/itzmwqKCrH
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Ok to taper?
In PsA and AxSpA pts on TNFi, a T2T w/ tapering strategy was non-inferior to a T2T w/o tapering.
69% of tapered group remained in LDA, 73% no-taper group in LDA after 12 months.
Taper group did use more NSAIDs, cDMARDs, steroids
@RheumNow #EULAR2022 ABST#OP0261
Robert B Chao, MD doctorRBC ( View Tweet)
Pregnancy data in SpA from 122 pts
40% flared during pregnancy, more frequent 2nd trimester, pts w/ axial dz
7 pts required start of TNFi during 2nd or 3rd trimester
40% post-partum
@RheumNow #EULAR2022 ABST#POST0151 https://t.co/cdFRhRuCVH
Robert B Chao, MD doctorRBC ( View Tweet)
SpA pregnancies in #EULAR2022 POS1051 found that 40% of pts flared, particularly during their 2nd trimester in those with axial involvement OR post-partum. Seven flares led to TNFi initiation in 2nd or 3rd trimesters and were without correlation in post-partum flares. @RheumNow https://t.co/0ZWjYMwmzn
Dr. Rachel Tate uptoTate ( View Tweet)
The third SARS-CoV-2 vaccine in IMID (RA, SpA, PsA, UC, CD) patients on immunosuppression improves the serologic response follow the first two vaccine doses and allowed them to close the gap compared to the two-dose vaccinated controls #EULAR2022 @RheumNow OP0192 Jyssum et al
Dr. Antoni Chan synovialjoints ( View Tweet)
#EULAR2022 OP0274
Hospitalization for TB and other opportunistic infxn (OI) w inflamm joint disease:
⭐️9% with RA, 6% with PsA and AS in Western Australia
⭐️Decrease overall since 1985, but recent increase
⭐️Sharp rise of mycotic infections
⭐️No PJP, likely due to ppx
@Rheumnow
Eric Dein ericdeinmd ( View Tweet)
#OP0248 #EULAR2022 In contrast to data from #OP0247 where SpA was protective, a matched population study in Canada found the opposite - increased risk of hospitalisation & death in SpA. A meta-analysis cd help to disentangle this @RheumNow https://t.co/keNZ2RPnXF
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
WATCH: New 2022 ASAS/EULAR Recommendations on the Management of AxSpA
Dr. Sophia Ramiro (Leiden University Medical Center) presents an overview of the new Spondyloarthritis treatment guidelines from ASAS/EULAR Task Force. #EULAR2022
https://t.co/AiCNQPm6KB https://t.co/kn4rmcbZrH
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Dr. John Cush RheumNow ( View Tweet)
What is "backfill" on MRI? Answer: joint space lesions with a calcified matrix resembling new bone formation found in axSpA. #EULAR2022 POS0149 argues for a standardization of this nomenclature. @RheumNow https://t.co/ifrowQnRcn
Dr. Rachel Tate uptoTate ( View Tweet)
Women with spondyloarthritis at increased risk of gestational diabetes, elective and emergency C-sections, and spontaneous pre-term birth. Infants were not more likely to be born SGA.
@RheumNow #EULAR2022 ABST#OP0126 https://t.co/BTXQqruvPs
Robert B Chao, MD doctorRBC ( View Tweet)
Differentiating AS from OCI using CT scanning by Terrier et al showed that Subchondral Bone Attenuation Coefficient (SBAC) was higher in OCI than AS with a threshold of >7500 Hounslow Units discriminating the two conditions #EULAR2022 @RheumNow POS0126 https://t.co/8MdSe3Dqp7
Dr. Antoni Chan synovialjoints ( View Tweet)
GM-CSF increased in patients with active ankylosing spondylitis, correlates with disease activity, not duration. TNFi does not affect GM-CSF levels. Could explain efficacy of JAKinibs and response for residual inflammation during TNF blockade.
@RheumNow #EULAR2022 ABST#OP0107
Robert B Chao, MD doctorRBC ( View Tweet)
Depression was the most prevalent comorbidity (31%), hypertension (26%) and uveitis the most common EMM (30%) in AS from the PSOAS cohort by @rheum_cat .
Five clusters identified with depression and hypertension groups having higher disease activity #EULAR2022 @RheumNow OP0154 https://t.co/dpqaFD4Qzw
Dr. Antoni Chan synovialjoints ( View Tweet)
JAKi for nonradiographic axSpA
One area of continued interest for many rheumatologists is the field of non-radiographic axial spondyloarthritis. And the question of the utility of JAK inhibitors for the treatment of axSpA has been on the rise.
https://t.co/xq8ICyKKv0 https://t.co/o2iUgyU60A
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Dr. John Cush RheumNow ( View Tweet)
💫Trajectory analysis in SpA💫
Data on 1,125 patients
Prediction of spinal radiographic progression
⭐️FAST associated w/ onset at older age & 👁involvement
⭐️SLOW progression associated w/ female gender & peripheral involvement.
#EULAR2022 @RheumNow OP0151 https://t.co/E80qCLEtBv
Aurelie Najm AurelieRheumo ( View Tweet)
Comorbidity in AS from @rheum_cat , Karmacharya et al. Clustering of comorbidities. Depression and hypertension clusters assoc worse disease activity and function @RheumNow #EULAR2022 OP0154 https://t.co/jGQXayAYs9 https://t.co/SnVDhVYQq5
Links:
Richard Conway RichardPAConway ( View Tweet)
#EULAR2022 ASAS/EULAR AxSpA Recs
⭐️Last: 2016
▶️All: education, exercise, 🚭
▶️❌csDMARD for axial disease
▶️TNF/IL17 (or JAK) with high disease: ASDAS>/=2.1
▶️Monoclonal TNF for uveitis/IBD, high PsO: IL-17
▶️Sustained remission: tapering of bDMARD "can be considered"
@RheumNow https://t.co/3yYU0Vb37r
Eric Dein ericdeinmd ( View Tweet)
Hamroun @annamolto et al. Factors assoc with increased time to conception in SpA. 56 pregnancies. Multivariate model, age (HR 1.22 (1.08-1.40)) and preconception NSAID use (HR 3.01 (2.15-3.85)) assoc increase time to conception. @RheumNow #EULAR2022 OP0153 https://t.co/y2EAyAdRmk https://t.co/28aLimRInE
Links:
Richard Conway RichardPAConway ( View Tweet)
