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EULAR 2022 – Day 1 Report
It’s good to be back into full, big meeting mode.
Highlights included a EULAR Recommendation Session, where updated guidelines were presented for the management of a) ANCA-associated Vasculitis, b) ASAS/EULAR recommendations for axSpA and c) RA. Here are a few of my favorites from Day 1.
#ClinicalPearl #SLE has ⬆️mortality until v advanced age and if not in remission or v low disease activity Mortality is higher. Ideas: control disease activity, prevent damage, limit prednisone. @RheumNow #EULAR2022 T Dormer Session #Lupus https://t.co/90cpsBVgAb
Janet Pope Janetbirdope ( View Tweet)
Rahman et al. Pooled safety data from IL23i guselkumab clinical trial programme in PsA. 1508 patients 2125 PY. No increase (and generally lower) than PBO. No IBD. @RheumNow #EULAR2022 POS1015 https://t.co/9otcpwW9ni
Richard Conway RichardPAConway ( View Tweet)
#OP0141 #EULAR2022 What do our #lupus patients think about Treat-to-target (T2T) and are they involved? A patient survey showed improvement in QoL as most important. They were open to T2T concept but concerned of more visits + new drugs. 61% felt they were involved @RheumNow https://t.co/rT500lhrih
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Rahman et al shows factors associated with variability of fatigue in PsA are systemic disease 34%, joint disease 16%, skin involvement 12%, accounting for 62% and leaving a residual effeect of 38% that was unexplained and needing further research #EULAR2022 @RheumNow OP0025 https://t.co/RoqjS64Xjy
Dr. Antoni Chan synovialjoints ( View Tweet)
The CONSUL study @ProftDr showed there was no significant difference in Celecoxib(CEL)+Golimumab (GOL) vs GOL alone. The mSASSS change was 1.1 vs 1.7, p=0.79 between the 2 groups. The combination may be clinically relevant in high-risk progressors #EULAR2022 @RheumNow OP0018 https://t.co/AUOL7IDx9L
Dr. Antoni Chan synovialjoints ( View Tweet)
ASRI @Gillianfitzger1 @bososhea @Sineadm15 Current smoking is associated with lower risk of uveitis and arthritis in males with axSpA. I wonder why this would be? @RheumNow #EULAR2022 POS1001 https://t.co/3bKmyvI606
Richard Conway RichardPAConway ( View Tweet)
Sanchez-Bilbao et al. TCZ for large vessel GCA. Has been a concern due to limited LVV/imaging in RCTs 196 patients. Seems to work well. 20% sustained remission month 6, 60% month 12. Clinically significant reduction steroid doses as shown in figure. @RheumNow #EULAR2022 POS0802 https://t.co/Z0HEVal6RI
Richard Conway RichardPAConway ( View Tweet)
Dermatologists doing ultrasound (US) for earlier diagnosis of PsA? Grobelski et al showed in this study of 140 PsA patients, pre-US sensitivity/specifity was 81%/55%, post-US this changed to 62%/91%. Targeted US improved accuracy of referrals for PsA #EULAR2022 @RheumNow OP0029 https://t.co/iajqMuPqcd
Dr. Antoni Chan synovialjoints ( View Tweet)
Sex differences may affect the response to first line TNFi in AxSpA. Hellamund et al EuroSpA study showed the TNFi 6/12/24 month retention rate was lower in females (58%) compared to males (72%). Females had lower CRP level and higher PROs at baseline #EULAR2022 @RheumNow OP0020 https://t.co/ANgRYMxpat
Dr. Antoni Chan synovialjoints ( View Tweet)
MIRACLE study: High or Low dose MTX w/ ADA in eRA?
✨ LOWd (6-8mg/w) 38.4% non-inferior to HIGHd (>10mg/w) 44.8%
✨But safety profile looks better 9.1% vs 22.1% 👀
Are you already looking for minimal dose of MTX in patients treated w/ biologics?
#OP0062 @Rheumnow #EULAR2022 https://t.co/dq0EIKSnOe
Aurelie Najm AurelieRheumo ( View Tweet)
RA patients close to the equator (i.e. ‘Global South’) get RA earlier in life than the temperate world.
Is it patient-level characteristics like smoking? No.
It’s country-level factors e.g. socioeconomic status.
Are rich world and poor world RA the same?
#EULAR2022 @RheumNow https://t.co/tAzGHzaZGe
David Liew drdavidliew ( View Tweet)
#POS0114 #EULAR2022 Can we identify #lupus patients better in electronic health records? Barbero et al. used machine learning and developed a model to distinguish SLE diagnosis vs "near-misses". AUC: 0.90. Further validation can help future epidemiological studies @RheumNow https://t.co/vpLH8SWlWm
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Upadacitinib shows promising response in the treatment of nr-AxSpA in the SELECT-AXIS 2 study. Deodhar et al showed the ASAS40 response rate for UPA was twice vs placebo (45% vs 23%). 12/14 of the secondary endpoints were also met #EULAR2022 @RheumNow OP0016 https://t.co/dOWVJdLRtG
Dr. Antoni Chan synovialjoints ( View Tweet)
Updated #EULAR2022 AxSpa Recc: The Algorithm @rheumnow https://t.co/fu46QJ3jmQ
TheDaoIndex KDAO2011 ( View Tweet)
ANCA vasculitis guidelines make sense. Less use of cyclophosphamide was already the case, rituximab can be for induction & maintenance, I am reluctant though in severe disease to stop maintenance Rx at 1 or 2 yrs and go longer as at least 1/3 will relapse beyond 2 yrs. @RheumNow https://t.co/3xRHWya2Uq
Janet Pope Janetbirdope ( View Tweet)
Occupational and non occupational silica exposure in RA increases ILD. At home exposure was higher in women due to cleaning - talc, laundry detergents, etc. Maybe some items should be banned or people protected - ? Masks. V interesting #OP0006 @RheumNow #EULAR2022 @eular_org
Janet Pope Janetbirdope ( View Tweet)
Kading et al reports axial disease in 1/3 of patients with PsA, 55% females, 45% HLA-B27+, in 20% there was spinal but no SI joint involvement. Starts to define the Axial PsA patient as more female, less HLA-B27+ and may have only spinal inflammation #EULAR2022 @RheumNow OP0026
Dr. Antoni Chan synovialjoints ( View Tweet)
Botson et al. 152 patient RCT. MTX combo with pegloticase (to decrease antidrug abs). 6-month response (sUA<6 mg/dL) 71% vs 39%. Infusion reactions 3% vs 31%. @RheumNow #EULAR2022 OP0171 https://t.co/N29kYT3xkR https://t.co/Z4dUMD4Tt3
Links:
Richard Conway RichardPAConway ( View Tweet)
GR2 cohort prospective study of pregnancies in 126 pts w/ SpA over 15 years
-Rx exposure 23% steroids, 11% NSAIDS, 55% biologics
- 116 live births, 7 miscarriages, 3 stillbirths
- 36.5% had unfavorable pregnancy outcomes
- 19% SGA
- 4.8% preterm birth
#EULAR2022 @rheumnow POS1000
TheDaoIndex KDAO2011 ( View Tweet)
