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RA and cancer risk in the biologic era
A nationwide population-based study, by Beydon et al. (OP0044), has performed a more recent (2010-2020) analysis of cancer incidence in people living with RA within the French national claim database, compared to general population, measured in the French Network of Population-Based Cancer Registries.
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AI in RA: the story grows along the patient pathway
The use of artificial intelligence to analyse large data sets using its subset component machine learning has taken centre stage recently in the management of rheumatic conditions, including rheumatoid arthritis. The use of AI is now starting to cross the various stages in patient care from detection, diagnosis, treatment and the prediction of long-term outcome.
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The key data for treating clinically suspect arthralgias (CSA):
TREAT-EARLIER (MTX)
ARIAA, APIPPRA (abatacept)
but what we need to do going forward:
stratify pts better for studies
predict individual risk better, to weight up risk-benefit of intervention
#EULAR2023 @RheumNow https://t.co/h3gNIyLxPY
David Liew drdavidliew ( View Tweet)
Key arguments for CSA skeptics:
- definitions, imaging aren’t anywhere near as good as our own suspicion as clinicians is
- we still struggle to prevent RA
- it’s easy to go down a therapeutic slippery slope, and hard to track back
- labels are hard to remove
#EULAR2023 @RheumNow https://t.co/4adop3IR8g
David Liew drdavidliew ( View Tweet)
ILD in RA and PsA
@AurelieRheumo discusses inconsistent data inconsistent data have proposed on the effect of bio/tsDMARDs on the risk of ILD.
ILD is a severe extra articular manifestation of RA, with limited treatment strategies and poor prognosis.
https://t.co/U1RjvgTCL8 https://t.co/qmxXBTK05N
Links:
Dr. John Cush RheumNow ( View Tweet)
Tune it at 1pm EST for RheumNow's daily #EULAR23 recaps. You can find us live on Twitter, YouTube and LinkedIn. https://t.co/t531csjXo8
Dr. John Cush RheumNow ( View Tweet)
Clinically suspect arthralgia-what is needed are predictors that enrich WHO will develop RA. Otherwise in 85% of Pts your (sham) Rx will work. If we need to reset the immune response- early makes sense but many will NOT have #RA over the next few yrs. @RheumNow #EULAR2023 https://t.co/vDv6cHqFUn
Janet Pope Janetbirdope ( View Tweet)
#Clinically suspect #arthralgia debate BE CAREFUL how you apply the criteria as sensitivity / specificity will vary if low pretest likelihood. @eular_org @RheumNow https://t.co/2XAwXbp1fi
Janet Pope Janetbirdope ( View Tweet)
#ClinicalPearls #rheumatoid #arthritis is changing. Less extra articulation and less mortality except ILD. Legacy pts exposed to ASA high dose, NSAIDs and injectable gold. We still see it rarely. @RheumNow #EULAR2023 @eular_org https://t.co/sC8vZkjO2x https://t.co/BFdpubei4u
Janet Pope Janetbirdope ( View Tweet)
Debate @ #EULAR2023 @eular_org about clinically suspect arthralgia. Myth or just #rheumatoid #arthritis in the making? https://t.co/Kj4CeE3NtU
Janet Pope Janetbirdope ( View Tweet)
Did you know?
Painter Peter Paul Rubens had Rheumatoid Arthritis as demonstrated in swellings and deformities observed in this self-portrait
An image I often use in my teaching to student of clinical aspects of RA
#rheumatologyandart #teachingpearls
#EULAR23 @RheumNow https://t.co/xwDisTUHdy
Aurelie Najm AurelieRheumo ( View Tweet)
Herpes Zoster vaccination in RA patients treated with Upadacitinib and MTX showed a satisfactory response,
slight reduction in response compared to general population in both antibody and cell mediated responses Winthrop K, Abst#OP0225 #EULAR2023 @RheumNow https://t.co/wxwbOYsn5K
Dr. Antoni Chan synovialjoints ( View Tweet)
Let le introduce you to ARTHUR 🤖
A very skilled robot who scans your hands and wrists in 15 mn 🤚
Amazing to see new #AI developments that will make our lifes’ easier!
#EULAR23 @ROPCA3 @JustSoren Stand M6
@RheumNow https://t.co/7PtR2CGqTt
Aurelie Najm AurelieRheumo ( View Tweet)
So what kind of changes do we see in ACPA+ arthralgia patients, in the 6 months prior to them developing inflamm arthritis?
- ACPA titre up, RF pos
- EMS, pain up
- ESR up
Good things to keep an eye on in pre-RA
Emery group POS1046 #EULAR2023 @RheumNow https://t.co/cSKPb5SbVH
David Liew drdavidliew ( View Tweet)
‘Where have all the rheumatoid nodules gone?’
(Fantastic poster title @MayoClinic)
Don’t get to see them much in clinic anymore. Almost surprised when I do
Smoking is down
Therapies are better
RA is changing
(a fact worth remembering!)
POS1066 #EULAR2023 @RheumNow https://t.co/VxDNusIjOa
David Liew drdavidliew ( View Tweet)
#EULAR2023 #POS1069 SLR & meta-analysis to inform EULAR Points to Consider which included 15 studies showed that targeted therapies were not associated with increased risk of cancer recurrence in patients with inflammatory arthritis AND a historyof cancer (85% had RA) @RheumNow https://t.co/uK2XHLjpj8
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
‘Clinically suspect arthralgias: fact or myth’ - a great debate topic #EULAR2023
First, the argument for. And we start with a reminder as to what we really mean by CSA
@RheumNow https://t.co/e1CdxKi69m
David Liew drdavidliew ( View Tweet)
To treat or not? Clinically suspect arthralgia does affect QoL including function. Both premises of treating with a DMARD are valid. OverRx v missing the very early window of opportunity @RheumNow #EULAR2023 @eular_org https://t.co/86CVZ2IjEf
Janet Pope Janetbirdope ( View Tweet)
Use of antîmalarials in RA reduced the risk of bacterial infection in RA, smaller number of viral and fungal to study impact on systematic infections Bredemeier M, Abst#OP223 #EULAR2023 @RheumNow https://t.co/RXuFi3LdZC
Dr. Antoni Chan synovialjoints ( View Tweet)
Natural sequence of events happening in a subclinically inflamed joint, serial MRI study
When progressing to clinical RA
First osteitis then synovitis & tenosynovitis
🦴➡️✋
During resolution tenosynovitis reduces first then synovitis & osteitis
@RheumNow #EULAR23 OP0261 https://t.co/ic94htYv6T
Aurelie Najm AurelieRheumo ( View Tweet)