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We know HCQ adherence is poor in both RA and SLE
>50% in this BC 🇨🇦 cohort
All despite being such an important medicine
What’s super interesting are the trajectories of adherence - and we’d like to understand more about what motivates each group
OP0222 #EULAR2023 @RheumNow https://t.co/rbx1l9T36C
David Liew drdavidliew ( View Tweet)
Antimalarial adherence in RA and SLE showed 4 patterns of adherence over time, with 53% drop off in 1 year, with higher adherence with age, SLE and socioeconomic class, Hoque MR, Abst#0222 #EULAR2023 @RheumNow https://t.co/Bld5kWVQxE
Dr. Antoni Chan synovialjoints ( View Tweet)
#EULAR2023 #POS1075 Which biologics have the lowest retention rate in Elderly patients (=>65 yrs) in Rheumatoid Arthritis? Data from Italian registry showed 1/3 discontinued biologics at 2 yrs. IL6-i: lowest persistence; Abatacept: highest @RheumNow https://t.co/28n4qzR3aM
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
So we need protocolized extra steroids in new RA? A debate as old as time
Individual patient data metaanalysis
- slight gains early on, not sustained
- fewer DMARD changes
- but a heap more PNL, well after the protocol ends
Life is about trade-offs😐
OP0220 #EULAR2023 @RheumNow https://t.co/M8SBKjGncv
David Liew drdavidliew ( View Tweet)
#EULAR2023 #POS1066 “Diagnosis: Seropositive Nodular Rheumatoid Arthritis” - I can probably get rid of Nodular soon in my letter. Trends of Nodules have decreased over time. Could be because we are getting better at preventing erosion and smoking cessation @RheumNow https://t.co/fmQvyNHCUJ
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Impact of menopause & on function in RA
HAQ increases slightly after menopause
Premature menopause = worse function
Slightly better HAQ (but moderate & no effects on other PROs) in THR group vs. non THR
No safety data
@RheumNow OP0268 #EULAR23 https://t.co/7KJScF8O2X
Aurelie Najm AurelieRheumo ( View Tweet)
Initial use of glucocorticoids GC as bridging treatment in RA resulted in increase use of GC later, fewer DMARD changes later, van Ouwerkek L, Abst#OP220 #EULAR2023 @RheumNow https://t.co/IjxgQTZ8SE
Dr. Antoni Chan synovialjoints ( View Tweet)
We need to assess CV risk in IA but how?
Performances of QRisk3, Framingham & Reynolds scores for prediction of CV event in OA RA PsA AS PSO
Bummer: these 3 prediction tools are less accurate in IA but also OA.
We need a dedicated tool.
@Rheumnow OP0267 #EULAR23 https://t.co/O73cETXXoe
Aurelie Najm AurelieRheumo ( View Tweet)
EULAR 2023 – Day 2 Report
Day 2 at the international EULAR Congress meeting is always bigger and busier. There were sessions on JIA therapies, crystal arthritis, novel drugs for SLE and Sjogren's, early RA and preclinical RA interventions, IgG4 disease, osteoporosis and the growth and application of artificial intelligence in medicine and rheumatology.
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Better at Predicting RA from MRI: Humans or Computers?
An artificial intelligence model to assess pre-RA hand MRIs has confirmed what human readers have known before: that bone marrow edema and tenosynovitis are objectively the best predictors of future RA development in patients with clinically suspect arthralgias or undiffer
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Would you rather have Erosive hands OA or RA?
130+ EHOA and 370+ RA, dis duration > 10 yrs for both cohorts
📍EHOA associated w/ > pain & functional impairment
📍RA associated w/ > comorbidities
@RheumNow #EULAR23 POS0103 https://t.co/KdDG7E6PZw
Aurelie Najm AurelieRheumo ( View Tweet)
The risk of osteoarticular infection following Staph aureus bacteremia is twice higher in RA (1/4) than non RA pop (1/8)
Use of TNFi & orthopedic implants associated w/ OAI risk
Mortality however similar in RA and non RA groups
@RheumNow #EULAR23 POS0033 https://t.co/H6JYkbNu0B
Aurelie Najm AurelieRheumo ( View Tweet)
Can combined US examination of nail-enthesis complex & nailfold videocapillaroscopy differentiate PsA from PSO RA and HC?
Brief answer is no, but:
-PsA > tortuous capillaries vs. PSO & HC
-Abnormalities in PSO to be used as predictor of PsA?
TBC...
@RheumNow #EULAR23 POS0025 https://t.co/RNbpht8QGh
Aurelie Najm AurelieRheumo ( View Tweet)
Fluorescence optical imaging in early arthritis?
Nice images but not ready for clinics yet
Can not differentiate OA from RA & PsA
SLE/SSc associated arthritis display a specific pattern, but usually auto-antibody profiles help w/ diagnosis
OP0173 #EULAR23 @Rheunow https://t.co/bAMi9kDKS5
Aurelie Najm AurelieRheumo ( View Tweet)
🛑Doing Hands and feet Xray in undifferentiated arthritis?
Retro study 700+pts shows:
✔️only few patients w/ UA present w/ RA-associated erosions at presentation
✔️Rarely leads to change in diagnosis or prognosis.
Will you stop? I probably won't 👀
@RheumNow #EULAR23 OP0172 https://t.co/BRpmDqaN0r
Aurelie Najm AurelieRheumo ( View Tweet)
In Brazil, if you’re in the early RA clinic (yellow bars) you do a lot better than other academic clinics, even w bDMARD access.
Maybe it’s early Rx, or love & care, or other patient factors
- but it’s a reminder that RA isn’t a level playing field.
POS0055 #EULAR2023 @RheumNow https://t.co/jI2dvuIHWP
David Liew drdavidliew ( View Tweet)
Tapering pred in RA - this just rings true from everyday clinic life.
Some patients just seem to hit a wall at PNL 2.5. Sometimes it’s GC withdrawal arthralgias/tertiary adrenal insufficiency, but often it’s genuine inflammation.
I still wonder why?
POS0050 #EULAR2023 @RheumNow https://t.co/JBh26VqPuM
David Liew drdavidliew ( View Tweet)
Can machine learning help bDMARD selection in RA?
Early days limited by the data available, so not great yet, but efforts underway are a good start for an area where we need to do better than our status quo guessing.
Watch this space
POS0641 #EULAR2023 @RheumNow https://t.co/2j8H40iFWo
David Liew drdavidliew ( View Tweet)
TNFi & Disease activity-guided dose optimization in RA⬇️prog of ADA or ETA daily dose (100%66%50%0%)
10yrs followup in 170pts
⭐️74% tapered until full discontinuation
⭐️Median time to restart 8 mo
⭐️21% never restarted!
What's lacking? % of recovery
@Rheumnow OP0131 #EULAR23 https://t.co/Ms6lqQ7cWf
Aurelie Najm AurelieRheumo ( View Tweet)
Rituximab in RA - do you need to maintain B cell depletion?
Well, in this Paris cohort, if you divide up patients by B cell depletion (at time of next infusion) - no diff in efficacy.
Bias possible but B cell depletion in RA isn’t the hill to die on POS0636 #EULAR2023 @RheumNow https://t.co/GLdu9YkL7g
David Liew drdavidliew ( View Tweet)