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EULAR 2021 – Day 2 Report
During Day 2 there were great sessions devoted to RA, spondylarthritis, fatigue and more. Here are some of my highlights from Day 2.
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New insights in RA-ILD therapeutics
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?
Pregnancy is a minefield for RA pts:
dx activity➡️preg risk
PNL➡️preg risk, but dx activity proxy?
bring on Swedish/Danish linked data:
1739 RA preg matched 1:10
⬆️pre-term/SGA risk with bDMARDs/PNL
adj for dx activity: less bad, but still concern?
OP0210 #EULAR2021 @RheumNow https://t.co/AlwFtmGcZH
David Liew drdavidliew ( View Tweet)
Ever wonder why one drug works in a pt & not another? Study of bio markers in PsA from RCT of #upadacitinib vs #adalimumab shows diff pathways affected by each drug & some overlap too @RheumNow #EULAR2021 @eular_org OP0030 https://t.co/WifrVOIMkW
Janet Pope Janetbirdope ( View Tweet)
Double hit”: #OP0015
Phase IIA ABBV-3373 (Adalimumab linked to GC receptor modulator GRM) vs. PBO and historic ADA show promising results with a satisfactory safety profile compared to ADA. A potential new IV drug in RA! #EULAR2021 @Rheumnow https://t.co/mqLtXx9zBI
Aurelie Najm AurelieRheumo ( View Tweet)
Acute Coronary Syndrom incidence in > 24,000 RA from Nordic registers followed up to 5 yrs = 5.5/1000 pyrs. After 5yrs RTX show > risk of ACS compared to ETA. In patient with >= 2 previous DMARDs ABA, INF and RTX > risk of ACS compared to ETA.
#EULAR2021 @Rheumnow #OP0114 https://t.co/MjW9LI2cjt
Aurelie Najm AurelieRheumo ( View Tweet)
Does skin #lupus respond differently to rituximab?Dr Carter @LucyCarter6 reported 75% cutaneous response rate but overall non-response to tx was caused by skin domain. Interestingly, resistant skin post-tx was associated with low baseline #IFN scores #EULAR2021 #OP0134 @RheumNow https://t.co/JdtwdwNR4Z
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
➡️COMPLETE-AS = obs study of bDMARD-naive Canadians w/ active AS tx w/ ADA or nbDMARDS/NSAID.
➡️> overall⬇️in dz burden & shorter time to achieve therapeutic response w/ ADA. But, ADA pts had higher b/l dz
OP0143 #EULAR2021 @RheumNow https://t.co/FpJmugsdVw
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
#POS0196 1 year results of the SELECT-PsA 2 study: Inadequate responders to ≥1bDMARD subjected to #upadacitinib maintained efficacy throughout week 56 (74% of pts completed 1-year)
#EULAR2021 @RheumNow https://t.co/xpqhzgeI6q
Paul Studenic Stiddyo ( View Tweet)
Can well controlled SLE pt taper #Belimumab? Maybe. Single site w 48 pts & over 2 yrs 44% could taper esp if on #plaquenil. This may change my practice but will follow pts closely POS0107 @RheumNow #EULAR2021 @eular_org https://t.co/8WCrt11ubV
Janet Pope Janetbirdope ( View Tweet)
No requirement to stop cDMARDs before surgery. For biologics stop 1 dose before and restart 14 days post op, JAKi stop 7 days before, restart 14 days post op, glucocorticoids >10mg/day increases risk of infection in #rheumatoidarthritis Michael D George #EULAR2021
Dr. Antoni Chan synovialjoints ( View Tweet)
SPACING trial OP0138 at #EULAR2021
⭐️RCT by the French showing non-inferiority of spacing TNFi in r-axSpA pts w/ LDA (BASDAI<4 x 6mo)
⭐️ 88% in spacing group remained w/ LDA vs 91.5% in standard tx
⭐️ADA, CTZ, GOL, IFX spaced by 1w intervals. ETN by 3-4d & 1w. @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
#EULAR Presentation 3478: Infection risk with surgeries:
⭐️Continue conventional DMARD
⭐️Some risk with biologics, may be confounder and no association with timing of infusions
⭐️Steroids are major risk factor! Esp >10 mg/d
⭐️Recommendations shown
⭐️Address other risks!
@rheumnow https://t.co/Bi02d4p9Mw
Eric Dein ejdein1 ( View Tweet)
Abst#OP0137 at #EULAR2021:
➡️TNFi use for at least 1 year decreased radiographic sacroiliitis progression in early AxSpA in this ten year multicenter study of the German Spondyloarthritis Inception cohort (GESPIC) .
➡️This effect becomes evident 2-4 years after tx.
@RheumNow https://t.co/GNnYqYmxhl
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
COAST-V: IXE ⬇️SP-N & spinal pain in r-axSpA pts w/ or w/o ⬆️ CRP or morning stiffness. Pts treated w/ ADA re-randomized to IXE showed further⬇️in SP-N & spinal pain. Poster #POS0901 #EULAR2021 @RheumNow https://t.co/46qiqrohbX https://t.co/uB15oTwztV
Dr. Rachel Tate uptoTate ( View Tweet)
#OP0049 corevitas observational registry: ax-SpA patients showed younger age, more males, greater spinal pain, more exposure to cs- or bDMARD but similar fatigue and work impairment compared to ax-PsA #EULAR2021 @RheumNow
Paul Studenic Stiddyo ( View Tweet)
#EULAR2021: If we review ASAS40 response from infliximab to tofacitinib, then there has not been much evolution in efficacy of therapy for SpA in the past 20 yrs. This suggests we haven't been looking at the right endpoint in measuring efficacy! MDA instead!
@RheumNow https://t.co/E61yb97CRN
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
#Eular2021: Do you start a bDMARD for nr-AxSpa without objective evidence of inflammation (elevated CRP, negative structural damage on MRI)? @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Novel Results from the @rheum_covid register in #RA patients presented by @jeffsparks #OP0006
Higher risk for patients on rituximab or on JAK inhibitors for hospitalisation & ventilation or death after #COVID19 infection compared to TNFi users. #EULAR2021 @RheumNow https://t.co/40h5zVpxAO
Paul Studenic Stiddyo ( View Tweet)
Can we taper IV belimumab in #SLE? Dr Fredi reported 14/48 (29%) extended tx to at least 5-weekly after 12mo of tx. No worsening C3/C4 & PGA but interestingly #steroid and SLEDAI ⬇️. More works needed to identify suitable pts for taper and regime #EULAR2021 #POS0107 @RheumNow https://t.co/Gwe7mPWPdY
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)