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MSK US before 1st clinic visit?
Abs#POS0260 showed ⬇️ in time to diagnosis of inflammatory arthritis from 31 to 12 days and ⬇️clinical visits 2.8 to 2.1
How do you use MSK US in your clinic?
#EULAR2021 @RheumNow
Robert B Chao, MD doctorRBC ( View Tweet)
Mavrilimumab (GM-CSFi) phase II trial of COVID-19 PNA and systemic hyperinflammation
⭐️65% risk reduction in ventilation/death
⭐️no sig difference in ventilation requirement
⭐️no serious AE
Abs#LB0001
#EULAR2021 @RheumNow
Robert B Chao, MD doctorRBC ( View Tweet)
Excellent talk on SLE, APS abs pregancy
⭐️pregnancy counseling is important
⭐️aspirin 81mg in all pregnant SLE pts
⭐️do not discontinue HCQ
⭐️stable LN - can switch MMF to AZA
Abs#6888
#EULAR2021 @RheumNow
Robert B Chao, MD doctorRBC ( View Tweet)
Close call between LLDAS and DORIS Remission as a treat-to-target in #SLE. Thank you for participating in the polls #EULAR2021 @RheumNow https://t.co/r3OnSrmQkH
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Results are out. The majority would use #anifrolumab to treat refractory skin and joints disease #SLE. Thank you for participating in the polls #EULAR2021 @RheumNow https://t.co/wguBCkhZ7B
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
No clear winner here. The majority would use #IL23 inhibitors as either 2nd or 3rd line bDMARDs and for #psoriaticarthritis with severe #psoriasis. Thank you for participating in the polls #EULAR2021 @RheumNow https://t.co/b8wzaRVTqw
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
This is by far the biggest rheum dx COVID vaccinated cohort described I'm aware of 👏
Looking forward to full paper, & we will need data with more pts, more details, cellular response etc.
Nevertheless, invaluable & reassuring.
So glad to see it at #EULAR2021 LB0003 @RheumNow https://t.co/jsHZjLdCTT
David Liew drdavidliew ( View Tweet)
6. Rheum disease activity was stable with COVID vaccination.
(RA, PsA, axSpA, SLE - total n = 597)
7/
LB0003 #EULAR2021 @RheumNow https://t.co/xxkrunjPa0
David Liew drdavidliew ( View Tweet)
Israel was early to COVID vaccinate on mass scale. How well did the vaccine work in their rheum dx pts?
rheum pts n=686 (vs controls n = 121)
- fewer w immunogencity, but not bad (86% vs 100%)
- safety good
- dx activity stable
more details below ⬇️
LB0003 #EULAR2021 @RheumNow https://t.co/h2WT404mkF
David Liew drdavidliew ( View Tweet)
Rituximab in PMR. Intriguing
proof of concept (SB?) RCT
(1:1, total n=47 (recent dx 38/relapsing 9))
17w rapid PNL taper
ritux 1g x1
21w:
steroid-free remission: 48% v 21%
PNL ≤5mg/d: 100% v 54%
effect mainly from recent dx pts
We do need options!
POS0343 #EULAR2021 @RheumNow https://t.co/g6xJekY92O
David Liew drdavidliew ( View Tweet)
Treat-to-target is the robust algorithm that dictates all modern RA treatment.
What's the target? Ummmm
We use it in everyone, right? (both doctors & pts say 66%)
We at least use the principles sometimes, right? (86% of us)
[holds up mirror to self]
POS0305 #EULAR2021 @RheumNow https://t.co/A9MXHMYbag
David Liew drdavidliew ( View Tweet)
On choosing an agent for MTX-IR RA:
"(at the end of talk) My short answer could have been... there's no right or wrong. It's still one of the dilemmas we have in the treatment of RA: choosing the right drug for the right patient" - @DanielAletaha
#EULAR2021 @RheumNow https://t.co/C45ey1SrA1
David Liew drdavidliew ( View Tweet)
@KDAO2011 @UpToDate @TammyTilley @ACRheum @CreakyJoints @UnaMakris @DrDavidKarp @JointMD @ejdein1 @jeffsparks @Janetbirdope @uptoTate @RichardPAConway @MeralElRamahiMD @Yuz6Yusof @AurelieRheumo @Stiddyo @doctorRBC @RheumNow also, and I still remember this from the very first time I met him in person:
"Do you know what the most important thing to remember is?"
(nervous pause from me)
"Have fun. You've gotta have fun!"
I still live by this...
David Liew drdavidliew ( View Tweet)
I write more about this for @RheumNow - it’s powerful to know that AI can accurately tell the difference between RA, PsA, and healthy controls on the basis of the bony surface at MCP 2:
https://t.co/ChDfihnW4f
@LkasDer @maier_ak @FAU_Germany OP0145 #EULAR2021
(ping @DrCMcMaster) https://t.co/Pl7yxYfEqr
Links:
David Liew drdavidliew ( View Tweet)
#OP0223
US disease activity and damage score for PsA - ~300 patients from 19 centres - 6 components for disease activity score & 5 for damage -->~90% variability explained
--> weighted score
-->many sites to scan
--> evaluation as BL pred. for MDA
#EULAR2021 @RheumNow https://t.co/5kC6YDQi8D
Paul Studenic Stiddyo ( View Tweet)
#OP0219
Population based matched medical record database study in PsA vs. non PsA from Israel:
-> no differences in mortality
-> BL predictors of death
-higher risk: higher age, male sex, prior hospitalisation, prior psoriasis, comorbidties
-lower: csDMARDs
#EULAR2021 #RheumNow
Paul Studenic Stiddyo ( View Tweet)
@DanielAletaha @RheumNow In the end the best treatment choice after #MTX insufficient responders not yet clear.
Head to head JAK-i vs. non-TNFi interesting
Brilliant developing discussion
number needed to harm vs. number needed to treat
#EULAR2021 @RheumNow
Paul Studenic Stiddyo ( View Tweet)
Making decisions session at #EULAR2021
@DanielAletaha
When designing for a superiority trial you cannot conclude on non-inferiority.
Trials in JAK-i show more or less similar efficacy results to #TNFi
Some JAK-i might work better for specific patient #pain
#EULAR2021 @RheumNow https://t.co/Bo81nwBFbZ
Paul Studenic Stiddyo ( View Tweet)
#OP0220
EuroSpA 17 European registries
17452 bionaive PsA Patients 1999-2018:
BL age, disease duration, disease activity decreased 99-18
- disease activity progressively decreased on treatment
- At 6M REM rates higher in recent years, 24M REM rates similar
#EULAR2021 @RheumNow https://t.co/gZ4tOpRLIf
Paul Studenic Stiddyo ( View Tweet)
OP0318 What to consider when tapering DMARDs
RETRO – RA pat with DAS<2.6 for >=6months randomised to 3 strategies: remain – taper to 50% - taper then STOP
HR for flare 3|4.3 for TAP|STOP
Remission depth, disease duration and RF/ACPA as risks to consider
#EULAR2021 @RheumNow https://t.co/SR4NDKKrGN
Paul Studenic Stiddyo ( View Tweet)