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All credit to the @karolinskainst @Rigshospitalet @WH_Rheumatology investigators for:
- tackling this issue
- bringing it to #EULAR2021
- acknowledging limitations publicly & graciously
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It's... complicated. But each time we get closer!
OP0210 https://t.co/2L3RDH276v @RheumNow https://t.co/UtcTukt3r8
David Liew drdavidliew ( View Tweet)
We know dementia (which is a/w inflammation) used to be a problem for RA pts.
What's happened with that as we've got better at treating RA?
Not only has dementia in RA pts decreased over time, the gap with non-RA pts has completely closed!
@KronzerMD OP0216 #EULAR2021 @RheumNow https://t.co/bbbnQtv4vE
David Liew drdavidliew ( View Tweet)
The advantage of the #EULAR2021 portal - the motivated speaker can answer all the excellent questions that the chairs don't ask! @RheumNow https://t.co/hewk02lFfM
David Liew drdavidliew ( View Tweet)
We keep on advancing in rheumatology but some things stay the same:
Our RA pts are stuck with multimorbidity more than other pts, esp for the women
(ā”ļødepression, hypothyroid, T2DM, lung dx)
How can we support all of our pts needs better?
@MayoClinic OP0213 #EULAR2021 @RheumNow https://t.co/0Y96Xa0fi2
David Liew drdavidliew ( View Tweet)
I donāt care if weāre virtual, and not actually in Paris.
Itās #EULAR2021 and no-oneās going to stop me from getting my French cheese
@RheumNow https://t.co/w3Juvz5hfc
David Liew drdavidliew ( View Tweet)
with TNFi therapy in RA:
new ANA seroconversion is common (75%)
TNFi-induced lupus is rare and mild
(in this cohort of ANA/dsDNA neg RA pts from Porto)
so don't be tempted to serially check the ANA with TNFi Rx! Let's put this rare habit to bed
POS0204 #EULAR2021 @RheumNow https://t.co/5da34Ya3Xp
David Liew drdavidliew ( View Tweet)
Which confers greater CV risk:
- RA dx in early 2000s
- T2DM dx c. 1990?
The answer may surprise you.
Amsterdam POS0213 #EULAR2021 @RheumNow https://t.co/SGsgKHf61U
David Liew drdavidliew ( View Tweet)
Immunogenicity makes a difference for mAbs like TNF inhibitors.
from Bart van den Bemt #EULAR2021 @RheumNow https://t.co/38ImlXdwUp
David Liew drdavidliew ( View Tweet)
So where might mAb therapeutic drug monitoring have the most value for us, going forward?
Proactive testing not at the moment (e.g. NOR-DRUM-A) but plenty of opportunities still exist!
6/
@MeghnaJani #EULAR2021 @RheumNow https://t.co/W5JATFHLfx
David Liew drdavidliew ( View Tweet)
So what might therapeutic drug monitoring (TDM) be able to do for you?
1/
@MeghnaJani #EULAR2021 @RheumNow https://t.co/f6x4JAE5pQ
David Liew drdavidliew ( View Tweet)
oh wait!
no photos, but NOR-DRUM B results:
Proactive TDM for dose optimisation during infliximab maintenance
- proportion pts w/o dx worsening: TDM better by 15%
- flare risk 2x with standard care vs TDM
- benefit across diseases (incl RA) & subgroups
Wow.
#EULAR2021 @RheumNow https://t.co/nTAuKE2ZJa
David Liew drdavidliew ( View Tweet)
Prof. Alten outlined the value of patient-reported outcomes for clinical practice!
How do you collect patient-reported outcomes - PRO - in your rheumatology clinic?
#EULAR2021 @RheumNow
Paul Studenic Stiddyo ( View Tweet)
#OP0145 Using a mixture of > 300 individuals with RA PsA or healthy the analyses via neural networks of HR-pQCT can differentiate the diagnosis assessing the bone surface with an accuracy of
89% #EULAR2021 @RheumNow
Paul Studenic Stiddyo ( View Tweet)
#OP0146 explores #US biomarkers in #at-risk RA individuals:
Tenosynovitis shows a HR of 2.9 to predict arthritis development - 57% of those with tenosynovitis developed arthritis vs 23% without
#EULAR2021 @RheumNow https://t.co/SPkzQqQ0e5
Paul Studenic Stiddyo ( View Tweet)
#OP0117 explores differences of TNFi or non-TNFi use on disease activity in a diverse population of the RISE register:
Black and Asian #RA patients greater reduction of #CDAI in non-TNFi
#EULAR2021 @RheumNow
Paul Studenic Stiddyo ( View Tweet)
#OP0127 A post-hoc analysis of two RCTs showed that continued
methotrexate increases clinical response rates in patients randomized to
placebo therapy who were considered as having previous insufficient response
to #bDMARDs. #EULAR2021 @RheumNow https://t.co/YeEVe0uwQs
Paul Studenic Stiddyo ( View Tweet)
Wednesday afternoon = @eular_org recommendations. @alessia_alunno presented EULAR PtC on COVID-19 pathophysiology and immunomodulatory therapies from the Rheumatology Perspective
Bottom Line: Proven efficacy in severe COVID-19 based on RCTs only dexamethason #EULAR2021 @RheumNow https://t.co/didtYEEWmq
Paul Studenic Stiddyo ( View Tweet)
Looking forward to the discussions in these sessions. #EULAR2021 https://t.co/GPLf4LbXLP
Paul Studenic Stiddyo ( View Tweet)
#OP0210
Analyses of RA patients using SRQ, DANBIO and national maternal registers: extensive anti-rheumatic treatment before and maternal disease activity during pregnancy associated with higher risk of pre term birth and small gestational age
#EULAR2021 @RheumNow https://t.co/qEniF4RC0l
Paul Studenic Stiddyo ( View Tweet)
#OP0229 GRAPPA recommendations crisply presented by @DrLauraCoates
Importantly it needs to be tailored to the patient taking amongst under comorbidities and the heterogeneity of features of the clinical presentation into account.
#EULAR2021 @RheumNow https://t.co/MpZGzhq0Ic
Paul Studenic Stiddyo ( View Tweet)