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Clever from @DanielAletaha's group, asking: have trial patients really been MTX-optimised pre-enrollment?
Placebo arm data from bDMARD trials x2:
MTX continuation ACR20 w16: 25% v 12%
(MTX works!)
Should clinical trials have mandatory run-in periods?
OP0127 #EULAR2021 @RheumNow https://t.co/Sx3IKOVKB6
David Liew drdavidliew ( View Tweet)
I'm not always a 'What Is New' session kind of guy, but given that it's Maria Cid introducing the always insightful @Sarah_L_Mackie on GCA I'll happily join the other 1012 viewers at #EULAR2021 tuning in!
(So far, definitely and elegantly worth it.) @RheumNow https://t.co/kHOus21T1z
David Liew drdavidliew ( View Tweet)
After many years without love, RA-ILD therapy seems like it's on the move.
MUC5B aside, we've seen abstracts at #EULAR2021 about:
- tofacitinib (OP0125)
- abatacept (POS0513)
- rituximab (POS0645)
- nintedanib (below)
I discuss it a bit for @RheumNow:
https://t.co/nk87kfjacb https://t.co/EjNbA2oLWs
Links:
David Liew drdavidliew ( View Tweet)
Great to have my @OMERACT irAE group co-chair and friend @MarieKostine remind #EULAR2021 of the EULAR points to consider for irAEs - still relevant in a fast-moving field!
available here in full @ARD_BMJ: https://t.co/wFZqKsdDoz
in the Oncorheumatology session @RheumNow https://t.co/RuhIlkFRgM
David Liew drdavidliew ( View Tweet)
I remember when we used to teach residents how to differentiate RA & PsA patients on imaging from normal scans.
Give the right computer a whole lot of HR-pQCT scans, and it probably can do as well as the teaching rheumatologist...
@LkasDer @maier_ak OP0145 #EULAR2021 @RheumNow https://t.co/kFx3oKzWKc
David Liew drdavidliew ( View Tweet)
All credit to the @karolinskainst @Rigshospitalet @WH_Rheumatology investigators for:
- tackling this issue
- bringing it to #EULAR2021
- acknowledging limitations publicly & graciously
š
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)