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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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The key data for treating clinically suspect arthralgias (CSA):
TREAT-EARLIER (MTX)
ARIAA, APIPPRA (abatacept)
but what we need to do going forward:
stratify pts better for studies
predict individual risk better, to weight up risk-benefit of intervention
#EULAR2023 @RheumNow https://t.co/h3gNIyLxPY
David Liew drdavidliew ( View Tweet)
Tune it at 1pm EST for RheumNow's daily #EULAR23 recaps. You can find us live on Twitter, YouTube and LinkedIn. https://t.co/t531csjXo8
Dr. John Cush RheumNow ( View Tweet)
#EULAR2023 #POS1207 Promising therapy for dermatomyositis. Data from Stage One of Phase 2 RCT (N=18) showed Anti-IFN Beta mAb improved clinical, PROs, extra-muscular activity and reduced CK levels vs Placebo. No cases of HZV. One to watch out in the next few years @RheumNow https://t.co/Oh8sZlMzUt
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2023 #POS0222 Post-hoc Analyses of Phase 3 RCT in Rituximab-treated ANCA vasculitis patients only (65% of total) showed more patients met Remission rate & with lower GC Toxicity vs Pred Taper + RTX at 52 weeks, consistent with Trial Main Results @RheumNow https://t.co/BmiujbhQI9
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
For our rheum patients who have had cancer previously - the default can’t be to not have DMARDs.
@eular_org points to consider SLR:
no clear risk, across b/tsDMARDs
For too long these patients were unnecessarily asked to ride it out. No more please
POS1069 #EULAR2023 @RheumNow https://t.co/7m4Yh0h7rd
David Liew drdavidliew ( View Tweet)
Retro French database study shows reassuring data.
Overall mortality after IRAEs =similar between pts receiving b/tsDMARDs vs. those who don't
70000+ pts treated w/ ICI, 7800+ IRAEs (most frequent colitis) & 330 treated w/ b/tsDMARDs, 10% Rheum IRAE
OP0270 @RheumNow #EULAR23 https://t.co/OFNaIU4kzt
Aurelie Najm AurelieRheumo ( 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)
75 different biosimilars in Europe, and nearly 20 years since the journey started. @EMA_News has led the world on biosimilars #EULAR2023 @RheumNow https://t.co/LFs3FR9dfW
David Liew drdavidliew ( View Tweet)
ANSWER cohort
Retrospective study 6600+ bio/tsDMARDs ttmt courses, 20 yrs
✔️IL-6Ri is the lowest discontinued for lack of efficacy
✔️CTLA4-Ig is the lowest discontinued due to AEs
✔️Concomitant GC ⬆️30% drug discontinuation due to AEs
@Rheumnow #EULAR23 POS0051 https://t.co/8e6U5KHmX4
Aurelie Najm AurelieRheumo ( View Tweet)
#EULAR2023 #POS1147 Primary endpoint for Cenerimod (S1P1 modulator) phase 2 RCT in #SLE was not met after multiple testing. Post-hoc analysis showed greater reduction in SRI-4 and mSLEDAI in IFN-High vs IFN-Low at 6mths. A biomarker to stratify response in Phase 3 @RheumNow https://t.co/wKM5V1JgXT
Md Yuzaiful Md Yusof Yuz6Yusof ( 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)
Do we use too much PNL in GCA (when not using TCZ)? Could we wean quicker?
Salvarini group n=22
26w PNL weaning protocol from GiACTA, but no TCZ
10/26 in relapse free remission at 1y
Much less PNL, still some steroid AEs
Way of the future for some?
POS0728 #EULAR2023 @RheumNow https://t.co/qeZHeCi9vq
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)
#EULAR2023 #OP0143 Promising therapy. A Phase 2 RCT of Dazodalidep (CD40L-i) in #Sjogren showed significantly more patients on DAZ group met reduction in ESSDAI vs placebo. Interesting to see higher hurdle ESSDAI favoured DAZ Group. Phase 3 RCTs are underway @RheumNow https://t.co/I9uHxvRlnr
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
JAKi are NOT associated w worse safety vs bDMARDs when adjusting for confounding. Did regulators get it wrong? #EULAR2023 @RheumNow #OP0116 https://t.co/ZNk0NI7Ky5
Janet Pope Janetbirdope ( View Tweet)
Abatacept use in individuals at risk of RA reduced the rate of progression to RA during the treatment phase and împrovement in clinical symptoms over 2 years in the APIPPRA trial by Cope A, Abstr#OP0130 https://t.co/k0SFDHBRE9
Dr. Antoni Chan synovialjoints ( View Tweet)
Get Un ‘DRESSED’? Use of #etanercept or #adalimumab for #rheumatoidarthritis. #RCT of dose optimization-observational f/u over 10 yrs with attempts to lower and even d/c Rx in #RA You CAN lower dose in many Pts & even d/c Rx and recapture. X-rays OK @RheumNow #EULAR2023 #OP0131 https://t.co/PGK5SQJ1WU
Janet Pope Janetbirdope ( View Tweet)
@RheumNow Safety is pretty good too - this is abatacept we are talking about here. Cost is a different question, as is the pharmacoeconomics, but at least it’s safe. One other thing about the study ⬇️ #EULAR2023
@RheumNow https://t.co/H3AdBsK8t9
David Liew drdavidliew ( View Tweet)
Well certainly, despite the absence of synovitis, these pre-RA patients felt better on their 12m of abatacept. They could do more and hurt less.
That does count for something for many patients.
But wait, there’s more ⬇️
#EULAR2023 @RheumNow https://t.co/3naNdWGMuX
David Liew drdavidliew ( View Tweet)
