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Identifying Gaps in axSpA: Lessons from European Map of Axial Spondyloarthritis (EMAS)

Sheila Reyes, MD Nov 07, 2021

Despite the increasing scientific knowledge on axSpAs, a substantial gap still remains. Delay in diagnosis continues to pose a threat in the early identification of patients and those already on treatment may deal with additional issues such as work productivity or quality of life.

Dr. R Thomas: current studies on prevention of RA: 👉oral DMARDS (MTX, HCQ) 👉biologics (RTX, abatacept) 👉 studies regulating T cells to restore tolerance 👉biomarkers of tolerant state & look at people who don't develop RA 👉 imaging as window of subclin dz. #ACR21 @rheumnow https://t.co/5bsu5459az

#ACR21 Abs#0818: Starting biologics in moderate vs severe RA activity: ▶️ Moderate disease activity: more likely to reach LDA, remission ▶️ Severe disease: greater overall improvements, but less likely to reach remission https://t.co/9jBtN9wUGF @Rheumnow

https://bit.ly/31Ec4AB

Tocilizumab biosimilar study. Pharmacokinetic and pharmacodynamic bioequivalence. Delighted to see this, we really need a toc biosimilar after the negative impact of supply shortages of Actemra/Roactemra this year on patients. Abstr#0823 #ACR21 @RheumNow https://t.co/MMVCwaar3r

How useful are validated #PROMs in remote monitoring? Abs#0746 Remote patient-completed assessments of disease activity may be useful in #telehealth settings- a study looking at single-item and scale measures. #ACR21 @RheumNow https://t.co/Xr6pqJy91q https://t.co/PKAugkgNzU

Application of Existing Patient-Reported Outcome Measures for Telehealth Encoun…

#SLE pts will.... answer in abst#0858 #ACR2021 @RheumNow

So it's day 2 at #ACR21, and you know what that means - it's ORAL Surveillance day! This is the figure everyone will be talking about, leading up to details in the plenary. Why are the other bars higher than the pink bars? ABST0831 plenty of @RheumNow coverage coming on this https://t.co/B80cSmhNV7

Abst#0788 #ACR21. Forgot to measure vitamin D? ▶️ Red cell distribution width (RDW) inversely correlates w vit D 25(OH) levels prior to MTX ⭐️ RDW ⬆️ after starting MTX, no longer correlates https://t.co/b5EPDmGE18 @Rheumnow https://t.co/cNN14ErOmF

https://bit.ly/3BPL5hL

ORAL Surveillance In mod-severe RA pts >50yo, with CV RF & no hx malignancy, patient-years of exposure required for one event (vs TNFi): MACE tofa 5mg bid: 567 tofa 10mg bid: 319 malignancy tofa 5mg bid: 276 tofa 10mg bid: 275 #ACR21 ABST0831 @RheumNow https://t.co/9vyXPTMFzj

Safety and Efficacy of Tofacitinib vs TNF Inhibitors in RA Patients Aged 50 Yea…

#ACR21 Abst#0793. Japanese multicenter US cohort (KUDOS) study, looked at difficult to treat (D2T) RA pts ▶️ 1/5 pts are D2T (fail 2+ b/tsDMARD, mod disease or GCs) ⭐️ Contributors of good outcomes: IL-6i (OR 9.6), concomitant MTX (OR 7.1) @Rheumnow https://t.co/9YSa4ebQlR

https://bit.ly/3ka1iZa

Greater #comorbidity burden is assoc. w/ worse improvement and disease activity in 1st yr of treatment in ERA @earlyarthritis. Comorbidities esp affect SJC and patient and physician global assessments. #ACR21 Abs#0798 @RheumNow https://t.co/02BRqYp9Yk

The Impact of Comorbidities on the Simple Disease Activity Index (SDAI) and Its…

#ACR21 Abst#0801 Early remission at 6 mos is a predictor of long-term remission in patients w new onset RA ▶️ DAS28-CRP, SDAI, CDAI at 6mo predicted remission at 60 months https://t.co/vWy7EmseZp @Rheumnow https://t.co/HWJSjvFY8d

https://bit.ly/3CSPFNr

Good news for #COVID vaccine in #SLE. ✅doesn’t cause #lupus flares ➡️ no increase in APS. What about #SARS-CoV2 infection in SLE. Flares ↔️ stable but ⬆️APS Abs. from Hopkins cohort. Petri #ACRBest #ACR21 abst0858 @RheumNow https://t.co/ABx4C4lwvs

How can we better identify patients with #RA-ILD using #EHRs? Abs#0561: previously validated algorithms have clinical & research utility when applied to EHRs, esp when well-integrated with key info such as CT chest reports #ACR21 @RheumNow https://t.co/OU8BdwqHpc

Enhancing the Identification of Rheumatoid Arthritis-Associated Interstitial Lu…

ADACTA & MONARCH both showed IL6i monoRx > TNFi monoRx for RA in DBRCTs. What about in real-world data? Looking at CorEvitas, less so LDA: aOR 0.99 MCID in CDAI: 1.06 Even without MTX, both great drug classes for RA Equally so? #ACR21 ABST0834 @RheumNow https://t.co/6wvzVrXTW6 https://t.co/fYEktJhZuV

https://meet.acrconvergence.org/meetings/virtual/dSEeRFsuxifj8bZbz

#ACR21 A#0563 - Is FRAX score applicable for RA? 10 yr Olmsted County epi study: Yes ▶️ 76 osteoporotic fxs in RA pts, FRAX predicted 67 fx (SIR 1.13, not signif) ▶️ 21 observed hip fx, FRAX predicted 23.3 (SIR 0.9) ⭐️ No differences by ages/sex https://t.co/vWy7EmseZp @Rheumnow https://t.co/8BlzgQYqaV

https://bit.ly/3CSPFNr

6 year f/up study of sacroilitis in nr-AxSpA pts ⭐️~10% of pts progressed from nr-AxSpa to AS every 2 years Abs#907 #ACR21 @RheumNow https://t.co/kiWGmKhpWu

Radiographic Sacroiliitis Progression up to Six Years of Follow-Up in Patients …

Watch: What I'm Looking Forward to at #ACR21: Dr. Arthur Kavanaugh https://t.co/WygW1czwXn https://t.co/1qlZsFBd4Z

https://bit.ly/3BVCr1g

Guidance on self-efficacy (SE) in IA were published this yr- what factors influence this? 👉PROMs & treatment response determine long-term SE 👉This may help identify pts benefitting most from interventions to improve SE Abs#0795 #ACR21 @RheumNow https://t.co/dx28WgxNsE https://t.co/7uN6XctnQb

Treatment Response and Several Patient-reported Outcomes Are Early Determinants…

#ACR21 Abst#0786. Fibroscan screening for liver injury in pts on MTX: ▶️No significant correlation between cumulative MTX dose and liver stiffness by fibroscan, even at high dose MTX. ⭐️Age, sex, waist circumference, BMI are risks @Rheumnow https://t.co/IhcNr9fhEh https://t.co/c7TUoGrNZ7

https://bit.ly/3bLe4Jb

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Identifying Gaps in axSpA: Lessons from European Map of Axial Spondyloarthritis (EMAS)

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