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An update on JAK inhibitors and cardiovascular risks
Dr. Antoni Chan ( @synovialjoints ) shares #EULAR23 developments on JAK/TYK2 inhibitors.
https://t.co/VovWE2OuXW https://t.co/QXKZLh5RuK
Links:
Dr. John Cush RheumNow ( View Tweet)
Depositions of crystals in coronary arteries were associated with MACE @rheumnow #EULAR2023 https://t.co/VHxtsB7ZsA
Bella Mehta bella_mehta ( View Tweet)
The incidence of MACEs at 8 years is low in AS patients treated with NSAIDs. Study of 22929 patients, NSAIDs (SHR: 0.40 [0.32-0.49], p<0.001) and anti-TNFs (SHR: 0.61 [0.47-0.81], p<0.001) associated with a lower risk of MACE, Fakih O, Abst#POS0301, #EULAR2023 @RheumNow https://t.co/i5GZMcJwyO
Dr. Antoni Chan synovialjoints ( View Tweet)
MmF and Tacrolimus both work in systemic sclerosis with ILD. @RheumNow #EULAR2023 https://t.co/Ro6AjP3nij
Bella Mehta bella_mehta ( View Tweet)
#EULAR2023 Clinical Highlights. CTD: OP0240 Open label study (N=26) showed stabilisation/improvement in FVC in patients with #ILD treated either Tacrolimus vs MMF. No efficacy difference between both therapies @RheumNow https://t.co/d3rCzNgYHK
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
EULAR 2023 – Day 3 Report
Day 3 was a sunny warm day in Milan at the 2023 EULAR Congress meeting. Here are a few of my favorite abstracts from today.
Read Article
ILD in RA and PsA
@AurelieRheumo discusses inconsistent data inconsistent data have proposed on the effect of bio/tsDMARDs on the risk of ILD.
ILD is a severe extra articular manifestation of RA, with limited treatment strategies and poor prognosis.
https://t.co/U1RjvgTCL8 https://t.co/qmxXBTK05N
Links:
Dr. John Cush RheumNow ( View Tweet)
Predictors of myocarditis in anti-synthetase syndome - 43 pta 30% with myocarditis. More frequently males with high troponin levels. Only fever was more frequently observed in myocarditis pts. Pos1224 @rheumnow #EULAR2023
Bella Mehta bella_mehta ( View Tweet)
Should we use #immunesuppression EARLY in #scleroderma to prevent #ILD? Answer from a study comparing Y vs N immune suppression- there was no difference in FVC decline. Maybe not a long enough study, ? Chanelling bias scleroderma #lung #disease OP0239 @RheumNow #EULAR2023
Janet Pope Janetbirdope ( View Tweet)
Can’t escape ORAL Surveillance RCT talk
Lots of real world data on CV risk & JAKi here
(with all the selection, measurement bias)
First up: multinational JAK-pot study (n=>50k)
Even if you mirror the high-risk RCT cohort - not much there for MACE
OP0219 #EULAR2023 @RheumNow https://t.co/FfNspdivri
David Liew drdavidliew ( View Tweet)
No new predictors for decline in #SSc lung function in ILD Progression of #scleroderma Lung disease is common - risks male, dcSSc, low FVC, Topo1 @RheumNow #EULAR2023, OP0236 @eular_org https://t.co/bTxTyLE8dZ
Janet Pope Janetbirdope ( View Tweet)
Risks for #ILD #SSc lung progression. FVC decline >5% is the gold standard but there are other criteria. OP0236 #EULAR2023 @RheumNow @eular_org #scleroderma Some criteria are stricter - larger PFT changes and/or worsening symptoms or fibrosis, so depends on def’n for % def’n https://t.co/TCuX2KY64w
Janet Pope Janetbirdope ( View Tweet)
>= 2 tophi and carotid plaque by ultrasound could independently predict major adverse cardiovascular events in addition to conventional CVD risk factors in #gout, data from a single center cohort of 262 pts with 10 yr follow up #EULAR2023 @rheumnow abst#OP0154
Bella Mehta bella_mehta ( View Tweet)
Malignancy in real world datasets:
do we see differences between DMARDs - particularly JAKi, with ORAL Surveillance in mind?
RABBIT German data (limited risk window):
Point estimates slightly up vs TNFi, esp in high CV risk pts
but magnitude not big
OP0218 #EULAR2023 @RheumNow https://t.co/Ou7TgWvf3b
David Liew drdavidliew ( View Tweet)
#ClinicalPearl Updated #scleroderma Rx recommendations OP0234 New recommendations included ILD, early dcSSc 20 vs prior 16 guidelines. And they recommend ??! Won’t release yet due to importance of wording which will be finalized soon EULAR2023 @RheumNow @eular_org https://t.co/lES6pqkgeT
Janet Pope Janetbirdope ( View Tweet)
The JAK-pot study did not show any significant differences in MACE and other CV outcomes in RA patients treated with JAKi, slight increase signal in VTE/PE, Romain Aymon, Abst#OP0219 #EULAR2023 @RheumNow https://t.co/oPMnw2QmW3
Dr. Antoni Chan synovialjoints ( View Tweet)
We need to assess CV risk in IA but how?
Performances of QRisk3, Framingham & Reynolds scores for prediction of CV event in OA RA PsA AS PSO
Bummer: these 3 prediction tools are less accurate in IA but also OA.
We need a dedicated tool.
@Rheumnow OP0267 #EULAR23 https://t.co/O73cETXXoe
Aurelie Najm AurelieRheumo ( View Tweet)
Early Rx with immunosuppressives doesn’t seem to prevent ILD in #scleroderma ? Chanelling bias as dcSSc get more ILD, esp if active disease but in this side it didn’t make a difference #EULAR2023 @RheumNow OP0239 https://t.co/xt0mtpOpYl
Janet Pope Janetbirdope ( View Tweet)
#EULAR2023 #POS0627 Researchers in Manchester identified several proteins associated with subclinical cardiovascular abnormalities on Cardiac MRI in Scleroderma using proteomics. Need validation. Could be useful for stratification and identify therapeutic targets @RheumNow https://t.co/55eNGhMu5f
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2023 #POS0618 This is cool! Researchers from Switzerland are developing new Quantitative Radiomic Risk Score (from HRCT) to stratify response to Anti-Fibrotic in #ILD. Data presented in pre-clinical study & paralleled molecular effects. Human study is in progress @RheumNow https://t.co/qAsWew4FEO
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)