#EULAR2020 Updated RA Mgmt Recc Main points: 1. MTX 1st line (if contraind, then SSZ/LEF; NOT HCQ) 2. Add bDMARD/JAKi if 1st csDMARD doesn't work + poor Px 3. Use IL-6i or JAKi for pts who can only take monoRx and failed csDMARD @RheumNow https://t.co/AIXz2dEOrX

• https://ard.bmj.com/content/79/6/685

Do not be tempted to stop MTX or other DMARDs perioperatively! They probably help rather than harm #EULAR2020 https://t.co/jb4ZuZlqSu

#EULAR2020 #op0225 sub study of OPAL Balance: withdrawal of MTxdoes not negatively impact Tofa efficacy in PsA. At 6 mo deltaPASDAS 0.229 (0.079) for tofa mono & 0.q138 (0.081) for tofa+mtx. LFT elevation more common in combination arm @RheumNow https://t.co/NO1agViScD

Don’t forget significant fibrosis with ILD has +RCT with nintedanib INBUILD study. Lots of buzz of RA ILD where MTX is OK, TNFi may have more ILD than other bDMARDs, biomatkers KL-6 @eular_org OP0038 #EULAR2020 @CRASCRRheum https://t.co/OihF3LmNYQ

#guselkumab #axialdisease - who would have thunk it - IL23 p19 works in axial involvement PsA with radiology! https://t.co/TaSFBJFRnx

MTX in GCA (+/- TCZ): can GiACTA data provide insights? MTX didn't add anything from data provided, but channelling bias a definite issue (note PNL numerically higher in non-MTX). MTX as adjunct/cover post-TCZ? We'll need to test for it properly FRI0220 #EULAR2020 @RheumNow https://t.co/BCsEKqqaMh

Primary Sjogren’s syndrome showed benefit of leflunomide + #Hydroxychloroquine vs placebo - past neg RCT of HCQ for PSS Sicca (dry eyes/mouth) so is it just leflunomide that works or combo? Likely pt selection - arthritis and rash likely respond to either @RheumNow @CRASCRRheum https://t.co/lsIeG2uv2H

• https://twitter.com/thelancetrheum/status/1268934457781862407

For a drug that everything in RA has been built on, we're not great at predicting who will respond to methotrexate. It's probably because we don't have all the info. Adding pharmacogenomics increased optimal AI prediction from 55% to 76% @MayoClinic FRI0046 #EULAR2020 @RheumNow https://t.co/bwpSYQIBLG

Filgo reduces PsA markers OP0224. ? Unique to filgo, a JAK1 effect , class effect or part of any effective PsA Rx or some of the above? @eular_org @RheumNow @CRASCRRheum @earlyarthritis #EULAR2020 https://t.co/2O5wsLPNl2

• https://twitter.com/DrPetryna/status/1269006416569827331

Analysis of the UK THIN database shows that delays in receiving followup Denosumab injx results in higher fracture risk (vertebral & Maj OP Fx). 6144 infusions in 2594 pts, shows risk if delay is >16wks (long delay), but not if 4-16wks #EULAR20 SAT0453 https://t.co/DkJK3dHeRN https://t.co/r7ckpSF6PA

• https://bit.ly/2z6UhnA

H2H UPA vs ABA RCT; UPA is clinically superior to ABA in DAS-CRP remission, ACR50, ACR70 at wk 12/24 (NOT diff in Pain, FACIT, Boolean remission); But UPA has more serious AE (vs ABA) - esp hepatic, OI, SIE, SAE, CPK (but not zoster VTE) #EULAR20 SAT0151 https://t.co/K96lybdg7L https://t.co/vQM2MSCNzD

• https://bit.ly/3eXAaYu

Dr Mariette summarizes the evidence for using cytokine-targeted therapies in #COVIDー19 Several studies with favorable results with #Tocilizumab and #Anakinra, however, almost all with methodological limitations (e.g., historical groups) #EULAR2020 #EULAR20 #EULAR2020goesvirtual https://t.co/cMUKoeGfK9

Do certain TNFi get more affected by obesity in RA? I have colleagues convinced infliximab is better for obese pts (weight-based dosing). It actually seems obese RA pts might do as well as other RA pts w etanercept, but not w infliximab! @DrMiniDey OP0220 #EULAR2020 @RheumNow https://t.co/EsaLTqINpd

JAKi and VTE from @WHO VigiBase @UMCGlobalSafety Why the difference between Europe and US? There may be a class effect here (there may not be), but if we really want real-world answers we need effective systematic real-world data collection OP0237 #EULAR2020 @RheumNow https://t.co/Bh2iLpGdXM