Your #RA patients in low disease or remission, do you maintain, reduce or stop DMARDs #EULAR2020

#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

Study in Norway reveals that the majority of the women w/ SpA were not treated with TNF inhibitors before or during pregnancy. Few on TNFi were continued on tx during pregnancy. #EULAR2020 @RheumNow https://t.co/t7B6pASeWQ https://t.co/BwU6RF5Qkn

• EULAR Abstract Archive

Switching TNFi to VDZ in pts IBD-related SpA associated w/ articular exacerbation of SpA in 1 out of 4 patients within the first 5 months. New-onset MEM is also observed in up to 15% of patients with IBD treated with VDZ. #EULAR2020 @RheumNow https://t.co/ZVjZC7hvxs https://t.co/d1RT3GzB2b

• EULAR Abstract Archive

Study of the French registries for TCZ, RTX, ABA, compared the risk of GI perforations (GIP). GIP risk was higher with TCZ (vs RTX,ABA) but was largely due to TCZ increasing the risk of diverticulitis. #EULAR2020 #OP0022 https://t.co/MGGWiVh5Jv https://t.co/nC2NblYnGO

• https://bit.ly/2XC5gyX

When starting IV Pegloticase in #Gout, Do you start a DMARD too? #EULAR2020

#EULAR2020 Recc for irAEs w/ICI: 1. GC's ok, goal<10 mg/d, any csDMARD, bDMARD (TNFi/IL-6),🚫ABT xcept life-threatening myositis 2. Myositis beware bulbar signs: dysphagia, dysarthria, dysphonia: stop ICIs,⬆️GC, IVIG/PE 3. Don't test autoAbs b/f ICI Rx https://t.co/P5jDgnjK94

• https://ard.bmj.com/content/early/2020/04/23/annrheumdis-2020-217139

Avacopan is as effective as steroids in ANCA Assoc Vasculitis – 330 pt RCT AAV Rx w/ RTX or CTX but randomized to prednisone or avacopan (C5aR antagonist). Avacopan=prednisone remission rates same (72% vs 70%) wk 26 & wk 52 (66% vs 55%). #EULAR2020 #OP0011 https://t.co/WIXJCYkxSb

• https://bit.ly/2Y3zV7g

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