#ClinicalPearl Update on @eular #rheumatoid #arthritis guidelines. Reassuringly not much of an update. Very reasonable discussion of #JAKi safety. @RheumNow Day 1 of #EULAR202 T2T, shared decision making, limit #glucocorticoids to shortest time. Change MOA or not, after failure.

The amazing @SuAnnYeoh1 oral presentation showing terminally differentiated T effector memory re-expressing CD45RA are associated persistent disease activity in TNF non-responders (but not other bDMARDs) ?role in driving disease @RheumNow #EULAR2022 OP0011 https://t.co/OFradjuGvo https://t.co/flpFmcvixO

• EULAR Abstract Archive

178,000 cells from knee synovium studied to eval diff in RA vs PsA transcriptomes. With RA: 👉synov Tcells ⬆️TGFB1 express'n 👉⬆️FAP+ THY1+ synovial fibroblasts 👉receptor ligand network➡️synovial T cell & macrophage synergy 👉IL-1b & TGFb synergy #EULAR2022 OP0067 @rheumnow https://t.co/0uaFyqZqBg

#Plenary OP0066. Consider Whipple Dz in pts inflammatory rheum dz Screen with PCR saliva/stool samples, confirm with duodenal bx or PCR on joint fluid. pts on doxycycline and HCQ can lead to rapid remission. @rheumnow https://t.co/VcGp8pr3dT

NORD-STAR substudy looking at anticoagulant effects. Important as RA assoc. ⬆️DVT/PE. DMARDs improve haemostatic imbalance, with bDMARDs stronger effect than csDMARD (may relate to better disease control with this) @RheumNow #EULAR2022 OP0059 https://t.co/TKwAZMOZjY https://t.co/IazrfD7z7k

• EULAR Abstract Archive

Pedersen et al report 6-fold mortality⬆️over 10 years in RA patients with co-existent depression. Even stronger effect in younger patients (<55) @RheumNow #EULAR2022 OP0067 https://t.co/vYYTmTnstQ https://t.co/xKgMu7zaOA

• EULAR Abstract Archive

NORD-STAR TRIAL drug does better in ttmt naive eRA? 48wks CDAI remission ▶️ w/ ABA and CERTO PEG vs. MTX+ GCs while TCZ not stat ▶️. Is the difference clinically sufficient to recommend these in first intention over MTX ? not convinced 🧐 OP0058 #EULAR22 @rheumnow

Screen for depression in RA patients! From the #DANBIO registry of 11,000 pts, they found 6X ⬆️mortality in pts w/#RA and #depression . The mortality curve separates early. #Plenary OP0067 @rheumnow #EULAR2022 https://t.co/qfjyejGVzQ

#EULAR2022 POS0241 shows JAKi ⬇️ pain catastrophization/central sensitization in RA patient via CSI (Central Sensitization Inventory) and (PCS) Pain Catastrophizing Scale. No decrease of articular inflammation on ultrasound with JAKi shown, but study had just 22 pts @RheumNow

#EULAR2022 OP0066 French retrospective obs study 2019-2021 with 73 cases of Whipples disease treated for rheum disease ▶️M/F ratio 3, middle aged ▶️1/2 met RA criteria ▶️Peripheral jts, 1/3 had axial involvement ▶️Rx: HCQ, Doxi - 80% cured, DMARD stopped in >90% cases @RheumNow https://t.co/t7zlDrPfJB