Rheumatoid Arthritis
Janet Pope Janetbirdope
2 years 4 months ago
Get Un ‘DRESSED’? Use of #etanercept or #adalimumab for #rheumatoidarthritis. #RCT of dose optimization-observational f/u over 10 yrs with attempts to lower and even d/c Rx in #RA You CAN lower dose in many Pts & even d/c Rx and recapture. X-rays OK @RheumNow #EULAR2023 #OP0131 https://t.co/PGK5SQJ1WU
David Liew drdavidliew
2 years 4 months ago
As Jack himself pointed out - we’re looking at patients without loads of inflammation. For me, to get anything out of this population is very interesting. Adding this to ARIAA, it does make us think about which pre-RA might benefit from abatacept, and how.
#EULAR2023 @RheumNow https://t.co/UKHfc1X8QM
David Liew drdavidliew
2 years 4 months ago
What’s more - if you have arthralgias and more autoantibodies than just ACPA IgG, then maybe abatacept might actually make a substantial difference. There is prob a population in whom abatacept substantially prevents RA developing.
Is it safe? ⬇️
APIPPRA #EULAR2023 @RheumNow https://t.co/94Y7HrBuEp
David Liew drdavidliew
2 years 4 months ago
Well certainly, despite the absence of synovitis, these pre-RA patients felt better on their 12m of abatacept. They could do more and hurt less.
That does count for something for many patients.
But wait, there’s more ⬇️
#EULAR2023 @RheumNow https://t.co/3naNdWGMuX
David Liew drdavidliew
2 years 4 months ago
Abatacept for 12m in ACPA pos arthralgias probably doesn’t impact RA progression that much once the abatacept stops…
but are there other reasons you might want to give it? Read on in the next tweet⬇️
APIPPRA study #EULAR2023 OP0130 @RheumNow https://t.co/68CViUeWHy
David Liew drdavidliew
2 years 4 months ago
How much MTX do we need with adalimumab in RA? Can blood concentrations help?
MTX RBC polygluts:
- don’t seem to match to efficacy
- do seem match to safety, a bit
(no ADAb data here)
*One day* we’ll get better at what MTX dose is needed with TNFi #EULAR2023 OP0128 @RheumNow https://t.co/OGM3hxr4fG
Md Yuzaiful Md Yusof Yuz6Yusof
2 years 4 months ago
#EULAR2023 #OP0007 What are the recent trends of autoimmune disease (AID)? A database study (22m) in UK showed:
- 1 in 10 people had AID in the last 20yrs
- socioeconomic, seasonal & regional disparities cd influence pathogenesis
- CTD (SLE,pSS,SSc) tended to co-occur @RheumNow https://t.co/3DDPR2K5NC
In the last 2 years, there has been more caution and vigilance with the use of JAK inhibitors in the treatment of rheumatoid arthritis due to the risk of CV events, including MACE and VTE. The ORAL surveillance study, a post-approval safety study conducted in RA patients aged ≥50 years with ≥1 CV risk factor, has resulted in increased caution and greater emphasis on assessment of MACE and VTE risks in patients starting JAK inhibitors.
Interstitial lung disease (ILD) is a severe extra articular manifestation of RA, with limited treatment strategies and poor prognosis. While for a long time RA treatments, such as methotrexate (MTX), have been considered a risk factor, recent data have shown the innocuity of MTX on lung disease (and in fact suggests it could reduce risk of ILD by increasing disease control and remission).
Dr. Antoni Chan synovialjoints
2 years 4 months ago
A highlight at #EULAR2023 AI in predicting RA from MRI scans of hands and feet in patients with early onset arthritis or clinically suspect arthralgia. From 1,974 people, 651 went on to develop RA. The accuracies were close to expert level prediction, Li Y, Abst#OP0002 @RheumNow https://t.co/MP8yn18PWI
Aurelie Najm AurelieRheumo
2 years 4 months ago
Beydon et al., french registry study 255000+ RA patients 2010-2020
Increase ⬆️ overall malignancy by 20% vs. general pop
⬆️lung 40%, ENT 40%, cervix 80%, prostate 8%, melanoma 37%
Pancreatic cancer 10% less frequent in ♂
Breast 9% & Uterine body 23% less frequent in ♀
David Liew drdavidliew
2 years 4 months ago
So can computers beat humans in predicting RA from pre-RA arthralgia MRIs?
No, for now… but unsupervised they pick up the same culpable features we look for: bone marrow edema & tenosynovitis. Sometimes it’s nice when the machines tell us we’re right
#EULAR2023 OP0002 @RheumNow https://t.co/71Zo2JyC8d
Aurelie Najm AurelieRheumo
2 years 4 months ago
I swear it is muscle, Doctor!
GLORIA trial substudy
Pred 5 mg/day 2 years in RA pts >65yo:
Weight gain 1kg vs. PBO, no increase or redistribution of fat mass but augmentation in lean mass 💪
Probably explained by better disease control (although NS in study, small sample size)
Aurelie Najm AurelieRheumo
2 years 4 months ago
EULAR PtoC management of targeted therapies in pts w/ IA & Hx cancer
1) If remission, initiate targeted therapy w/out delay
2) Prefer anti-cytokine bDMARDs if Hx solid cancer
3) B cell depleting therapy if Hx lymphoma
4) Use JAK inhibitors and abatacept with caution 🛑 https://t.co/cKhQVZwGh1
Poster Hall