Having said that, the EMA warning has elements making it extremely tough: - still very broad criteria that capture 80% of people who were starting JAKi - the need for "no suitable treatment alternatives" before using a JAKi, right across all diseases (not just RA) 3/ #EULAR2024 https://t.co/IsrYO7qzqM

• https://twitter.com/drdavidliew/status/1801144544035225737/photo/1
• https://twitter.com/drdavidliew/status/1801144544035225737/photo/1
• https://twitter.com/drdavidliew/status/1801144544035225737/photo/1

So I think there is plenty we could do instead. better regulation better risk stratification better counselling better risk factor management (and definitely read this if you want to be a good clinician: https://t.co/RA6ktQB7gm) 18/ #EULAR2024 https://t.co/bC5nmi8SoM

• The Art of Communicating Risk and Benefit to Promote Shared Decision‐Making, In…
• https://twitter.com/drdavidliew/status/1801144689774735739/photo/1
• https://twitter.com/drdavidliew/status/1801144689774735739/photo/1
• https://twitter.com/drdavidliew/status/1801144689774735739/photo/1
• https://twitter.com/drdavidliew/status/1801144689774735739/photo/1

Here's my 'pub test' for whether the warning is appropriate. And, debate aside, I do believe that it behoves any regulator to consider the unintended consequences of their regulation, because regulation has real consequences. 5/ #EULAR2024 https://t.co/aurbAwgl9P

• https://twitter.com/drdavidliew/status/1801144562095940083/photo/1

“One way to get rid of TDM is to get more drugs, and that’s what we’re doing” - Gertjan Wolbink, the godfather of rheumatology therapeutic drug monitoring (TDM) #EULAR2024 @RheumNow https://t.co/SYM8hjMMPJ

• https://twitter.com/drdavidliew/status/1801229073999638532/photo/1

In the ‘why therapeutic drug monitoring’ debate, we’ve heard a lot about TDM utility, but the con argument is interesting. Desiree van der Heijde compares TDM to IL-6 levels, which never displaced her DAS then puts up some confronting points. Interesting #EULAR2024 @RheumNow https://t.co/7zomungi3e

• https://twitter.com/drdavidliew/status/1801227167780770230/photo/1
• https://twitter.com/drdavidliew/status/1801227167780770230/photo/1

AMPLIFIED RCT, 300+ pts ABA NOT (!) superior to ADA in dual seropositive SE+ MTX IR RA pts ACR50 rate high in both gps ABA 59% vs ADA 64% No new safety signal Defeating the encouraging data from smaller trials Abstr#OP0007 #EULAR2024 @RheumNow https://t.co/PvRUnpthHl

• https://twitter.com/AurelieRheumo/status/1800938588101599607/photo/1

I chaired great debate at #EULAR2025 - JAK Inhibitor Special Warnings: can observational data debunk an RCT? Drs Janet Pope(NO) vs David Liew(YES). Voting suggests most are concerned about JAK warnings, but Liew won by converting a minority his way @janetbirdope @Drdavidliew https://t.co/bV1JdO7c4e