The development of JAK inhibitors represents an advance for the treatment of inflammatory rheumatic diseases. However, the enthusiasm in using this target has waned since the publication of the ORAL surveillance clinical trial in 2022. Subsequently, both the FDA and EMA issued a warning on using JAKi in patients with certain risk factors, e.g., ≥65 years, at increased risk of MACE, current smoker or past smoker and at increased risk of cancer,

With a better understanding of pathophysiology, improved management guidelines, available medications, and a multidisciplinary approach, pregnancy for lupus patients has become more feasible. Despite these improvements, some patients still experience poor outcomes, highlighting the need for biomarkers that can predict these risks. An abstract presented at #EULAR2024 (POS1393) explored this possibility.

Multi-modal analysis of rheumatoid arthritis (RA) synovitis pathotypes enables more accurate choices of first line cDMARDs treatment, suggesting a predictive value to synovial biopsy. 

Two large retrospective cohort studies presented by the team at Mayo Clinic, Rochester MN examine the burden of stroke, as well as overall and cause-specific mortality in people with RA (POS0591 and POS0592).

Day 2 at EULAR 2024 was a big poster day for many with several good sessions and oral presentations on Preventing RA, new vasculitis therapies and a session devoted to the 50th anniversary of the Moll & Wright Criteria.

Do the clinical features of axSpA patients with and without IBD differ? In Abstract OP0085 at #EULAR2024, De Hooge M et al presented data from the METEOR cohort that identify clinical differences between these two groups. This will be important in order to stratify the management approach in axSpA patients with or without IBD as the emerging therapies have different effects on EMMs.

Analysis of French claims data, found over half of women initiating oral bisphosphonates (BP) between 2015 and 2020 discontinued treatment for at least one year, which was associated with a 12% increase in fracture risk. While not recommended, 42.5% of women initiating Dmab discontinued treatment for at least one year, which almost doubled their fracture risk. No increased risk was observed for long term discontinuation of IV BP.

Dual seropositivity (rheumatoid factor and/or anti-citrullinated protein antibodies) as well as shared epitope are known to be associated with poor prognosis and structural damage in RA.

In the wake of the EULAR 2023 guidelines on the management of SLE, it is perhaps pertinent that the EULAR 2024 congress features three abstracts from a large integrated analysis from five international Phase 3 belimumab trials in adults with active SLE (BLISS-76, BLISS-52, North East Asia, EMBRACE and BLISS-SC). Participants were randomised to belimumab (10 mg/kg/month intravenously or 200 mg/week subcutaneously) or placebo, plus standard

Wednesday was Day One at EULAR 2024 in Vienna. While the day was a slow start, the poster halls and auditoriums quickly filled with thousands of rheumatologists, eager to reunite at this international educational forum. Below are a few of my favorites from Day 1.

Psoriatic arthritis (PsA) can affect up to 30% of patients with psoriasis (PsO). Understanding the factors that predispose patients with PsO who progress to PsA is the first step in understanding how early interventions in PsO may augment the progression to PsA. At #EULAR2024, there are a few presentations on this topic that will help us understand this progression from PsO to PsA better.

Several abstracts are presenting new compounds, targeting either RA well-known inflammatory pathways or offering new mechanisms of action or therapeutic sequences; these are summarized below.

Large language models, such as ChatGPT, are advanced systems trained on vast amounts of text data, far exceeding what a human can read in a lifetime, to understand and generate human-like language. With these tools at our disposal, they are inevitably making their way into healthcare. One notable example is response optimization for SLE patients, as highlighted in abstract #0989.

Inhibition of B cell activating factor (BAFF) and B cell depletion are the two most evaluated strategies over the last 15 years in the field of SLE therapeutics, with licensing of belimumab and off-label use of rituximab. Despite this, some patients remain refractory to these effective therapies.

The advantage to patient care without the crutch of an EHR. What do you do?