The final day of EULAR 2024 was rich in posters, Late-breaking oral presentations and EULAR updates and recommendations.  Below is a synopsis of the half-day's action.

Glucocorticoids (GC) have been the mainstay of treatment in SLE for nearly three quarters of a century. GC induce a range of anti-inflammatory effects, quickly relieve some symptoms and lower mortality in some life-threatening flares. However, they also have multiple side effects that limit the duration of treatment, as well as the dose used. Accordingly, the 2023 EULAR recommendations for SLE set a target dose of ≤5mg/day. Is low dose GC an

A clinical trial in early axial spondyloarthritis (axSpA) demonstrated sustained inactive disease status in over 60% of patients. In axSpA patients with less than 1 year of disease symptoms, male sex, abstinence from smoking and lower BASDAI score at baseline were associated with higher chances of remission. Despite stable inactive disease state successfully induced by medication, drug-free remission in axSpA remains challenging.

There are a number of diseases where new biologic and targeted synthetic therapeutic options are coming online, and the temptation will be to consider them all equally. GCA is one of those diseases.

It is almost four years since EULAR published its definition of difficult-to-treat (D2T) rheumatoid arthritis (RA) (1). This marked a formal recognition of the group of patients who, despite the advances in pharmacological therapy for RA, remain symptomatic.

EULAR treats its attendees to a wonderful lunch each day – Schnitzel, gnocchi, goulash at lunch after muffins and coffee in the morning. It's no wonder the meeting has been a lively one, well attended with a wealth of stimulating ideas, research and discussion. Here are a few of my favorite abstracts and presentations from today, day 3 in Vienna.

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