EULAR 2019 Report – Day 2 Save

It was a full and lively 2nd day in Madrid with sessions dedicated to Lupus, RA, Sjogren’s, imaging, rare diseases, psoriatic arthritis and spondyloarthritis. Here are a few of the highlights from day 2 EULAR in Madrid 

• Riociquat in SSc-ILD: riociquat is approved in the US for pulmonary arterial hypertension and chronic thromboembolic pulmonary HTN and is now applied to 121 patients with early SSc (<18 mos. Symptoms) and limited scleroderma (mRSS 12-20).  This 52 week ended with a downward trend in skin thickness but did not achieve its primary endpoint (p=0.08).  However when they looked at the 20% of patients who had interstitial lung disease, they found significant reductions in FVC. This was encouraging as the drug was well tolerated.  OP0183
• The Earlier the Better.  A longitudinal study from a Swedish RA registry examine 6559 RA patients enrolled since 1991 and shown that new, DMARD naïve RA patients, have overtime, demonstrated decreasing levels of joint activity (initial SJC, TJC), CRP, ESR, and increasing patient and evaluator global assessments.  Also decreasing was the time from symptom onset to diagnosis of RA.  So if RA is getting milder, it may well be that we are seeing them sooner, with more expedited diagnoses and hopefully earlier DMARD initiation.  THU0073
• Machine Learning with Psoriatic Arthritis.  Dr. Ian McInnes presented a novel and futuristic analysis of PsA patients by applying “machine learning” to the secukinumab PsA trials that included >2,700 patients to identify clusters that may lead to more personalized treatment.  Overall they defined 13 clusters of PsA based on patterns of tender joint (TJ) and swollen joint (SJ) involvement. They plan on doing further study of other psoriatic manifestations such as skin and nail involvement to describe a range of phenotypes that explains PsA variability.  OP0114