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Day 1 Top 5 - EULAR2020

Jun 08, 2020 7:30 pm

Here is my top-five from day one at EULAR:

  1. Merkel PA, et al. (OP0011) Avacopan as effective as steroids in ANCA Associated Vasculitis (AAV) – 330 patient RCT where AAV was treated with either with rituximab or cyclophosphamide but were randomized to also receive prednisone or avacopan (an oral C5aR antagonist). Week 52 results showed avacopan and prednisone remission rates were same (72% vs 70%) at week 26 and 66% vs 55% at week 52. There was less steroid related toxicity in avacopan treated patients.
  2. Juge PA, et al (OP0036).  Methotrexate does not increase the risk of interstitial lung disease (ILD).  Retrospective, case sontrolled, multinational study compared 482 RA patients with ILD vs. 741 RA without ILD; they found an inverse relationship between MTX exposure and ILD risk (OR 0.41; 95%CI 0.27-0.63).  MTX use also delayed the onset of ILD.
  3. McInnes I, et al (LB0001).  Upadacitinib superior to adalimumab in active psoriatic arthritis.  1705 active PsA patients were randomized to either UPA 15mg/d, UPA 30 mg/d, ADA 40 mg EOW or placebo. At week 12 ACR20 responses were higher with UPA15 or UPA30 (70.6%, 78.5%) compared to ADA 65% and placebo (36.2%).
  4. Helliwell P, et al. (0P0054). Guselkumab effective in psoriatic spondylitis. A subanalysis of 1120 psoriatic arthritis patients in the DISCOVER 1 and 2 trials where patients were given either placebo or GUS 100 mg every 4 or every 8 week.  A total of 312 had radiographic sacroiliitis (30% HLA-B27+). BASDAI50 responses were significantly better with GUS (37.9% and 40.5%) compared to placebo (19.1%). ASDAS responses were similarly better with GUS.  Clinical improvements were seen irrespective of HLA-27 status.
  5. EULAR COVID-19 provisional recommendations for the management of MSK diseases and SARS-Cov@-2. Landawe et al. (OP  )  Dr Landawe presented the April 2020 EULAR recommendation (submitted) that should be soon published. They believe that RMD patients are not at higher risk for COVID-19 and that rheumatologists should be involved in COVID management discussions and there was concern for DMARD or biologic shortages due to COVID. There were 4 overarching principles, 13 recommendations and they stressed that the evidence is still evolving with COVID and RMD.
The author has received compensation as an advisor or consultant on this subject

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