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Rheumatoid Arthritis

#SARD #ILD Who to screen for #rheumatic #diseases For ILD #ACR guidelines Screening May also depend on ILD prevalence Not sure if frequency of screening and how to screen @jeffsparks #ORA24 @ORAexec https://t.co/BcyyYLKvr6
Janet Pope @Janetbirdope( View Tweet )
Oral presentation at #EULAR2024 about clustering #RA #ILD 🫁 @PhilippeDieude @jeffsparks @RaphaelBorie @bruno_crestani https://t.co/jz1unKIZmN

EULAR 2024 – Day 2 Report (A Difficult RA Day)

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.

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I was allocated to bring down the warning, & I did apologise up front to both the EMA and Janet #EULAR2024. It's a tough gig regulating impactful medicines with risk-benefit, especially when our world is full of other medicines with risk-benefit trade-offs (like prednisolone). 2/ https://t.co/6YPhYHbhg8
David Liew @drdavidliew( View Tweet )
So how do we get from slightly increased numbers of uncommon events in a single study (ORAL Surveillance)? Regulators think differently to us, which partly is the difficulty of a restrictive warning. So being the Aussie I am, I asked - does it pass the 'pub test'? 4/ #EULAR2024 https://t.co/Ih9H87wH22
David Liew @drdavidliew( View Tweet )

Dual seropositivity and shared epitopes in RA: friends or foes?

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.

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What happens when RA patients only on csDMARDs want to stop their meds? in BIO-FLARE, only half flared within 6mo of stopping all csDMARDs suddenly. They’ve got a clinical predictive model. Many milder patients ask, and could benefit! #EULAR2024 POS0068 John Isaacs @RheumNow https://t.co/B7ZjP5Pj70
David Liew @drdavidliew( View Tweet )
Risk of developing RA increased in antibody double-positive and single-positive compared to seronegative individuals. Highest risk in double-positive in first year. Single-positive increased risk of RA for up to five years after testing. In double-positive the risk remained… https://t.co/XLDHK4d4AE https://t.co/3Ek8knGExU
Dr. Antoni Chan @synovialjoints( View Tweet )
OP0201- clinical characteristics of pts failing ≥2 b/tsDMARDs D2T RA pts characterised by ⏰ Earlier disease ⏰ Later initiation of DMARD therapy Discontinuation of drugs mainly due to inefficacy regardless of number of drug lines or MOAs used #EULAR2024 @RheumNow

Mrinalini Dey @DrMiniDey( View Tweet )

OP0140-When should we give #pneumococcal #vaccine to pts starting MTX? Study in RA:PCV13 vaccine given 1 month BEFORE starting MTX leads to higher immunological response at 1m, vs pts vaccinated simultaneously w MTX ⏩Vaccinate patients before starting MTX! @RheumNow #EULAR2024

Mrinalini Dey @DrMiniDey( View Tweet )

When patients say their joints are swollen, what does it mean? Easy to dismiss it as a symptom, but this clinically suspect arthralgia cohort from Leiden shows: - some correlation with MRI/USS findings - predicts RA development still worthwhile! #EULAR2024 POS0609 @RheumNow https://t.co/dw2p5Eo26C
David Liew @drdavidliew( View Tweet )
We’ve got better at treating RA over the last 20 years, and it’s genuinely saving lives. Something to be very proud of. Let’s not forget that! 5y mortality from DANBIO 🇩🇰 (still, we still have work to do in seropos RA in men!) #EULAR2024 OP0162 @RheumNow https://t.co/RfvABXhPvS
David Liew @drdavidliew( View Tweet )
OP0181- What are the best drugs to treat D2T RA? In this cohort of 185 pts, switching biologic or JAKi improved disease activity & was considered to be effective for patients with D2TRA, regardless of mode of action @RheumNow #EULAR2024

Mrinalini Dey @DrMiniDey( View Tweet )

OP0165- incidence & risk factors of D2T RA in an early RA cohort Factors assoc with D2T RA: 🩸 Seropositivity 🦴 Erosions 📈 Disease activity 📊 D2T pts have higher steroid doses & more commonly develop iatrogenic-related #comorbidities, e.g. osteoporosis #EULAR24 @RheumNow

Mrinalini Dey @DrMiniDey( View Tweet )

I’ve always thought new RA meds get prescribed to the most risky patients, and therefore you see more adverse events. Turns out it’s marginally true - maybe out to five years. Worth being careful of judging new meds too early! #EULAR2024 OP0114 @karolinskainst @RheumNow https://t.co/Q8dIHiIYQk
David Liew @drdavidliew( View Tweet )
#EULARBest OP0156- validation & prevalence of D2T RA Data from @BrighamResearch BRASS In this cohort, the #EULAR definition of D2TRA correctly identified a subset of RA pts who have not achieved low disease activity despite multiple b/ts DMARD treatments #EULAR2024 @RheumNow

Mrinalini Dey @DrMiniDey( View Tweet )

OP0137 is comparative analysis of clinical efficacy & drug retention of b/tsDMARDs >1/2 D2T RA pts starting JAKi, RTX, IL-6Ri, or TNFi, but ~1/3 w abatacept, achieved remission or low disease activity in 6m & maintained consistent drug retention for 2yrs @RheumNow #EULAR2024

Mrinalini Dey @DrMiniDey( View Tweet )

Is it worthwhile delaying MTX start for a month in RA, to vaccinate effectively? VACIMRA (multicentre 🇫🇷) showed it marginally improves pneumococcal vaccine immunogenicity, persisting to 1y, no extra pred needed. I’ll admit, I’m still not game! #EULAR2024 OP0140 @RheumNow https://t.co/58qJxki8ov
David Liew @drdavidliew( View Tweet )
How can we predict the 1/3 of palindromic rheumatism patients who will go on to develop persistent inflamm arthritis? Easy to use score derived from 15y data from @UniversityLeeds - can exclude the low-risk so they don’t need to be followed. #EULAR2024 OP0127 @RheumNow https://t.co/gB0FpUPOFC
David Liew @drdavidliew( View Tweet )
OP0131 on occurrence & predictors of #DMARD treatment failure in #RA 8% of pts failed ≥3 b/tsDMARDs with ~4yrs to failure In pts starting first b/tsDMARD, up to 25% fail ≥2 b/tsDMARDs in 3yrs Risk of fulfilling EULAR D2T criterion 1 ➡️ 2.3% in first 5yrs @RheumNow #EULAR2024

Mrinalini Dey @DrMiniDey( View Tweet )

🗣️Abstract session on difficult-to-treat #RA kicks off with OP0118 on predictors of D2T RA 📈Female sex, high joint count, erosions, pulmonary #comorbidities, depression & fatigue assoc with D2T RA 💊MTX after start of advanced therapy protective of D2T RA @RheumNow #EULAR2024

Mrinalini Dey @DrMiniDey( View Tweet )

GC treatment duration for <90 and 90 to 360 days is associated with a higher risk of cumulative SI compared to nonexposed, especially the first year but also up to two years since first visit in RA patients. Maximum RR for <90 days is observed at 8 months since first visit (RR:… https://t.co/ecK2ylqrRk https://t.co/IQ5QQjExYQ
Dr. Antoni Chan @synovialjoints( View Tweet )
Poster tours at #EULAR2024. A third of seropositive RA patients with long disease duration had subclinical lung abnormalities. This pilot study showed the potential role of lung ultrasound for the screening of subclinical ILD among these patients. Abstract 070 @RheumNow https://t.co/ypAh4idV3j
Dr. Antoni Chan @synovialjoints( View Tweet )
OP0072 @RheumNow #EULAR2024 Effects of #Upadacitinib or #Adalimumab on pain in #RA SELECT-COMPARE Phase 3 study UPA & ADA led to improvements in pain vs PBO PtGA & TJC28 pain improvement similar between UPA & ADA ➡️ UPA may be more effective in control of pain than ADA in RA

Mrinalini Dey @DrMiniDey( View Tweet )