Articles By Antoni Chan, MD, PhD
ICYMI: Towards Personalised Care in Rheumatoid Arthritis
Since the millennium, we have seen an expansion in the number of advanced treatments both biologic and targeted synthetic disease modifying anti-rheumatic drugs for rheumatoid arthritis. The challenge remains on how best to characterise the subtypes of RA in order to choose the best drug to ensure optimal outcome for patients.
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Race to the top: how high will treatment response rates in RA reach?
We have become accustomed to the 60/40/20% rule for the outcome of ACR 20/50/70 respectively for biologics and targeted synthetic DMARDs.
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How early is early in psoriatic arthritis?
Guidelines (ACR/EULAR/GRAPPA) for the management of psoriatic arthritis (PsA) recommend the early referral of patients with the suspected condition for early assessment and treatment.
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Towards Personalised Care in Rheumatoid Arthritis
Since the millennium, we have seen an expansion in the number of advanced treatments both biologic and targeted synthetic disease modifying anti-rheumatic drugs for rheumatoid arthritis. The challenge remains on how best to characterise the subtypes of RA in order to choose the best drug to ensure optimal outcome for patients.
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Methotrexate - an old trusted friend who deserves better
Methotrexate (MTX) has been used as the anchor drug for the treatment of RA and PsA for many years. Despite our long experience with the use of MTX, one area that has remained uncertain is its effect on male fertility. There is now increasing evidence that cessation of MTX in males prior to trying conceive is not necessary.
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AI in RA: the story grows along the patient pathway
The use of artificial intelligence to analyse large data sets using its subset component machine learning has taken centre stage recently in the management of rheumatic conditions, including rheumatoid arthritis. The use of AI is now starting to cross the various stages in patient care from detection, diagnosis, treatment and the prediction of long-term outcome.
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An update on JAK inhibitors and cardiovascular risks
In the last 2 years, there has been more caution and vigilance with the use of JAK inhibitors in the treatment of rheumatoid arthritis due to the risk of CV events, including MACE and VTE. The ORAL surveillance study, a post-approval safety study conducted in RA patients aged ≥50 years with ≥1 CV risk factor, has resulted in increased caution and greater emphasis on assessment of MACE and VTE risks in patients starting JAK inhibitors.
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The disconnect between objective inflammatory response and PROs in AxSpA
The assessment of disease activity in AxSpA involves the use of objective inflammatory response (OIR) and patient reported outcomes (PROs). In clinics, a combination of OIR and PROs are used to measure disease activity and response to treatment.
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Dual inhibition of IL17A and IL17F in AxSpA
A new target for treatment in AxSpA is the dual inhibition of IL17A and IL17F (IL17A/F). IL17A is a key driver of the inflammation in the AxSpA and Psoriatic Arthritis (PsA). IL17A and its structurally related IL17F share biologic functional properties. Inhibition of both cytokines (IL17A/F) should result in a greater clinical benefit in AxSpA and PsA than IL17A inhibition alone.
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Practical use of JAK inhibitors in select groups in Axial SpA
A new treatment for AxSpA that has come on the scene are JAK inhibitors. In clinic, considerations for JAKi use are body mass index, smoking status, prior use of biologics and patients with high inflammatory states such as high CRP and inflammatory change on MRI scan of the spine and sacroiliac joints. There are further studies at #ACR22 which help answer these questions.
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