I’ve attended the recent EULAR Annual Meeting in Rome, and I've selected 5 interesting studies to report on.
The study looks at the American Academy of Ophthalmology revised recommendations regarding screening for hydroxychloroquine (HCQ), published in 2011. “Only 0.6% of the rheumatologists and 19% of the ophthalmologists were aware of the recommended ophthalmologic assessments for baseline and follow up evaluation.” “Use of inappropriate tests to detect HCQ retinal toxicity may lead to unnecessary cessation of beneficial HCQ treatment while lack of consideration of risk factors may pose patients at risk for toxicity.”
Risk factors for retinal toxicity are:
. Therapy duration of more than 5 years
. Cumulative dose of more than 1000 g
. Daily dose of more than 400 mg
. Kidney or liver failure, and macular disease
. Advanced age
By J. Wollman, S. Shulman, S. Brikman, et al. Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel. Assessment of the implementation of the revised recommendations for screening of hydroxychloroquine retinopathy in the clinical practice of opthalmologists and rheumatologists. Abstract #THU0405 DOI: 10.1136/annrheumdis-2015-eular.6050
Ultrasound and MRI show a prevalence of synovitis in osteoarthritis, that is inflammation. This study shows that inflammation is independent of erosive hand osteoarthritis but is associated with the degree of joint damage.
The authors conclude that erosive hand osteoarthritis is a more severe form of osteoarthritis rather than a separate entity.
By A. Mathiessen1, I.K. Haugen1, PS Robinson 1,et al. 1Rheumatology, Diakonhjemmet Hospital, Oslo; 2Faculty of Medicine, University of Oslo; 3NKRR, Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. Erosive hand osteoarthritis (OA): A separate inflammatory entity or a severe form of OA? Abstract #THU0448 DOI: 10.1136/annrheumdis-2015-eular.3617
Antinuclear antibodies (ANA) may develop in patients receiving TNF inhibitors (TNFi) like infliximab, adalimumab, and golimumab. The authors found a meaningful degree of such “seroconversion” – a rate of 45.2%, with a median time of 22 months. Therefore, the development of ANA after TNFi in patients with spondyloarthritis may “affect clinical response with worse outcomes.”
I think maybe a small dose of methotrexate may alter this path, but a prospective study has yet to come.
By R. Fonseca, R. Vieira, P. Madureira, et al. Rheumatology, Sao Joao Hospital Centre, Porto, Portugal. The induction of antinuclear antibodies in spondyloarthritis patients under anti-TNF-alpha: a new outcome predictor? Abstract #THU0225 DOI: 10.1136/annrheumdis-2015-eular.4095