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European League Against Rheumatism, June 12-15, 2013

Last Updated: June 19, 2013.

The European League Against Rheumatism 2013 Annual European Congress of Rheumatology

The annual meeting of the European League Against Rheumatism (EULAR) was held from June 12 to 15 in Madrid and attracted approximately 15,000 participants from around the world, including clinicians, academicians, allied health professionals, and others interested in rheumatology. The conference highlighted recent advances in the prevention, detection, and treatment of rheumatic diseases.

In one study, Nicola Ruperto, M.D., M.P.H., of the Instituro Giannina Gaslina in Genoa, Italy, and colleagues found that children with systemic juvenile idiopathic arthritis treated with canakinumab, a selective fully human anti-interleukin-1β monoclonal antibody, discontinued corticosteroids in approximately one-third of cases after a median of four canakinumab injections.

"Children are more likely to discontinue corticosteroids if they have, at the start of treatment, a lower number of active joints or a lower number of joints with limitation on motion," said Ruperto.

The investigators provided a clinical feature that could aid practitioners in identifying children who would be more likely to discontinue corticosteroids during an earlier phase of treatment.

"The results of this study could help practitioners to better select the children who are more likely to benefit from the treatment with canakinumab, thereby avoiding the known side effects of corticosteroids, especially those related to growth patterns," said Ruperto.

Several authors disclosed financial ties to Novartis, the manufacturer of canakinumab.

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In another study, Vibeke Strand, Ph.D., of the Stanford University School of Medicine in Portola Valley, Calif., and colleagues used U.S. data to evaluate 6,209 patients with rheumatoid arthritis to gain insight into the durability of continued treatment.

"We found that, at two years, 50 percent of patients discontinued treatment, with one-third of patients discontinuing treatment after one year. The reasons for discontinuation were available for approximately one-half of patients. Up to three reasons were captured," said Strand. "We found that the most common reasons for discontinuation included lack of efficacy of treatment, physician preference, safety, patient preference, and access to treatment."

The investigators also found that the strongest predictors of discontinuation included higher disease activity, anxiety and/or depression, and initiating biologic therapy between 2007 and 2010, compared with 2002 and 2003. In addition, patients remained on tumor necrosis factor (TNF) inhibitors longer than non-TNF inhibitors -- a median of 26.5 months compared with 20.5 months. Patients initiating TNF inhibitors had shorter disease duration and lower disease activity.

"We understand that there are limitations to our dataset, as we did not have reasons for discontinuation for one-half of the patients who discontinued treatment," Strand added. "While we don't know if this would have been generalizable to the general population, we have good reason to believe that the population we had information for would be reflective of general rheumatology practice."

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Angela Zink, Ph.D., of the German Rheumatism Research Center in Berlin, and colleagues found that depression indicators were stronger predictors of work disability in early arthritis than disease activity or response to therapy. The investigators evaluated 573 patients ≤63 years of age with early inflammatory arthritis regarding their decision to request a disability pension within the first 12 months of treatment.

"Our findings demonstrate that whether or not patients with early arthritis consider applying for disability pension is more dependent on mental conditions than disease activity," Zink said in a statement. "As arthritis has a significant financial impact on patients and society, well-directed attention on well-being in the early stages of disease may help patients remain in the workforce."

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EULAR: Rate of RA Remission Down for Obese, Overweight

MONDAY, June 17 (HealthDay News) -- For patients with early rheumatoid arthritis (ERA), being overweight or obese is associated with an increased likelihood of not achieving remission, according to a study presented at the annual meeting of the European League Against Rheumatism, held from June 12 to 15 in Madrid.

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EULAR: RA Patients Discontinue Meds at Median of Two Years

MONDAY, June 17 (HealthDay News) -- For patients with rheumatoid arthritis (RA), the median time to discontinuation of therapy is 25.1 months, with longer time to discontinuation noted for those receiving tumor necrosis factor inhibitors (TNFi's), according to a study presented at the annual meeting of the European League Against Rheumatism, held from June 12 to 15 in Madrid.

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EULAR: Knee, Hip Replacement Outcomes Compared for RA, OA

FRIDAY, June 14 (HealthDay News) -- Patients with rheumatoid arthritis (RA) undergoing total knee replacement (TKR) have outcomes at two years similar to those seen in patients with osteoarthritis (OA); while for total hip replacement (THR), two-year pain and function is significantly worse for those with RA versus OA, according to two studies presented at the annual meeting of the European League Against Rheumatism, held from June 12 to 15 in Madrid.

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EULAR: Triple Tx Non-Inferior After Methotrexate Failure in RA

WEDNESDAY, June 12 (HealthDay News) -- For patients with rheumatoid arthritis with methotrexate failure, triple therapy with methotrexate, sulfasalazine, and hydroxychloroquine is non-inferior to etanercept plus methotrexate, according to a study published online June 11 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the European League Against Rheumatism, held from June 12 to 15 in Madrid.

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