Australian researchers and clinicians were well represented at the 2021 EULAR Congress. Here is a selection of their posters.
Australian researchers and clinicians were well represented at the 2021 EULAR Congress. Here is a selection of their posters.
Poster 619: Modelling of disease activity in patients with inflammatory arthropathies treated with etanercept originator or biosimilar as first-line biologic in an Australian real-world dataset.
The biosimilar version of etanercept achieves similar reductions in disease activity in patients with rheumatoid arthritis and related conditions.
A retrospective study looked at data from 366 patients – 230 of whom were being treated with etanercept and 136 with the biosimilar – in the Australian OPAL rheumatology registry. Dr Claire Deakin from OPAL Rheumatology Ltd told the conference that patients on etanercept achieved slightly lower DAS28CRP levels over time, but the difference with the biosimilar was not clinically meaningful.
Poster 1147: Costs and factors affecting health service utilisation in patients with gout: a longitudinal, population-level linked data study in Western Australia.
While gout by itself is not a major reason for emergency department visits or hospital admissions, it is nonetheless associated with a high rate of readmission after an initial hospital or ED visit.
Dr Erin Kelty, from the University of Western Australia, and colleagues examined data from 4379 individuals admitted to hospital with gout, who were followed up for five years after the initial admission.
The main causes of readmission were cardiovascular disease, digestive diseases, musculoskeletal disease, cancer and respiratory disease. However just over 17% of readmissions were deemed potentially preventable.
Poster 632: The longitudinal associations of methotrexate and biologic use on hospital admission for rheumatoid arthritis patients in Western Australia population
Increased use of conventional disease modifying anti-rheumatic drugs such as methotrexate and leflunomide is associated with a significant decline in hospital admissions with rheumatoid arthritis from 1995 to 2014.
From 1995-2002, the number of rheumatoid arthritis admissions fell from 7.9 per 1000 admissions to 2.6, while conventional DMARD use increased. From 2003-2014, admissions declined further to 1.6 per 1000, while biological DMARD use increased from 0.01 defined daily doses per 1000 population per day to 1.
PhD candidate Khalid Almutairi, from the University of Western Australia, noted that conventional DMARDS achieved a more cost-effective reduction in hospital admissions than biologics.
Poster 84: Septic arthritis in children. A longitudinal population-based study in Western Australia
The overall incidence of septic arthritis in children in Western Australia did not increase significantly from 1990-2010, in contrast to the rates in adults, but did increase among Indigenous children.
A study using state-wide rheumatic disease registry data and linked hospital data found an overall incidence of septic arthritis of 9.8 per 100,000 population. Nearly one-third of cases were reported in Indigenous children – representing a six-fold higher risk than in non-Indigenous children, according to a presentation by Professor Johannes Nossent from the University of Western Australia.
Poster 906: Prevalence of sleep disturbance in patients with ankylosing spondylitis within the Australian Clinical Setting (ASLEEP study): A Real-World Observational Study using the OPAL Dataset.
Poorly controlled ankylosing spondylitis is associated with seven-fold higher odds of insomnia compared to well-controlled disease.
Analysis of data from 495 patients in the Australian OPAL rheumatology registry found 16% reported moderate insomnia and 3.2% reported severe insomnia. Among a propensity-matched sub-group of 142 patients, those with a BASDAI below four were seven times more likely to report insomnia than those with good disease control.
Dr Kathleen Tymms from OPAL Rheumatology Ltd said the study found treatment with either TNF inhibitors or IL-17 alpha made no difference to insomnia rates.
Poster 28: Defining the prevalence of unmet need in SLE: data from a large multinational longitudinal SLE cohort
Nearly one quarter of patients with systemic lupus erythematosus have never achieved low disease activity status and one third have persistently active disease.
Analysis of data from 3384 patients – and more than 30,300 healthcare visits – in the Asia Pacific Lupus Collaboration cohort found significant unmet need among patients, Professor Eric Morand from Monash University told the conference.
For example, 24% had never achieved LLDAS during the study period, 34% had an AMS score greater than four, and one in five patients had at least one episode of high disease activity combined with glucocorticoid use and serological activity.
Poster 691: Effects of anifrolumab on renal disease in patients with SLE
Interferon receptor antibody anifrolumab is associated with improvements in renal endpoints in patients with systemic lupus erythematosus and renal involvement.
Professor Eric Morand from Monash University said that the phase 3 TULIP trials of anifrolumab excluded patients with active severe renal disease at baseline. However post-hoc analysis suggested anifrolumab treatment was associated with greater improvements in urine protein to creatinine ratios and reduced renal flares compared to placebo in patients with mild renal disease at baseline.
Poster 731: Clinical associations of cognitive dysfunction in systemic lupus erythematosus
Greater disease damage from systemic lupus erythematosus is associated with cognitive decline.
Dr Sudha Raghunath, from Monash University, and co-authors examined factors associated with cognitive decline in 91 patients with systemic lupus erythematosus and 48 healthy controls.
They found SLICC damage index score was the only disease parameter that was significantly associated with cognitive decline, although age, premorbid IQ and metabolic risk factors were also associated with decline in multiple cognitive endpoints.
Poster 297: Hospital Admissions for Patients with Rheumatoid Arthritis in Western Australia Hospitals Have Declined over Time
The number of hospital admissions for rheumatoid arthritis in Western Australia decreased by nearly 2.9% annually from 1995 to 2015.
A study of 17,125 patients admitted to hospital with rheumatoid arthritis found that while hospital separations overall in Western Australia increased by around 4.7% per year during that time, rheumatoid arthritis separations decreased.
PhD candidate Khalid Almutairi, from the University of Western Australia, and colleagues noted that the decline in admissions coincided with the introduction of biologics and so could result from improved treatment.
