CRAJ Fall 2019

Fall 2019 (Volume 29, Number 3)

EULAR 2019 – Report From Madrid

By Philip A. Baer, MDCM, FRCPC, FACR

EULAR returned to Madrid for the third time in seven years in 2019. I attended in 2013 but missed the 2017 version. The conference was again at the IFEMA Feria de Madrid, close to the airport but far from downtown, though both metro and taxis were efficient ways to travel. A direct flight from Toronto was a bonus this time around. The weather was slightly cooler than many expected, but ideal for sightseeing and navigating the conference centre, with its combination of indoor and outdoor areas.

Attendance was over 14,000, with 4,900 submitted abstracts covering all aspects of basic and clinical topics in adult and pediatric rheumatology. The abstract acceptance rate was 45% for presentation and 30% for publication, with 350 oral presentations, 2,226 poster displays and 10 late-breaking posters. More than 500 speakers were involved in the conference.

Canadian content is always high at these meetings. Satellite symposia-featured speakers included Drs. Dafna Gladman, Janet Pope and Carter Thorne, the latter of course discussing the virtues of subcutaneous methotrexate in rheumatoid arthritis (RA). One Canadian, Remy Pollock, PhD, of the Krembil Research Institute in Toronto, received a EULAR basic science abstract award for leading a study on the epigenomic landscape of patients with psoriasis who will develop psoriatic arthritis (Abstract OP0203). Numerous Canadians presented posters and podium sessions; our count would be even higher, but for Johannes Roth being listed as representing Germany and Vivian Bykerk as representing the U.S.

I presented one poster (FRI0109) covering the effectiveness and safety of golimumab and infliximab in RA patients from the BioTrac registry. Otherwise, I had the freedom to roam the conference looking for interesting or novel material. Biosimilar studies and those of newer janus kinase (JAK) inhibitors were prominent, including upadacitinib and filgotinib, as well as the less familiar peficitinib and the Bruton’s tyrosine kinase (BTK) inhibitor fenebrutinib. Studies of tapering therapy in controlled RA were topical. Long-term extension studies and integrated safety analyses for many currently marketed biologics and targeted synthetic (ts) disease-modifying antirheumatic drugs (DMARDs) were common, as were analyses drawn for registries, including Canadian stalwarts such as RhumaData, OBRI and RAPPORT. Some of these produced conflicting data, such as the importance of methotrexate as a co-therapy with JAK inhibitors (see FRI0163 vs. SAT0120).

Intriguing abstracts looked at the ability of sarilumab to reduce HgbA1c levels in diabetic RA patients (SAT0121), the benefits of continuing rather than withdrawing biologics in patients who had been hospitalized with severe infections (FRI0112), and the association between baseline anti-nuclear antibodies (ANA) positivity and the development of anti-drug antibodies in patients treated with two tumor necrosis factor (TNF) inhibitors (SAT0155).

Key points of emphasis in lectures included the search for treat-to-target (T2T) strategies in spondyloarthropathies (TICOSPA study ongoing, STRIKE study failed to recruit) and systemic lupus erythematosus (SLE) (using measures such as LLDAS and DORIS). The need to reach a level of proteinuria below 700 mg/day in lupus nephritis patients to preserve long-term renal function was also stressed, which will feature in new EULAR SLE treatment guidelines.

Madrid is a wonderful city for tourists, with a compact downtown suited to walking along Gran Via, and through Plaza Mayor, Plaza d’Espana, Puerta del Sol, Retiro park, Salamanca and many other areas. There were many gastronomic pleasures, once one adjusted to eating most dinners after 9 pm.

Next year EULAR moves to Frankfurt for the first time. Bookmark the dates of June 3-6, 2020, if you want to attend.

Philip A. Baer, MDCM, FRCPC, FACR
Editor-in-chief, CRAJ
Scarborough, Ontario