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What is new in Sjögren’s Syndrome (EULAR 2013)

Hendrika Bootsma (The Netherlands) at EULAR 2013 Madrid, June 14.

Diagnosis / classification criteria

2013-06-15 11.44.27Criteria must be clear, easy to apply and specific. “The previous AECG classification criteria for Sjögren’s syndrome had been criticized for including subjective tests (symptoms of oral and ocular dryness), physiologic measures that lack specificity, and objective tests that are not diagnostically equivalent. Therefore, the Sjögren’s International Collaborative Clinical Alliance Research Groups proposed an alternative criteria set composed of only objective measures (including lip biopsy). The level of agreement between the preliminary American College of Rheumatology (ACR) criteria and the AECG criteria was high when all objective tests were available to define the AECG criteria but low when subjective tests were allowed to replace the objective tests.” (Bootsma, H., Spijkervet, F. K. L., Kroese, F. G. M. and Vissink, A. (2013), Toward new classification criteria for Sjögren’s syndrome?. Arthritis & Rheumatism, 65: 21–23. doi: 10.1002/art.37701) 

My selection of ACR2012 Sjögren’s Syndrome Abstracts (2)

This year’s annual scientific meeting of the American College of Rheumatology (ACR) included 76 accepted abstracts on Sjögren’s Syndrome. In this blogpost I name a selection of them that may have clinical relevance for rheumatologists in daily practice together with a few more basic research oriented abstracts that I personally consider of interest. Read more…

My selection of ACR2012 Sjögren’s Syndrome Abstracts (1)

It is early November, and that is usually the time of the year for the annual meeting of the American College of Rheumatology (ACR). Indeed the ACR 2012 convention has just ended while adding this blogpost. It took place in Washington, D.C., from November 9-14. I did not physically attend it, but -and that’s new- I would almost say it has been the first scientific meeting I could almost attend virtually (live video- and aaudiostrems from the meeting would provide a strikethrough for the word “almost” in this sentence). Thousands of tweets from all kinds of authors attending the ACR 2012 convention passed in my Twitter timeline. Whilst on a previous occasion one could make a nice survey of topics discussed at the ACR or (european counterpart) EULAR meetings by downloading a transcript of all tweets with the meeting’s hashtag via Symplur, on this occasion one could speak of a twitter tsunami. The tweets containing the hashtag #ACR2012 were so numerous that the previously mentioned transcript downloads via Symplur no longer satisfied my objective to obtain a nice survey of the meeting (this might change when Symplur decides to add more query features then only filtering based on a specified time-interval, i.e. if one could filter all tweets containing the #ACR2012 hashtag including the word “gout” it could still deliver a nice transcript of what came by via Twitter on the topic gout). Read more…

Categories: meeting report

Meeting report (part 4b): evaluating muscle function in inflammatory myopathies

Advances in basic experimental as well as clinical research on pathophysiological mechanisms and treatment opportunities of various rheumatoid disease conditions have been complicated or frustrated by issues like how to define a disease (i.e. proper diagnosis) and how to define measurement of treatment response (i.e. which outcome measuers should be targeted and evaluated in trials). In this blog, after putting things in a broader context shortly, I will write what I learned about evaluating disease activity of inflammatory myopathies in daily clinical practise, and to be more precise evaluating muscle functioning. Two standardised examinations are available for that purpose: the MMT-8 and the FI-2. Read more…

Meeting report (part 4a): about the shifting classification of idiopathic inflammatory myopathies

28 January 2012 3 comments

What I also heard during my 2-day visit to the Karolinska Institute at Stockholm, Sweden, was a nice overview on the current status of both classification as well as (emerging) treatment options of idiopathic inflammatory myopathies. As a clinician, three take-home messages were what I took home from this oral presentation by professor Ingrid Lundberg MD PhD (photo), who can be regarded as one of the top-experts worldwide in this field of rheumatology.
The first two of three take-home messages are nothing new at all when I search the literature, but I must admit my knowledge of inflammatory myopathies was not as up-to-date as I thought, because they were both quite new for me. They were: (1) the so familiar classification into polymyositis, dermatomyositis and inclusion body myositis is becoming rather obsolete and may be rapidly replaced by a calssification that is much more defined by which (combination of) myositis specific autoantibodies (MSAs), which I will discuss in this blog post. Read more…

Meeting report (part 3): a survey of new SLE treatment modalities

The two-day international meeting for rheumatologists at the Karolinska Institute, Stockholm, Sweden was actually packed with oral presentations providing a lot of information on fairly all fields a rheumatologist might be interested in. Actually too much to report in a concise matter in this weblog, but I will conclude my third and fourth (to follow) part of this meeting report with a summary of the oral presentations on SLE treatment and classification of myopathies.

SLE: the ongoing search for new treatment modalities
Iva Gunarsson (photo) came with a talk that provided a survey of current treatment options for SLE and the difficulties encountered in clinical trials. Very similar to developments in the treatment of inflammatory myopathies, promising case reports on succesfull treatment with new monoclonal antibody agents like e.g. (amongst others) rituximab could not be confirmed with convincing data from double-blinded placebo controlled studies. As a result -untill the recent approval of belimumab as a new treatment modality in SLE-, for decades SLE has mainly been treated by trial-and-error making use of conventional disease modifying anti-rheumatic drugs and corticsteroids. As also was pointed out by several speakers during the EULAR 2011 meeting in London, UK, this does not necessarily mean that other biologics than belimumab that have been inevstigated in SLE are of no value in daily clinical practice. Study designs with regard to study population, disease activity definition as well as follow-up duration may have had quite some influence on the final findings in previous trials. In an era of highly advocated evidence-based medicine there may be a risk that -following suboptimal study designs- some previously tested drugs with potential have been put aside too rigourously, perhaps we will never know. Read more…

Meeting report (part 2): Biological treatment of rheumatic diseases with special focus on T cell modulation

Meeting report (part 2): Biological treatment of rheumatic diseases with special focus on T cell modulation

The meeting at Karolinska Institute Center for Molecular Medicine continued with a very interesting state-of-the-art lecture on safety of biologic treatment in rheumatic diseases, given by Johan Askling, associate professor rheumatology (photo). His lecture was structured in three sections: first some facts about cancer occurrence in rheumatoid arthritis, then a part adressing cancer occurrence related to treatment strategeis of rheumatoid artritis, and finally some clinical considerations to conclude with.
Read more…

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