EULAR 2007 Highlights

The Annual European Congress of Rheumatology was held in Barcelona Spain from June 13-16, 2007. This is the official meeting of the European League Against Rheumatism (EULAR). Full abstract reports may be can be found online by visiting the EULAR Congress website. While it is not possible to review all of the important findings from these meetings, some selected highlights are summarized. The majority of these highlights focus on diseases whose predominant manifestation is arthritis (consistent with the mission of this WebSite). The highlights are summarized by Clifton O. Bingham III, MD, Jon Giles, M.D. and Lisa Christopher-Stine MD.

Rheumatoid Arthritis : Current Therapeutics

The treatment of RA has seen a number of targeted biological therapies introduced in the last 7 years beginning with TNF antagonists, etanercept, infliximab, and adalimumab, the IL1-anagonsist anakinra, and most recently with the approval of the T-cell costimulatory blocking agent, abatacept and rituximab, a selective B cell depleting agent.  As agents have been incorporated into the treatment armamentarium of patients with RA and other inflammatory diseases, the questions that come up regarding their use change from ones of clinical efficacy to focus more on aspects related to safety, administration, and insights on mechanism of action for existing compounds.  The abstracts selected in this category for review reflect the evolving nature of some of the studies presented at EULAR 2007 for existing biological DMARDS in RA.

• OP 0125 Clinical and Radiological Efficacy of Four Different Treatment Strategies in Patients with Early Rheumatoid Arthritis: 3-Year Follow-up of the BeSt Study
• OP 0011 . Repair of Erosions Occurs Almost Exclusively in Damaged Joints without Swelling: Post Hoc Analysis of Radiographic Data from Year 1 of the TEMPO Study
• OP0121 The Safety Of Abatacept in patients with active rheumatoid arthritis and an inadequate response to Anti-TNF therapy: Results from the ARRIVE Trial
  
• THU0142 Improvement in Hemoglobin in patients with Rheumatoid Arthritis treated with Infliximab plus Methotrexate
  FRI0241 Anemia is an independent factor associated with physical disability among patients with Rheumatoid Arthritis.
• OP0119 Long-term safety data from extended follow-up and repeat use of Rituximab in Rheumatoid Arthritis
• OP 0014 Rheumatoid Arthritis, Interstitial Lung Disease, Mortality and Anti-TNF Therapy: Results from the BSR Biologics Register (BSRBR)
• OP0047 Long-Term Steroid Treatment may Decrease Lymphoma Risk in Rheumatoid Arthritis, Results from a Swedish Case-Control Study of 400 RA-Lymphomas
• OP 0097 Development of Autoantibodies in Patients with Very Early Arthritis – A Follow-up Study
• OP 0105 HLA-DRB1 Shared Epitope is Independently Associated with Severity of Coronary Calcification in Rheumatoid Arthritis
• OP 0128 Cartilage and Bone Biomarkers in Rheumatoid Arthritis: Prediction of 10-Year Radiographic Progression
• OP 0129 . Ethanol Consumption is Associated with Decreased Risk for Developing RA: Results from the Swedish EIRA Study

Rheumatoid Arthritis : New Therapeutics

Although we currently have 6 biological DMARDS approved for the treatment of RA representing 4 distinct mechanisms of action (TNF inhibition, IL1 Inhibition, costimulatory blockade, and B cell depletion), additional agents are in development that have similar mechanisms of action and distinctly novel mechanisms of action.  EULAR 2007 had a number of studies presented on several of these compounds, some of which have been selected for review below.  Because of the number of abstracts presented at EULAR, only a selection of these studies could be included for review. Details for some of these other agents have been reviewed in past meeting highlights (ACR 2006, EULAR 2006).

• DENOSUMAB - An Inhibitor of RANKL
  OP0120. The RANKL Inhibitor Denosumab reduces progression of the total Sharp Score and bone erosions in patients with Rheumatoid Arthritis: X-Ray results at 12 months.
  OP0226.  Inhibiting RANKL with Denosumab reduces progression of bone erosions in patients with Rheumatoid Arthritis: 6-Month MRI results from a randomized, Placebo-Controlled Study.
• TOCILIZUMAB—An Inhibitor of IL-6
  OP0117. TOCILIZUMAB, A Novel Monoclonal Antibody targeting IL-6 signalling, significantly reduces disease activity in patients with Rheumatoid Arthritis.
  SAT0001. TOCILIZUMAB, A Novel Monoclonal Antibody targeting IL-6 signalling, significantly improves quality of life in patients with Rheumatoid Arthritis.
• CERTOLIZUMAB PEGOL—A new TNF Antagonist
  OP0016. The Anti-TNF CERTOLIZUMAB PEGOL in combination with Methotrexate is significantly more effective than Methotrexate alone in the treatment of patients with active Rheumatoid Arthritis: Preliminary results from the RAPID 1 Study.
  THU0200. CERTOLIZUMAB PEGOL added onto Methotrexate improves physical functioning and reduces pain in patients with Rheumatoid Arthritis who have an incomplete response to Methotrexate: Data from RAPID 2
  THU0202. Efficacy and safety of CERTOLIZUMAB PEGOL in combination with Methotrexate in Patients with active Rheumatoid Arthritis despite MTX therapy: Result from the RAPID 2 Study
  

Spondyloarthopaties : Clinical and Treatment

While much of the information on our website has concentrated on patients with RA, many new developments have taken place over the last few years for patients with spondyloarthropathies that include psoriatic arthritis and Ankylosing Spondylitis.  Three TNF antagonsists (etanercept, inflicximab, and adalimumab) are now approved for the treatment of both psoriatic arthritis and ankylosinig spondylitis.  As effective medications are approved and treatment strategies develop for these conditions, we also have seen increasing research in these conditions that tell us about disease course, pathogenesis, and insights that may lead to additional therapeutic strategies for patients.  Some of the more important abstracts from EULAR 2007 were selected that highlight developments in treatment and disease course.

• Is There a Disconnect Between Spinal Inflammation and Bony Ankylosis in Ankylosing Spondylitis?
  OP0044. Sustained Reduction in Spinal Inflammation in Patients with Ankylosing Spondylitis after Treatment with Infliximab
  OP0111. Radiographic Progression in Patients with Ankylosing Spondylitis after 2 Years of Treatment not Inhibited with Infliximab
• OP0043. Efficay of Adalimumab in the treatment of Preradiographic Axial Spondyloarthritis: Results of a 20-Week, Randomized controlled trial with an Open-Lable extension phase

Myositis / Inflammatory Myopathies

• OP0055 - Clinical associations of Autoantibodies to a P155/140 KDA Doublet in Adult and Juvenile Dermatomyositis
• OP0056 - Serum Baff levels are increased in patients with Myositis and Anti-JO-1 Antibodies
  
• OP0057 - Human Cytomegalovirus - A possible activator of the immune system in Polymyositis and Dermatomyositis
• OP0058 - The Expression of TLR-4 and 9 is increased and correlated with the expression of IL-17, Interferon-Gamma and TNF-Alpha in patients with Idiopathic Inflammatory Myopathies
• 0292 - Rituximab for Refractory Polymyositis : An open-lable prospective study
• 0308 - Myositis Specific and Myositis Associated Autoantibodies in Idiopathic Inflammatory Myopathies : A Serologic study of 100 patients

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