THE EUROPEAN CONGRESS OF RHEUMATOLOGY (PARIS, 11–14 JUNE 2014): PROBLEMS OF RHEUMATOID ARTHRITIS

The 15th annual European Congress of Rheumatology took place in Paris in June 2014. Its program was extremely diverse and included a discussion of new data pertinent to the diagnosis and treatment of the most common rheumatic diseases and problems of their etiology and pathogenesis, personified therapy, and many others. The Congress focused on the problems of early rheumatoid arthritis (RA). A number of papers concerned the efficiency and safety of different therapy regimens for RA at its onset, the discontinuation of biological therapy after achievement of remission, and the maintenance of drug-free RA remission. The Congress discussed new results of the tREACH trial comparing three treatment regimens for early inflammatory arthritis: combined therapy with methotrexate (MT), sulfasalazine, and hydroxychloroquine in conjunction with intramuscular glucocorticoids (GC); combined therapy with these drugs in conjunction with oral GC; and MT monotherapy with oral GC. A large number of reports dealt with the use of tumor necrosis factor-α inhibitors, the evaluation of their immunogenicity, and the
analysis of reasons for therapy discontinuation and adverse reactions. Some aspects of therapy with disease-difying antirheumatic drugs were discussed. A number of reports concerned the application of novel laboratory biomarkers for RA.
Thus, sufficiently many new data that will be able to optimize therapy for common rheumatic disease, such as RA, were presented at the Congress.

1. Van Nies JA, Gaujoux-Viala C, Tsonaka R, et al. When does the therapeutic window of opportunity in rheumatoid arthritis close? A study in two early RA cohorts. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.5266.

2. Karateev D, Luchikhina E, Demidova N, et al. One year results of «Treat to Target» strategy in patients with early and long-standing rheumatoid arthritis in clinical practice: the REMARCA trial. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.3834.

3. Emery P, Burmester G, Bykerk V, et al. Induction of clinical remission followed by drug-free withdrawal with Abatacept combination and monotherapy in early RA: results from the AVERT study over 18 months. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.2132.

4. Peterfy C, Burmester G, Bykerk V, et al. MRI results from the AVERT study: a randomized, active-controlled trial to evaluate induction of remission and maintenance of drug-free remission using Abatacept in combination with methotrexate or as monotherapy in patients with early RA. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.1524.

5. Kuijper M, Weel A, de Jong P, et al. Fewer patients on biologicals and better functional ability two years after induction therapy with combination DMARD therapy versus methotrexate monotherapy. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.5357.

6. De Jong PH, Hazes JM, Barenndregt PJ, et al. Induction therapy with a combination of DMARDs is better than methotrexate monotherapy: first results of the tREACH trial. Ann Rheum Dis. 2013;72:72–8. DOI: http://dx.doi.org/10.1136/annrheumdis-2011-201162.

7. De Jong PHPD, Hazes JM, Luime JJ, et al. Randomized comparison of triple DMARD therapy with methotrexate mono-therapy. Ann Rheum Dis. 2013;72(Suppl 3):113.

8. Emery P, Hamouden M, FitzGerald M, et al. Induction of remission in patients with up to 12 months of moderate-to-severe rheumatoid arthritis symptoms treated with etanercept plus methorexate over 52 weeks. Arthritis Rheum. 2012;64(Suppl):S1077.

9. Emery P, Hammoudeh M, Fitzgerald O, et al. Assessing maintenance of remission with reduced dose etanercept plus methotrexate, methotrexate alone, or placebo in patients with early rheumatoid arthritis who achieved remission with etanercept and methotrextate: the PRIZE study. Ann Rheum Dis. 2013;72(Suppl 3):399.

10. Emery P, Pedersen R, Bukowski J, et al. Early response to etanerceptmethotrexate induction therapy predicts sustained remission with reduced-dose combination regimen in the PRIZE study. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 0.1136/annrheumdis-2014-eular.1704.

11. Verschueren P, De Cock D, Corluy L, et al. Associated with a glucocorticoid bridging scheme, methotrexate is as effective alone as in combination with other dmards for early rheumatoid arthritis, with fewer reported side effects: 16 weeks remission induction data from the CARERA trial. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.2137.

12. Filippi N, Morel J, Combe B, et al. Risk of relapse after discontinuing tumor necrosis factor inhibitors in rheumatoid arthritis patients with low disease activity: A systematic review and meta-analysis. Ann heum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.5498.

13. Borras-Blasco J, Gracia-Perez A, Antonio Perez-Torres A, et al. Adalimumab dose reduction in rheumatoid arthritis, psoriatic arthropathy and ankylosing spondylitis patients in sustained clinical remission. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.4919.

14. Hammond A, Batley M. RA patients with inadequate response to oral MTX maintain satisfactory disease control and durable long-term response when switched to SC MTX monotherapy. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.2353.

15. Ng B. Factors associated with methotrexate treatment duration, including subcutaneous use, in patients with rheumatoid arthritis: observations from the veterans affairs database. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.3021.

16. Bluett J, Chipping J, Marshall T. Long-term persistence with oral methotrexate in patients with early inflammatory arthritis. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.1866.

17. Skapenko A, Schulze-Koops H, Devanarayan V. Identification of genetic variants associated with response to methotrexate in patients with early rheumatoid arthritis: results from the OPTIMA study. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.1318.

18. Romao V, Santos M, Polido-Pereira J. Tocilizumab is associated with higher CDAI/SDAI remission in biologic-naive rheumatoid arthritis patients – data from REUMA.PT Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.2668.

19. Ramirez Garcia J, Inciarte-Mundo J, Ruiz-Esquide V. Comparative study on the presence of ultrasound subclinical synovitis between patients with RA and PSA in clinical remission or low disease activity in treatment with anti-TNF therapy. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.5519.

20. Rioux E, Rioux M-J, Fortin I. Biological therapy survival rate in a Canadian cohort of rheumatoid arthritis patients. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.3681.

21. Garcia-Carazo S, Plasencia C, Pascual-Salcedo D. Does immunogenicity influence on drug survival of anti-TNF? Ann Rheum Dis. 2014;73 (Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.4543.

22. Gainaru C, Diana M, Iliuta M. Infliximab vs etanercept: the importance of immunogenicity and serum drug monitoring in clinical practice. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis- 2014-eular.4828.

23. Bandres Ciga S, Salvatierra Ossorio J, Lopez-Sidro M. The utility of the mechanistic model in inflammatory arthropaties with secondary clinical failure to Adalimumab, but not to Etanercept. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.2563.

24. Kneepkens EL, van den Oever IA, Plasencia C. Tocilizumab levels are associated with clinical response in patients with rheumatoid arthritis. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.2915.

25. Ruiz-Esquide V, Gonzalez-Navarro A, Yague J. Serum levels of tocilizumab and its relationship with disease activity and drug dosage in patients with rheumatoid arthritis. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.3536.

26. Diana M, Iliuta M, Gainaru C. Correlation between serum rituximab level and clinical response in rheumatoid arthritis patients treated with b cell depletion therapy. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.4831.

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28. Bae S, Kim J, Choe J, et al. A randomized, double-blind, phase 3 equivalence trial comparing the etanercept biosimilar, HD203, with Enbrel®, in combination with methotrexate (MTX) in patients with rheumatoid arthritis (RA). Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.3558.

29. Kay J, Chopra A, Chandrashekara S, et al. A phase 3, randomized, double-blind, active comparator study of the efficacy and safety of BAW015, a biosimilar infliximab, in patients with active rheumatoid arthritis on stable methotrexate doses. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.1595.

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31. Alten R, Strand V, Fleischmann R. Effects of Tofacitinib monotherapy versus methotrexate on patient-reported outcomes in the 2-year phase 3 oral start trial in methotrexate-naive patients with rheumatoid arthritis. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis- 2014-eular.3168.

32. Dowty M, Lin T, Wang L, et al. Lack of differentiation of Janus kinase inhibitors in rheumatoid arthritis based on Janus kinase pharmacology and clinically meaningful concentrations. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.2490.

33. Takahashi T, Kojima T, Funahashi K. Long-term outcome of infliximab therapy in rheumatoid arthritis patients – results from Japanese multicenter registry system Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.1420.

34. Gomez A, Rosales Rosado Z, Pena R. Incidence of opportunistic infections in rheumatoid arthritis treated with biological agents. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.4509.

35. Aaltonen KJ, Joensuu JT, Liisa V. Rates of serious infections and malignancies among rheumatoid arthritis patients receiving either TNF-blocker or Rituximab therapy in Finland. Ann Rheum Dis. 2014;73(Suppl 2). DOI:10.1136/annrheumdis-2014-eular.2568.

36. Raaschou P, Frisell T, Askling J. TNF inhibitor therapy and risk of breast cancer recurrence in patients with rheumatoid arthritis –a nationwide cohort study. Ann Rheum Dis. 2014;73(Suppl 2). DOI:10.1136/annrheumdis-2014-eular.5011.

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39. Roubille C, Richer V, Starnino T, et al. The effects of TNF inhibitors, methotrexate, NSAIDS and corticosteroids on cardiovascular events in rheumatoid arthritis, psoriasis and psoriatic arthritis: a systematic review and meta-analysis. Ann Rheum Dis. 2014;73(Suppl 2). DOI: 10.1136/annrheumdis-2014-eular.5448.

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47. Schett G, Finzel S, Rech J. Residual inflammatory activity assessed by a multi-biomarker disease activity blood test is linked to structural damage in RA patients in low disease activity/remission and normal Creactive protein level. Ann Rheum Dis. 2014;73(Suppl 2). DOI:10.1136/annrheumdis-2014-eular.2976.

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