EULAR 2018 Review

EULAR 2018
Conference Highlights
Chairman’s Welcome
Dear CSF Member,
It is my pleasure to bring to you our review of the EULAR 2018 highlights, including a review of my ‘Chairman’s picks’.
This year, there continues to be considerable data published on JAK inhibition, with differences in the JAK-STAT
signalling pathway in synovial fibroblasts analysed in different joints [#OP0165], and the results of a systematic review
and meta-analysis of Phase 2 and 3 JAK inhibitor studies presented for the risk of patients developing malignancies or
serious infections [#OP0032].
It was exciting to see the Phase 3 data for upadacitinib: Burmester et al shared the results from patients with an
inadequate response to csDMARDs [#OP0036]; Genovese et al, presented the safety and efficacy of upadacitinib in
bDMARD inadequate responders [#SAT0219]; and Smolen et al evaluated updacitinib as monotherapy [#OP0035]. We
also saw the results of a Phase 2b/3 study of upadactinib in Japanese patients [#SAT0257].
Tofacitinib continues to be prominent this year: data from the ORAL Strategy trial were presented, including the impact of
glucocorticoids on tofacitinib efficacy and safety [#SAT0247], and the effect of live zoster vaccination [#SAT0220]; while
Kaine et al presented data on tofacitinib discontinuation and re-initiation in long-term extension studies [#OP0037].
Specific considerations included a comparison of the effectiveness of tofacitinib and bDMARDs in clinical practice
[#AB0485], improvements in left ventricular mass and cardiac output [#AB0489]; and identification of subgroups, which
could be used to develop personalised treatment algorithms [SAT0217].
Baricitinib showed interesting and varied data, with post hoc analyses from Phase 3 trials examining the impact of
controlling disease activity on physical function, and pain [#AB0258]. The effects of dose reduction were investigated
[#SAT0253] and hepatitis B reactivation was examined [#FRI0077]; efficacy and safety of baricitinib were reported from
the Phase 3 study RA-BALANCE, which enrolled patients in China, Argentina and Brazil [#SAT0218].
Beyond RA, there were data in psoriatic arthritis (PsA); the effects of tofacitinib on several composite endpoint measures
were presented from OPAL Broaden and Beyond [#THU0323]; and efficacy analysed by background methotrexate dose
[#AB0902], and by baseline demographics, disease activity and concomitant medications [#AB0921]. The efficacy and
safety of tofacitinib in patients with or without metabolic syndrome were also compared [SAT0317]. The safety,
tolerability and efficacy of tofacitinib over 36 months were presented from the ongoing OPAL Balance study [SAT0293].
Also of interest was an evaluation of the effect of tofacitinib on the ability of monocytes to differentiate into dendritic cells,
an important step in innate immunity [#AB0046].
The following pages provide a review of the highlights from EULAR 2018. Once again, thank you for your support, and
we hope you enjoyed your time at EULAR.
Yours,
Prof. Iain McInnes