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European League Against Rheumatism, June 11-14

The European League Against Rheumatism's 2014 Annual European Congress of Rheumatology

The annual meeting of the European League Against Rheumatism was held from June 11 to 14 in Paris and attracted approximately 15,000 participants from around the world, including clinicians, academicians, allied health professionals, and others interested in rheumatology. The conference highlighted recent advances in the prevention, detection, and treatment of rheumatic diseases.

In one study, James Jarvis, M.D., of the University at Buffalo in New York, and colleagues identified biomarkers to predict longer-term disease status in adolescents with juvenile idiopathic arthritis (JIA).

"Predicting long-term outcome using patterns of gene expression in JIA is challenging. However, short-term outcome (disease status at six months) is feasible," said Jarvis. "Longer-term outcome (disease status at 12 months) is feasible after four months on therapy."

The investigators also found that rheumatoid factor (RF) positive and RF negative patients respond differently to therapy, potentially explaining why RF positive patients are so much more difficult to treat.

"While there is much work still to be done, we are reaching the stage where clinical tests to assist diagnosis and guide therapy appear to be within reach," Jarvis added.

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In another study, Nicholas Young, M.D., of The Ohio State University Wexner Medical Center in Columbus, and colleagues found that regular exercise can function as a true systemic biological response modifier that can lead to the suppression of inflammatory responses.

"Our results suggest that exercise can regulate immune responses systemically, but that these effects are lost after 24 hours," said Young. "In rheumatology clinics, it is commonly recommended that patients get 30 minutes of exercise at least three times a week. In this study, the exercise regimen was moderate and lasted for 45 minutes per day (treadmill at 8 miles/minute). Therefore, our results suggest that a moderate daily exercise routine may actually be more efficacious for patients than what is currently recommended in clinics."

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Won Park, M.D., of the Inha University Hospital in Incheon, Korea, and colleagues found that the newly-approved infliximab biosimilar CT-P13 is just as effective as infliximab in improving disease activity associated with ankylosing spondylitis.

"The incidence of anti-drug antibody development in the biosimilar CT-P13 and innovator infliximab were very similar to each other," said Park. "The magnitude of the impact of anti-drug antibody on their clinical effectiveness and adverse events [was] similar between the biosimilar and innovator."

Several authors disclosed financial ties to Celltrion, the manufacturer of CT-P13.

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Harry Genant, M.D., of the University of California in San Francisco and a cofounder of Synarc, and colleagues found that romosozumab significantly increased bone mineral density and bone content as compared to teriparatide in postmenopausal women with low bone mass.

"These results show considerable promise for this novel agent as a potent anabolic for restoration of the osteoporotic and fragile skeleton," said Genant. "The impact on the elderly, severely osteoporotic could be enormous."

Several authors disclosed financial ties to pharmaceutical companies, including Amgen, which manufactures romosozumab.

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Erik Vogelzang, M.D., of the Jan van Breemen Research Institute in Amsterdam, and colleagues found that one-third of psoriatic arthritis patients did not receive the optimal dose of adalimumab.

"A proportion of patients treated with adalimumab are not within optimal range identified by the concentration-effect curve in our study. Thirty-five percent of patients have drug concentrations below 5 mg/L. Of these patients, 58 percent had detectable anti-drug antibodies. In addition, 47 percent of patients had adalimumab concentrations above 8 mg/L," said Vogelzang. "Patients with drug concentrations above the optimal range might be interesting from an economic perspective, since they might respond equally well to lower dosing frequencies of the drug. However, identifying an optimal range is a first step towards making personalized treatment possible."

Several authors disclosed financial ties to Pfizer, AbbVie, and/or Amgen. AbbVie manufactures adalimumab.

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