New Osteoarthritis Treatments Garnering Attention at EULAR

Ingrid Hein

June 06, 2018

AMSTERDAM — The use of zoledronic acid for osteoarthritis will be among the hot topics discussed at the upcoming European League Against Rheumatism (EULAR) Congress 2018.

"Interest in osteoarthritis is growing every year as we see more possibilities for treatment," said EULAR President Hans Bijlsma, MD, from University Medical Center Utrecht in the Netherlands. And with more than 130 million people affected by osteoarthritis in the European Union, this is a pressing issue.

"Suffering increases with age, and we have about 40 million people who are severely disabled with this," said Thomas Dörner, MD, from Charité Universitätsmedizin Berlin, who is chair of the EULAR abstract committee.

It is interesting that zoledronic acid, which is usually used for osteoporosis, might be effective in osteoarthritis, he explained. Two-year results from a study of knee pain for people with bone marrow lesions will be presented at the meeting.

A secondary analysis of data from the CANTOS trial (NCT01327846) of canakinumab (Ilaris, Novartis), which will also be presented, looks at the inter-relations between serum urate, gout, and cardiovascular disease.

"We look forward to understanding how we can intervene with this blocking antibody," Dörner said. Although the monoclonal antibody has been shown to reduce cardiovascular events, the big issue is the cost, he noted.

In addition, 23-year follow-up data from the COBRA trial (NCT01172639) will be presented. "These are going to be very interesting data, looking into the area of early rheumatoid arthritis," he explained. Researchers will be revealing how early intervention affects longer-term outcomes.

Excitement is building over results from several trials looking at developments in the treatment of systemic lupus erythematosus. "We've seen several trials fail in phase 3," Dörner said.

Systemic Lupus Erythematosus

Data on treatment and the prevention of complications, especially infection, will likely incite discussion, he noted. Among the presentations on systemic lupus erythematosus will be results from phase 2 studies of baricitinib and ustekinumab and a study on herpes zoster vaccination.

An in-depth analysis of treatments and risks related to pregnancy for women with rheumatic diseases will be discussed by Angela Tincani, MD, from the University of Brescia in Italy. She will also explore breast-feeding issues and outcomes in babies with mothers who have active disease. "We have to have our eyes open when pregnant patients with rheumatoid arthritis or other rheumatic diseases come in," Dörner said.

Research into the psychologic effects of rheumatic disease is on the increase. "This is becoming more important for us to understand, and requires consideration to provide the best outcomes for our patients," he told Medscape Medical News.

One study will examine the link between dementia and gout. "We're not sure if the association is a direct link between the two diseases, related to certain comorbidities (such as hypertension or hyperlipidemia), or a simultaneous event," Dörner explained.

Researchers have long known that patients with elevated blood pressure have an increased risk for dementia, "but there could be other confounding variables," he said. "I look forward to the researchers enlightening us."

EULAR is sharing the enormous Amsterdam RAI Convention Center with the European Society of Musculoskeletal Radiology this year, and the two groups will host a virtual joint session.

"We've never seen so deep into musculoskeletal structure, almost close to the molecular level," Dörner said. "What we see now with MRI and ultrasound is astounding."

More and more, the field of rheumatology has gained insight into diseases because of advances in imaging, and the joint session will highlight the link between the two disciplines.

Another area of focus — quality of care — will be addressed with the launch of seven new guidelines or recommendations for areas that include lupus, vaccinations, and arthritis. Not everyone has access to a quality-of-care framework, so "we will provide packages for those who don't have diagnosis and management guidelines, including how to implement, and outcome measurements," he said.

For the advocacy area of focus, there will also be strong representation from patient networks. "This is becoming increasingly important and we need to discuss how we do shared decision making," Bijlsma explained.

Follow Medscape on Twitter @Medscape and Ingrid Hein @ingridhein

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