EULAR 2021 – An Australian perspective

4 minute read

Prof Ranjeny Thomas, Prof Hans Nossent and Dr Feng Pan tell us which presentations or posters caught their attention.

We asked three Australians who presented at the EULAR Congress which other presentations or posters caught their attention.

Professor Ranjeny Thomas is a rheumatologist and researcher at the University of Queensland and Princess Alexandra Hospital. She has an interest in pathogenesis and curative strategies for the treatment of RA and presented Antigen-specific immunotherapy with peptides.

The session that particularly captured her interest was New toys in rheumatology: single cell RNA and epigenetic sequencing, the holy grail? Invited speakers covered lupus flare signatures, gene networks, X chromosome inactivation and TLR7 over-expression in lupus, and T cell receptor tracking over time.

“This technology is providing fascinating new insights into how rheumatic diseases develop and the immune response to infectious and autoantigens,” said Professor Thomas.

Q. What’s interesting about this session?

A. We are using this technology and I wanted to see what others are doing. There are so many directions in which people are taking it.

Q. How does this connect to broader themes in rheumatology?

A. Based on single-cell transcriptomic analysis we are rethinking the pathogenesis of rheumatic diseases. There are cell types dominating the diseased tissue that no one even realised were important until now. This has enormous application to the development of novel and more personalised therapies.

Q. What does this make you reflect on?

A. It’s a great time to be doing rheumatic disease research, bringing these technologies to bear on patient samples.

Winthrop Professor Hans Nossent is a clinical academic rheumatologist at the University of Western Australia. He has a particular interest in systemic autoimmune diseases (connective tissue diseases/vasculitis) and presented Non-gonococcal pyogenic arthritis of native joints in Western Australia: A longitudinal population-based study of frequency, risk factors and outcome (OP0095) at the session Infection-related rheumatic and orphan diseases.

The poster that caught his attention was Defining the prevalence of unmet need in SLE: data from a large multinational longitudinal SLE cohort (POS0028) presented by Professor Eric Morand from Monash University.

“The presentation highlighted the fact that we seem unable with our current therapeutic armamentarium to get sufficient numbers of patients with SLE in a sustained state of low disease activity, which is required to prevent secondary disease and drug induced organ damage,” said Professor Nossent.

Q. What’s interesting about this presentation?

A. It is reminiscent of the situation with RA and axial SpA 15-20 years ago.

Q. How does this connect to broader themes in rheumatology?

A. SLE targets are still not well defined; hopefully using the Lupus Low Disease Activity State (LLDAS) as a reasonable target will improve rates.

Q. What does this make you reflect on?

A. The frustrating inability to stop flares from occurring.

Dr Feng Pan is a researcher from the University of Tasmania with a special interest in chronic pain. He presented Circulating level of IL-6 is associated with 10.7-year knee cartilage volume loss and worse pain trajectory (OP0196) at the session The aftermath of metabolic imbalance in OA.

The presentation that caught his attention, also from that session, was Metabolic Syndrome and Osteoarthritis Pain: Common Molecular Mechanisms and Potential Therapeutic Implications, presented by Professor Ana Valdes from the University of Nottingham in the UK.

Q. What’s interesting about this presentation?

A. There is no cure for OA and pain control is not satisfactory. This presentation provides an overview of metabolic and molecular mechanisms in OA and OA-related pain. It has great clinical significance for developing treatments for OA and OA-related pain.

Q. How does this connect to broader themes in rheumatology?

A. In March 2021, the US FDA rejected tanezumab, a nerve growth factor (NGF) blocker that was considered a promising analgesic for patients with OA pain. Currently, the few pharmacological analgesics options available have limited efficacy and carry a substantial risk of adverse effects, so there is an urgent need for us to move forward. 

Q What does this make you reflect on?

A. My research interest focuses on developing targeted therapy for OA pain and I have developed OA pain subgroups that I think are convenient and stable phenotypic tools to select optimal OA pain populations for pain therapies. So, this presentation gives me an idea of how metabolic mechanisms drive OA pain heterogeneity I have identified in my future research.

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