Letter from the Editor EULAR 2020

Dear Reader,

I would like to welcome you to this summary of selected abstracts from EULAR 2020 that captures some key findings that have immediate clinical relevance or that will pique the community interest for further research towards improved patient care. This was the first ever virtual EULAR Congress reflecting the impact of the COVID-19 pandemic on the Global Rheumatology community. The Congress was due to take place in Frankfurt, which is a mere 45km from Mainz where sports terminology such as “heavy metal football” and “geggenpress”(counter press or on the front foot) have emanated and entered popular parlance.

I thought that these terms also applied well to the EULAR 2020 Congress in the context of the current pandemic. Rheumatology certainly had shining past with the Nobel Prize winning discovery of corticosteroids by the Rheumatologist Philip Hench and colleagues but had entered relative obscurity. The COVID-19 pandemic has shown Rheumatology now really is a “heavy metal” speciality with numerous therapeutic agents to treat inflammatory arthritis with these being repurposed and evaluated at the forefront of the COVID-19 battle. We now have a large squad of drugs and continue to acquire drug classes with several examples of these contained in the selected abstracts herein, such as the emergence of JAK inhibition as utility players in inflammatory arthritis and also covers aspects such as specialised drug players with more highly adapted roles in seronegative inflammatory arthritis and lupus.

The Congress also devoted time to dealing with the impact of COVID-19 in subjects taking DMARDS and also exploring the impact of DMARDS on reducing severe inflammation linked to COVID-19 in non-rheumatology patients. The 2020 SARS-CoV2 pandemic with its high inflammation levels linking to mortality and the absence of effective anti-virals has culminated in a rheumatological type “geggenpress” where our legacy drugs are at the forefront on strategies to contain this viral foe.

At the time of writing, corticosteroids have been the big winner in severe COVID-19 pneumonia. However, high-dose steroids in rheumatology patients may be a risk factor for more severe COVID-19. There was one other loser at EULAR 2020 and that was hydroxychloroquine where it failed to show efficacy in a clinical trial in OA, but the door was left open as there may have been an impact on pain. This is not dissimilar to the failure of hydroxychloroquine in COVID-19 pneumonia, although discussions lumbar on. The Rheumatology 2020 therapeutic geggenpress against COVID-19 is still very much in play. However, the EULAR e-congress appears to have been a great success and we, like Mr Klopp, the father of heavy metal football and geggenpressing, should take great solace from our achievements that have also taken place behind closed doors in 2020.

 

Sincerely,

Prof. Dennis McGonagle

 

Biography

Dennis McGonagle, FRCPI, PhD, is an Academic Rheumatologist at the University of Leeds and section head of Experimental Rheumatology. He graduated in Medicine from the University College Dublin in 1990 and undertook postgraduate training in Dublin and Leeds where he completed his PhD. He has developed the modern enthesitis model for spondyloarthropathies and psoriatic arthritis including the cytokine mediated enthesis originating theory of disease (Lancet 1998). He also described the synovioentheseal complex, nail anchorage to the skeleton, developed an integrated biomechanical and immunology model for PsA, and a mechanistic disease classification of immune diseases (PLoS Med 2006). His group also discovered synovial fluid mesenchymal stem cells, which is being researched towards osteoarthritis therapy development. Prof. McGonagle has also served on the EULAR scientific committee and is a member of the Editorial Board of ARD.

Conflict of Interest Statement:Prof. McGonagle has undertaken research and/or educational programme activities with Pfizer, MSD, AbbVie, BMS, UCB, Novartis, Celgene, and J&J.



 



Posted on 28 August 20205 August 2021