Letter from the Editor

Dear colleagues,

The EULAR 2021 Congress was again an E-congress that was originally planned for Paris in the early summer of 2021.

Naturally, there was considerable interest in the inter-relationships between SARS-CoV-2 viral infection or vaccination and rheumatic diseases and the impact of anti-rheumatic drugs on vaccination. The key findings are summarised in this report, including the impact of Rheumatology drugs including rituximab and JAK inhibitors in blunting humoral immune responses, which is not unexpected. Further work is needed on the impact of DMARDs on cell-mediated immunity to SARS-CoV-2 infection. Rheumatology cases fared well following vaccination, with little evidence for severe disease exacerbations beyond occasional case reports that are well recognised after infection or vaccination in general.  On the flipside, the evidence for the use of anti-rheumatic drugs as therapy for severe COVID-19 pneumonia including tocilizumab and corticosteroids for severe COVID-19 has continued to accumulate.

Other highlights from the meeting included consolidation of the IL-23 blockers in psoriatic arthritis and further evidence for excellent safety. Unlike inflammatory arthritis, investigators embarking on exploratory studies into SLE-related nephritis have further work to do to etch out a niche for anti-IFN therapy. In the case of osteoarthritis, the use of molecular therapies aimed at cartilage regeneration or for the targeting of inflammation have not either worked or are a long way from the clinic.

We look forward to hopefully meeting again in person at EULAR 2022. For this to happen, the rheumatologist’s natural enemy, the fully primed or auto-aggressive immune system that is responsible for so much of our workload, will hopefully show why it is also our greatest friend by warding off and intercepting SARS-CoV-2 mutants that could overcome the original vaccinations strategies and also progressively establish herd immunity. Let’s hope so!

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.

 

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Posted on 2 August 20213 August 2021