Conference Reports
The study of rheumatic diseases: 8th EULAR Barcelona
13th-16th June 2007
This year's European Congress of Rheumatology was held in Barcelona, Spain and blessed with its enchanting sunshine. In this stylish and cultural capital, The Centro Convencions International Barcelona attracted over 12,000 attendees from the allied health professional industries worldwide, representing a huge 30% increase from last year. With 1,482 posters on show and 1182 presentations, this year's EULAR schedule was extensive, reflecting the organisation's ongoing commitment to research with an aim to reduce the social and economic burden of rheumatic diseases.
The opening ceremony provided an excellent introduction, with tributes to past presidents and welcoming comments from the President Tore Kvien. Traditional Catalonian dancing followed interspersed with speeches from EULAR members. Most memorable was Martin de Wit (Vice-president representing the Social Leagues), who highlighted that Gaudí, the local architect and master of many Barcelonan buildings, was 'a long-term sufferer of rheumatoid arthritis from the age of six, and from him we could learn that certainly having such an illness does not prevent one from living and fulfilling their dreams'.
The programme began with a strong plenary open session addressing genetics, spondyloarthropathies, and epidemiology's role in the future treatment of rheumatic disorders. Simultaneously, parallel symposia with invited speakers took place, hosted by the big players in the pharmaceutical industry, including Lilly, Encysive, Roche/GSK, Rottapharm, Wyeth, Pierre Fabre, Pfizer and CombinatoRx to name but a few.
Among the presentations of cutting-edge research data were findings from ongoing genetic studies that have identified further risk factors associated with common rheumatic diseases. Data were presented on the identification of the IL-23 receptor as a newly-recognised risk factor for ankylosing spondylitis. Investigators from the Karonlinska Institute, Stockholm, Sweden, reported on findings that the non-HLA loci have a moderate but distinct effect on the genetic risk for rheumatoid arthritis (RA), depending on whether the RA is anti-CCP-positive or -negative.
Thursday saw an overview of RA, covering the concepts of pathogenesis and how this translated to new therapies. A more in-depth analysis was found at the 'Anti-TNF-therapy' session on RA, offering novel presentations describing the use of existing TNF-blocking agents such as etanercept and infliximab (IFX). Ferdinand Breedveld's group from the VUMC found that initial treatment with MTX (methotrexate) + IFX in patients with early-onset RA is more effective than reserving MTX+IFX for patients who failed previous DMARDs, resulting in more reduction in DAS and HAQ, more patients in clinical remission and more successful discontinuation. This further supports the theory that a window of opportunity exists to achieve an optimal effect of antirheumatic treatment. Investigators from UCB presented new data indicating that MTX monotherapy is insufficient compared to combination with certolizumab pegol 200mg every 2 weeks after 3 initial doses of 400mg, which showed a fast and significant effect in reducing the signs and symptoms of active RA.
On Friday, the 'New Biologics' session discussed data on the value of abatacept (ABA), tocilizumab and rituximab. Bristol-Myers Squibb (BMS) presented data showing a significantly higher flare rate in placebo-treated children and adolescents with active juvenile idiopathic arthritis than in ABA-treated patients and no adverse events of note. A further 1yr double-blind, randomized, placebo-controlled BMS trial of ABA or IFX treatment in RA patients with an inadequate response to MTX showed that at Day 197, clinical benefits were similar with either ABA or IFX. At day 365, the differences in mean scores/responders for the evaluated clinical efficacy measures were better for ABA, suggesting that ABA exhibits a more durable response than IFX through 1 year. A large Phase III study completed by Roche demonstrated the safety and tolerbility of tocilizumab, a novel monoclonal antibody targeting IL-6 signalling.
An option to break away from the scientific mania and enjoy the scenery of the city came on Friday evening, when EULAR's 60th anniversary celebration took place at Park Güell. A colourful candyland of gingerbread palaces and Dr Zeus-style landscapes located on a bare mountain in the neighbourhood of Gracia was a stunning and uplifting location for the festivities.
With minds well rested but possibly some sore heads, Saturday began with a special lecture on cytokines and the future of therapeutics in rheumatology followed by poster viewing and some strong scientific parallel sessions. New this year was the inclusion of the most recent EULAR recommendations for the management of rheumatic diseases and presentation of data concerning the agents rilonacept and ofatumumab in the session 'Non-TNF Biologics - Clinical Aspects'.
This year's congress was a scintillating success and hopefully the benefits of this meeting of great minds will translate from bench to bed, to arthritis patients worldwide. The 9th EULAR congress will take place in Paris, France, on 14-18 June 2008; one can only hope it will provide as inspiring an educational platform for advancing the field of rheumatology as the meeting did this year.
Una O'Rawe
Pharmaprojects Analysts
