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ACR23 – Day 3 Report
These year’s annual ACR Convergence has been a success with the return of an insanely active Poster Hall! F2F learning amidst miles of research and many young talented aside wizened establish presenters is such a welcome return to ACR, the way it should be.
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Greigert et al. IL17 in GCA. Increases vascular inflammation. Synergistic effect on myofibroblasts with IFN-γ - increases IL-1B, IL-6, GM-CSF, CCL20 (recruits T cells), CCL2 (recruits monocytes), VEGF (neoangiogenic). Abstr#2599 #ACR23 @RheumNow https://t.co/p4GumZStAZ https://t.co/zZv0TF4fmn
Richard Conway ( View Tweet)
⭐️Further Assessment of a patient with rash c/w leukocytoclastic vasculitis:
👉History:
⏺️Timing, onset, progression?
⏺️Recent infectious for infectious symptoms?
⏺️Recent/new meds?
⏺️Hx of cancer?
👉Laboratory assessment for ALL:
⏺️CBC w/ diff
⏺️CMP (w/ interest in Cr,… https://t.co/tVqz6XDXt2 https://t.co/LqZpx5j0Bp
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
#ACRbest Peter Merkel as Distinguished Investigator said Data are good.
Need data to develop questions, understand #vasculitis Hx of #vasculitis - great minds & drugs -
now challenged by funding and comparators
Session 15W127 #ACR23 @RheumNow @ACRheum https://t.co/5leIeLWZ6O
Janet Pope ( View Tweet)
#vasculitis clinical trials are accelerating. Need the right time - early studies have lessons learned re feasibility and design/endpoints #ACR23 @RheumNow @ACRheum Great lecture - P Merkel 15W127 great graphs of vasculitis developments https://t.co/YRdPiaflxY
Janet Pope ( View Tweet)
#ACRbest Abstracts – Day 3
Today was a big day for the Plenaries, Curbside Consults, ACR Business meeting (and induction of our new ACR President Dr. Deborah Desir) and Late-Breaking Posters. Our hot-button reporters have compiled these #ACRbest abstracts for you! (November 14, 2023 at #ACR23)
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👨⚖️ The Great Debate: should we use advanced therapies / biologics at disease onset in PMR & GCA? #ACR23
By Dr. Robert Spiera & Dr. Phil Seo @philseo #Vasculitis #PMR #GCA https://t.co/rkcUeEBLeZ
Mithu Maheswaranathan, MD ( View Tweet)
Plenary Abs #2425: Pregnancies among vasculitis pts - higher frequency of spontaneous abortion and preterm delivery. Risk of maternal complications associated with vasculitis were observed to vary by vessel size and parity. #ACR23 https://t.co/qLcpNapcjg @rheumnow https://t.co/sk3dhySVfP
Dr. Rachel Tate ( View Tweet)
Rector et al. Pregnancy outcomes in vasculitis. More spontaneous abortion, elective termination, ectopic & molar pregnancy, x2 preterm delivery. Preeclampsia in 12%. Worse again in small vessel vasculitis Abstr#2425 #ACR23 @RheumNow https://t.co/cotncE16ma https://t.co/QoJpJIHJfJ
Richard Conway ( View Tweet)
Intriguing data on #GCA treated with tocilizumab
#aneurysm still occurs
#vasculitis https://t.co/6cPlFRReLJ
KenWarringtonMD MdWarrington ( View Tweet)
Nepal et al. No increased risk of GI perforation for tocilizumab in GCA HR 1.05 . Diverticulitis (RR 3.51), IV methylprednisolone (RR 5.41) risk factors. This fits with my priors, steroids are a bigger risk than tocilizumab. Abstr#2560 #ACR23 @RheumNow https://t.co/BAmBQA0kEP https://t.co/zRjmDIkOHp
Richard Conway ( View Tweet)
Great work @HoromanskiMd on a vasculitis in pregnancy plenary session! #ACR23 https://t.co/WSmqJjfBes
Mike Putman EBRheum ( View Tweet)
Fantastic presentation by Desh Nepal from MCW on risk of GI perforation in patients with #GCA
Low incidence , no association with TCZ, but increased risk with IV methylprednisolone and h/o diverticulitis.
@EBRheum #ACR23 https://t.co/bgvmjAXBEY
Sebastian E. Sattui MD, MS SattuiSEMD ( View Tweet)
Kaymakci et al. 49 GCA patients in clinical remission undergoing thoracic aortic surgery. Active aortitis in 82%. Abstr#2557 #ACR23 @RheumNow https://t.co/WQh47LThGD https://t.co/DeORKmjYP7
Richard Conway ( View Tweet)
Pregnancies outcomes in vasculitis:
- Higher frequency of spontaneous abortion and preterm delivery
- 12% had pre-eclampsia
- Risk higher in multiparous > nalliparous
- Risk highest in small vessel vasculitis
Rector A, Abst#2425 #ACR23 #ACRBest @RheumNow https://t.co/TgbRWw9il5
Dr. Antoni Chan ( View Tweet)
MANDARA -52wk,ph3 non-inferiority study comparing efficacy & safety of benralizumab & mepolizumab in EGPA receiving SOC
👉Benralizumab was non-inferior to mepolizumab in achieving remission at wks 36 & 48 (2.71%; 95% CI –12.54, 17.96; p=0.7278)
#ACR ABSTL14 @RheumNow #ACRbest https://t.co/S3aa3g5mnN
sheila ( View Tweet)
Vasculitis patients associated with increased pregnancy risks
Large study of >600 pregnancies in >500 pts
Vasculitis pts higher frequency of spontaneous abortion, elective termination, ectopic and molar pregnancy, preterm delivery
12% pre-eclampsia
@RheumNow #ACR23 Abs#2425 https://t.co/Nqa77nxSFu
Robert B Chao, MD ( View Tweet)
Pregnancy outcome in Vasculitis - Claim database study
A#2425 #ACR23 @RheumNow
665 vasculitis pts, LVV 60, MV 160, SVV 217, variable 250
Incr risk of preterm delivery, particularly medically-ind deliv, esp Small vessel vasc (5x risk med-induced)
Higer risk pre-eclampsia/eclampsia https://t.co/bWMyY5oqNK
Eric Dein ( View Tweet)
Important data re:ADVOCATE study and health related quality of life
Interesting question: is this due to AVA or just simply giving less steroids?
I discuss this on recent podcast: https://t.co/7Jm6ArFpsB
@RheumNow #ACR23 https://t.co/53T1p2Vvyb
Mike Putman EBRheum ( View Tweet)
MANDARA: Benralizumab v Mepolizumab in EGPA
A#L14 #ACR23 @RheumNow
P3, 52w RCT, 140 pts
Remission rate: 59% Ben, 56.5% Mep
Relapse rate 30% in both
86% Ben, 74% Mep had reduction of GC dose 50%+, 41% v 26% tapered off
SAEs: 6% Ben, 13% Mep
Concl: Non-inferiority of Ben v Mep https://t.co/mSIFsDq8eL
Eric Dein ( View Tweet)