Tuesday, 20 Nov 2018

News

Checkpoint Inhibitor-related Myositis – Something Different

As expected, this year’s ACR meeting saw an upswing in the number of abstracts on immune related adverse events from checkpoint inhibitor therapy compared to last year. With the increase in approved indications for checkpoint inhibitors (CPIs), rheumatologists everywhere are going to be getting referrals for rheumatic irAEs.

Early Promise for Steroid-free Approach for Giant Cell Arteritis

A very small study presented at ACR18 looking at tocilizumab monotherapy in patients with a new diagnosis of giant cell arteritis has nevertheless given hope to the tantalising idea that some GCA patients might achieve drug-free remission without steroids, although broader data are required.

Pregnancy and Contraception in Patients with Rheumatic Diseases

A number of abstracts at this year’s ACR in Chicago highlighted issues around pregnancy and contraception advice in routine clinical practice.

ACR 2018 Podcast - Day 3

Audio Highlights and Interviews from Day 3 at the ACR 2018 meeting  LISTEN HERE

Hydroxychloroquine Dosing: the Great Debate

Rheumatologists tend to be a conservative bunch of people. We’re law abiding and we (mostly) follow guidelines. Which is fine when they are in the best interests of our patients, but what do we do when we fundamentally disagree?

ACR 2018 - Day 3 Report

Highlights from Tuesday, day 3 of the ACR Annual meeting in Chicago, included:

The PEXIVAS Study –  2x2 Trial of Plasma Exchange and Reduced Steroids in ANCA-Associated Vasculitis (AAV) - Abstract #2788

Axial Spondylitis Abstracts Roundup

There have been a number of interesting posters and presentations covering the field of axial spondyloarthropathy. I’ve picked out a few points that I found particularly relevant.

Classification Criteria

Negotiation Skills for Rheumatologists

Physicians as a group are trained to have excellent clinical skills, but the difference between an average and extremely successful physician often comes down to factors outside of their ability to provide clinical care. 

NK cells and a Potential Role in the Development of PsA vs PsC (Cutaneous Psoriasis)

Human NK cells express multiple receptors that interact with HLA class I molecules which, in turn, suppy peptides that bind HLA-E to form CD94/NKG2A NK receptor ligands. These peptides correspond to -22 to -14 residues in the leader sequences of HLA-A, HLA-B and HLA-C binding to the HLA-E site. Methionine – 21 delivers functional peptides in stark contrast to threonine – 21 which does not.

What is the Future of MTX for Psoriatic Arthritis?

Like most rheumatologists, I retain a deep and abiding love for methotrexate. And with each passing decade since the drug’s ‘re-discovery’ by rheumatology, evidence for a positive trade-off between its benefits and harms has continued to accrue, ensuring its role as the centrepiece of our treatment strategies for rheumatoid arthritis, even as an avalanche of biologics and targeted synthetic DMARDs has swept over us.

Autoimmunity in the Setting of Primary Immunodeficiency

There are many avenues for interdisciplinary collaboration within rheumatology, as our specialty encompasses every organ system and diseases with protean manifestations. The intersection of rheumatology and immunology is well known and has become increasingly important, given the association of autoimmune conditions with many of the primary immunodeficiency syndromes.

ACR 2018 Podcast - Day 2B

Audio Highlights and Interviews from Day 2 at the ACR 2018 meeting - LISTEN HERE