#Vaccinate your #SARD Pts esp if given strong #immune #suppression #Taiwan #College of #Rheumatology #recommendations for #vaccines Pre & Post #CAR-T Can apply for #IMMUNESUPPRESSED Pts in general who get #B #cell #depletion #ACR26 abst#2773 @RheumNow https://t.co/34xcBjsD99

Immune-Related Adverse Events: ICI-IA: the most common rheumatic irAE-> Heterogeneous presentation. 50-78% persist >6m after stopping ICI. Usually seronegative and have elevated inflammatory markers. ICI-PMR: some pt with peripheral inflammatory arthritis, less likely comorbid https://t.co/Ad5FPGZ8nP

Importance of genetics in rheumatic diseases #ACR26 #ReviewCourse @RheumNow https://t.co/weDtEQH0Cb

Don't use MTX post TCZ stoppage METEORITICS randomized 52 patients to MTX vs placebo post TCZ. NO difference in time-to-relapse (see km curve) Small trial & more flares in PLBO group... but difference not worth MTX exposure/ade/etc @RheumNow #ACR26 Ab#0179 #ACRBest https://t.co/BBz7eXwZhz

Depth of B Cell depletion matters 44 myositis pts on RTX - conventional B cells did not identify rewsponders... ...but highly sensitive flow (2 log higher sensitivity) did (93% of responders vs 31% of nonresponders) Promising biomarker but also suggests deeper b cell depleters https://t.co/LtWEg6NuyW

The Concern about Seronegative RA A current review of seronegative RA (SNRA) by D’Onofrio, et al in npj Autoimmunity shows the diverse fate of seronegative RA - which can resolve, persist or become refractory. Clearly dedicated trials of SNRA are needed to better predict. https://t.co/6OQhYemkUX

FDA Approves Tildrakizumab for Psoriatic Arthritis Sun Pharmaceuticals announced Friday that the FDA has approved its IL-23 inhibitor, tildrakizumab (Ilumya) for use in patients with active psoriatic arthritis. https://t.co/9vJoJ35iso https://t.co/KeA3Xh8QG9

-AZA is safe in pregnancy but can cause risk of ICP. -Monitor pts on AZA closely for ICP symptoms. #ACR26 @RheumNow https://t.co/v9mNKVNKcm

Emergence of systemic autoimmune rheumatic diseases can occur in menopause and difficult to differentiate from "MS syndrome of Menopause" HRT: Safe in Non-SLE autoimmune disease/SLE with negative APL+ use with caution/Not recommended in APL+/APS #ACR26 @RheumNow https://t.co/6al61n1ck3

-Biologic DMARDs are generally safe for pregnancy: ETA and CZP safer compared to others. -B cell depletion can be used in pregnancy but caution about neonatal cytopenias for first 6m if dosed in 2nd half og pregnancy. -Counsel on vaccination for biologic exposed babies. #ACR26 https://t.co/byQgPpAveT

After stopping TCZ in GCA (~2 yrs exposure), over HALF of pts still flared w/in 72 weeks, even among pts w/imaging remission Most flares 3-6 mos post stopping Good evidence for continuing longer; I continue many pts on TCAZ up to 5 years post dx @RheumNow #ACR26 Ab#0186 https://t.co/yq0rXv1l3S

Nice RWE study of UPA in GCA Refractory cohort w/multiple prior biologics; 22/34 evaluable pts had clinical remission at 6 months; 7/63 stopped for severe adverse events. Useful real-world signal, overall corroborates SELECT-GCA @RheumNow #ACR26 Ab#0184 https://t.co/hGRFAoV6B4