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NEW Guidelines for the Management of Takayasu Arteritis at #ACR19 (in one table!)
1. Everyone should get steroid sparing tx
2. Rec TNF > TCZ
3. Monitor pts closely!
4. Don't treat asymptomatic CRP
5. Med mgmt > surgical mgmt
Overall agreed - what about role of MTX?
@RheumNow https://t.co/vzpBHRDcKI
Mike Putman EBRheum ( View Tweet)
Do you feel comfortable combining apremilast with biologics in refractory/difficult to treat PsA patients ?
Olga Petryna DrPetryna ( View Tweet)
MMF potentially reduces serum levels of estrogen and progestin. Theoretically could reduce the efficacy of hormonal contraception. Consider IUDs and implants. #ACR19 @rheumnow #lupus
Maeve Gamble MaeveGamble ( View Tweet)
#RheumaTwitter celebrity @DrJuanOvalles is in the house! It was so wonderful to meet IRL! #ACR19 @RheumNow https://t.co/e2tAkkaZZL
Kanika Monga, MD DrKanikaMonga ( View Tweet)
What kind of level of disease control is enough in ANCA-associated vasculitis?
If you can get prolonged remission (BVAS=0 and PNL≥5mg/d for >2y) then you do better than even prolonged low disease activity. Something to target!
French Vasculitis Group #ACR19 ABST1684 @RheumNow https://t.co/L74kZOr9B3
David Liew drdavidliew ( View Tweet)
Certolizunab MRI study showed fewer inflammatory and structural lesions after 4y RX vs Placebo @RheumNow #ACR19 https://t.co/KgeVrPzvPy
Dr. Arthur Lau ArthurRheum ( View Tweet)
#acr19 @rheumnow Draft ACR guidelines for Takayasu:
1. Use noninvasive imaging over cath based imaging
2. Use high dose GCs
3. use DMARD with GCs (MTX, AZP, LEF, MMF)
4. With refractory dz, add TNFi (NOT TCZ!)
5. Monitor dz q3-12 months if in remission
k dao KDAO2011 ( View Tweet)
Therapeutic gaming (non-immersive environment)
Setting & games designed to meet the patient’s goal
Patients enter a state of flow & get engaged
#ACR19 @rheumnow 4M031 https://t.co/oJ7Ynz0Vvt
Dr Irwin Lim _connectedcare ( View Tweet)
MAS is a IFNg driven disease. Upstream IL-1 family members IL-18 and IL-33 are important treatment targets in MAS. Behrens E #ACR19 @RheumNow
Dr. Antoni Chan synovialjoints ( View Tweet)
Great question from the audience -> need to be very cautious about thromboembolic issues if thinking about using JAK inhibitors in #lupus #ACR19 @RheumNow Dorner
Philip Robinson philipcrobinson ( View Tweet)
Novel preliminary MRI Composite Structural Damage Score for SI joint assessment in axSpA including scoring of MRI progression of erosion through backfill to ankylosis. #ACR19 #ACRbest @RheumNow abst #1161 https://t.co/3eZs7B8QfC https://t.co/og7cjQ0e1G
Dr. Rachel Tate uptoTate ( View Tweet)
NEW Guidelines for the Management of Polyarteritis Nodosa (PAN) at #ACR19 (in one table!)
1. Go big w/biopsy
2. Cytoxan>Rituxan for severe dx
3. Follow cytoxan with GC sparing agent; stop after 18mos in remission
4. TNF for pts with DADA2
@RheumNow https://t.co/JhNIqVE9jH
Mike Putman EBRheum ( View Tweet)
Patients achieving low disease activity on Tofa 11mg were able to stop MTX and maintained similar SF36 scores @RheumNow #ACR19 https://t.co/s3vqVZq5Qf
Dr. Arthur Lau ArthurRheum ( View Tweet)
Hep C direct-acting agents have changed the game in Australia. Our national health coverage has a subscription model, and we're edging towards eradication.
I suspect our situation mirrors @HopPitieSalpe: new cases of HCV cryo vasculitis are going down #ACR19 ABST1723 @RheumNow https://t.co/upDbGQq3xW
David Liew drdavidliew ( View Tweet)
RheumNow's expanded coverage of the #ACR2019 annual meeting is sponsored in part by Sanofi Genzyme and Regeneron. All content chosen by RheumNow and its faculty.
Dr. John Cush RheumNow ( View Tweet)
Small study suggests subclinical inflammation detected by MRI in joints of hand in PsA patients in MDA. Abst #1171 #ACR19 #ACRbest @RheumNow https://t.co/WM3kmG1lYQ https://t.co/FaatgdlYbw
Dr. Rachel Tate uptoTate ( View Tweet)
How often do US gout patients have #urate testing? The % of the year they have a ULT script? The answers may surprise you...not in a good way. Dr Larry Edwards reviews his presentation at #ACR2019 on health care pathway/treatment for over 1 million #gout patients. @RheumNow https://t.co/Vg1axeEEu4
Gout Study Group GoutGroup ( View Tweet)
Toxicity of JAK inhibitors #ACR19 @RheumNow https://t.co/rqy1IfSEyP
Philip Robinson philipcrobinson ( View Tweet)
NEW Guidelines for the Management of GCA from #ACR19 in one table
1. Recommend TAB over TA U/S for dx GCA
2. Pts should receive TCZ upfront
3. Don't treat asymptomatic CRP, monitor patients closely
Overall in line with my practice, though I'm pro TA U/S
@RheumNow https://t.co/4mxcqqi1bA
Mike Putman EBRheum ( View Tweet)
IL-1 blockade beneficial in MAS. Ferritin to ESR ratio useful for identifying these patients. Cytokines Storm Syndrome is one way of thinking of the spectrum of conditions like MAS, HLH, auto inflammatory disease which respond to IL-1 and IL-6 blockade. Cron R #ACR19 @RheumNow
Dr. Antoni Chan synovialjoints ( View Tweet)