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Detectable hs-cTnT at baseline was associated with future MACE HR 5.6, in the hsCRP high→low cohort with high inflammation at baseline, not vice versa. hs-cTnT may provide additional info for assessing CV risk, Weber et al, Abst#0387 https://t.co/M4zyz2tzIO #ACR23 @RheumNow https://t.co/omMgpRzBA5
Dr. Antoni Chan ( View Tweet)
Non invasive screening for pulmonary involvement in early RA
Combination of PFT and Lung 🫁 US:
-50% with interstitial or focal changes or pleural effusion on US
-58% with abnormal DLCO
Correlation w/ higher disease activity.
Pathological meaning?
@RheumNow ABST 0393 #ACR23 https://t.co/BBcOEgcJK2
Aurelie Najm ( View Tweet)
WEAR study: adherence to wearable activity trackers in RA
Something that is consistent across all wearable studies is low adherence
Here under 50% for PRO + tracking
In an already selected population!
To implement, we need to make this better?
ABSTRACT 0344 @RheumNow #ACR23 https://t.co/csVZlzABGt
Aurelie Najm ( View Tweet)
Year in Review: Dr. P Seo
⭐️Does Pizza consumption favor improved dz activity in RA?
If in Italy
➡️ 365 pts w/RA in Milan: 18-65 yo w/ >3 mo dz
➡️Ate 1/2 a pizza > 1x/wk w/ decr in dz activity (SDAI⬇️: -3.6)
➡️Mozzarella & olive oil showed beneficial effects
#ACR23 @RheumNow https://t.co/qZTzThI39e
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Towards more personalised care in rheumatoid arthritis #ACR23 @RheumNow https://t.co/roxtcX8QHI
Dr. Antoni Chan ( View Tweet)
RA as a young woman used to mean kids were only a distant thought.
Japanese RA pts n=280 asked whether RA onset meant wanting fewer children & why.
Confidence improving across the board over time.
We want to give our RA pts choices to live their life!
#ACR23 ABST0473 @RheumNow https://t.co/OHZM2J5qxS
David Liew drdavidliew ( View Tweet)
Year in Review: Dr. P Seo
Novel RA therapy on the horizon:
⭐️ABBV-3373
➡️ Adalimumab (ADA) + GC receptor modulator vs ADA
➡️ Phase II, 48 pts, previously failed MTX
➡️ Wk 12: better DAS28-CRP, ACR20/70
🚩71% of responders stayed in remission after switch to PBO
#ACR23 @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Difficult to treat RA is not an homogeneous group!
Trajectory analysis 60months shows 4 different clusters
Cluster 2 = 1/3 of patients, do better but never reach LDA.
The ones Fibromyalgia, OA and other conditions blurring assessment?
#Abstract0382 #ACR23 @RheumNow https://t.co/dxxS7vCcMt
Aurelie Najm ( View Tweet)
Year in Review: Dr. P Seo
Novel RA therapy on the horizon:
⭐️Peresolimab
➡️ stimulates PD1
➡️ Phase II, 98 pts
➡️ tx-resistant to other therapies including biologics
➡️ Wk 12: better DAS28, ACR20, not ACR 50/70
#ACR23 @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
YR in Review: Dr. Seo
🚩GLORIA Trial
RA pts > 65yo: prednisolone 5 mg/d x 2 yrs vs PBO + std care
➡️decr dz activity (DAS ⬇️0.37) but 24% incr ADE
🚩Extension:
➡️Tapered off pred over 3m and..
⭐️NO ADRENAL INSUFF
But, small incr in dz activity (DAS ⬆️0.23)
#ACR23 @RheumNow https://t.co/YQbS6C8ZT5
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
It seems so simple. We should be able to use proteomics to better pick winners when it comes to b/tsDMARDs in RA.
Why is it hard? I guess:
- theory ≠ practice
- too many other factors
- it's too easy not to
Yet I hope/believe, one day we'll do better.
#ACR23 ABST0427 @RheumNow https://t.co/5VBVp3KOJN
David Liew drdavidliew ( View Tweet)
If you're >65 years old & have new RA, you start a DMARD, right? At worst, sometime in the first year?
US Medicare data 2008-17
n=33,373
only 30% have a DMARD on file
(of which bDMARD <10%)
>5% on PNL alone
Do we hate old people with RA?😔
@JihaRheum #ACR23 ABST0433 @RheumNow https://t.co/1CUXAh3fi0
David Liew drdavidliew ( View Tweet)
I underestimated how much joy not-bankrupting our healthcare system would bring me
ADA & RTX biosimilars have been wonderful; excited for IL6's to join the party
@RheumNow #ACR23 Abstr0445 https://t.co/HGwi37rZpd
Mike Putman EBRheum ( View Tweet)
Contributing Factors for Difficult-to-Treat RA using Natural Language Processing (NLP): joint erosions (OR 2.97 CI95% [2.17; 4.08], p< 0.001) , higher disease activity (median DAS28 3.16 vs 2.89) associated with D2T, Bergier Abst#0383 #ACR23 @RheumNow https://t.co/KARxoa2Z7H
Dr. Antoni Chan ( View Tweet)
COVID boosters in RA patients:
getting the job done (versus healthy controls, irrespective of non-withheld DMARDs excluding ritux)
@UChicagoMed #ACR23 ABST0416 @RheumNow https://t.co/HVRjC4dauw
David Liew drdavidliew ( View Tweet)
Can a picture tell a RA swollen joint?
(would be super useful for telehealth/remote monitor if so)
It's not prime time yet, but following with interest:
using photos to pick up on skin folds/joint swelling
Fascinating, but let's see it vs MRI, clinical
#ACR23 ABST0402 @RheumNow https://t.co/TFKiD5J4c8
David Liew drdavidliew ( View Tweet)
Year in Review by Dr. P Seo
NORD-STAR trial:
⭐️Abatacept or Certolizumab >> Tociluzumab > triple therapy in tx of 812 early RA patients based on clinical & radiographic results
➡️tx-naive, all got MTX
➡️mod-sev dz activity
➡️randomized to 48 wks therapy
#ACR23 @RheumNow https://t.co/vy2uYuyOse
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
NAFLD a real issue in RA
Does DMARD choice matter?
National Taiwanese data
newly dx RA n=41791
HCQ reduced NAFLD risk: adjHR 0.75
(other RF: obesity, NSAIDs, even low-dose PNL; but not DM, MTX)
Can HCQ improve liver health in RA?
Authors: ?adiponectin
#ACR23 ABST0396 @RheumNow https://t.co/9VMJpImFKs
David Liew drdavidliew ( View Tweet)
PROs are useful for tracking RA disease activity over time outside of the clinic setting for patients initiating new treatments without clinician-derived measures. Correlations in follow-up CDAI and PROs were 0.38 – 0.56, Nowell Abst#0380 #ACR23 @RheumNow https://t.co/LepCZ7sPY8 https://t.co/UYcZzIFEsx
Dr. Antoni Chan ( View Tweet)
Low-grade troponin rises in RA: ignore, or meaningful?
@BrighamWomens RA pts n=329
baseline hs-cTnT
Trops actually predict MACE:
HR 6.62
independent of traditional CV risk, CRP
Traditional CV RF not enough in RA
Maybe smoke does predict future fire?
#ACR23 ABST0387 @RheumNow https://t.co/33ZCgzYIl4
David Liew drdavidliew ( View Tweet)
