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Basic truths of irAEs:
Symptoms do not equal irAEs, in diarrhoea/colitis as in arthralgias/arthritis. Substantial proportion excluded on investigation
Local site Rx where possible: because they often work, and systemic steroids still can’t be exonerated
#ACR19 @RheumNow https://t.co/TJHQkKcvX8
David Liew drdavidliew ( View Tweet)
Normal inflamm markers in PMR: 14% (62/454) of the Nijmegen PMR cohort fell in this group, and they had similar rates of follow-up, steroid dependence, even similar rates of GCA (albeit low). A subgroup of PMR we need to understand better!
Diane Marsman #ACR19 ABST0759 @RheumNow https://t.co/XS2bPrWKUf
David Liew drdavidliew ( View Tweet)
One of the hardest things about PMR is getting a reliable diagnosis - no biomarker and no histopath. Imaging has potential, and my colleague @drceowen has made a simple algorithm for reliable/replicable PET/CT dx 👍
@DrCMcMaster @jlyleung @Austin_Health #ACR19 ABST0755 @RheumNow https://t.co/JGswa6Wjju
David Liew drdavidliew ( View Tweet)
The C-AxSpand study, Certolizumab-treated nr-axSpA pts with shorter symptom duration (< 5 vs ≥ 5 years) showed greater improvements across signs and symptoms of disease and in quality of life. Kay J et al #ACR19 @RheumNow
Dr. Antoni Chan synovialjoints ( View Tweet)
REDO trial: ultra low dose Rituximab for RA
500mg x 1 or 200mg x 1 compared against 1000mg
6mo non-inferiority
Could not formally show this but for many, ultra-low doses appeared effective
Should lead to longer term & tapering studies
#ACR19 @rheumnow Abst0931
Dr Irwin Lim _connectedcare ( View Tweet)
A Phase 2b study demonstrated the sustained efficacy of bimekizumab in pts with active AS to Week 48. Bimekizumab was generally well tolerated and no new or unexpected safety findings were identified #ACR19 @RheumNow
Dr. Antoni Chan synovialjoints ( View Tweet)
You can treat all of the Hep C all of the time - but you won’t get rid of related cryoglobulinaemic vasculitis >10% of the time.
SVR with DAA in HCV does not equal vasculitis cured!
(PS you can even get it de novo after SVR)
n=1019 Egypt, France, Italy
#ACR19 ABST0948 @RheumNow https://t.co/Lp3ZVMwTgj
David Liew drdavidliew ( View Tweet)
Here is result to save you looking it up in this highly refractory group
#ACR19 @rheumnow Abst0930 https://t.co/gYv7CZcMvL https://t.co/ToIavKEn4z
Dr Irwin Lim _connectedcare ( View Tweet)
Abstr# L14: data shows that in PsA you’re able to withdrawal MTX from the combo of tofacitinib+MTX without any loss of efficacy. Great news, because pts really like to minimize their meds when possible. #ACR19 @rheumnow https://t.co/3cDoTc1gWB
Dr. Paul Sufka psufka ( View Tweet)
@RheumNow #ACR2019 ABS899 Tart cherry concentrate had NO effect on serum urate, urine urate excretion or the frequency of gout flares over 28-day study period (p=0.76). However, those receiving allopurinol had significantly greater increases in urinary anthocyanins (p< 001) https://t.co/JJm9RCILoH
Olga Petryna DrPetryna ( View Tweet)
The amazing @GrantSchulert helps us begin to understand sJIA-associated lung disease #ACR19 @rheumnow #Abstr #ACRBest https://t.co/NGnjEYDBnL
Jonathan Hausmann MD hausmannMD ( View Tweet)
How would vagus nerve stimulation help Rheumatoid Arthritis??
#ACR19 @rheumnow Abst0930 https://t.co/NupaKJkXCL
Dr Irwin Lim _connectedcare ( View Tweet)
The C-VIEW open-label study found a significant reduction in the AAU flare rate in axSpA pts with a history of recurrent AAU during the first 48 wks of Certolizumab. Pts also experienced significant improvement in axSpA disease activity #ACR19 @RheumNow
Dr. Antoni Chan synovialjoints ( View Tweet)
@RheumNow #ACR19 ABS377 Stanford Univ retrosp stdy of pts w/ cardiac sarcoidosis supports use of TNFi in pts who failed cDMARs. Pts were able to reduce steroids dose w/no decline in LVEF in pts with preexisting CHF. larger, prospect studies needed
Olga Petryna DrPetryna ( View Tweet)
This is the device they used for the vagus nerve stimulation
#ACR19 @rheumnow Abst0930 https://t.co/XGKRjONTqf
Dr Irwin Lim _connectedcare ( View Tweet)
2 papers looking at TNFi on radiographic progression in Ankylosing Spondylitis. TNF inhibitor treatment slowed radiologic progression when compared to other therapies but covariables such as smoking and NSAIDs need to be considered #ACR19 @RheumNow
Dr. Antoni Chan synovialjoints ( View Tweet)
Filgotinib in RA (FINCH3); Another👍🏼 result for JAKi
How will we choose which JAKi to use in an increasing crowded space? Any thoughts?
#ACR19 @rheumnow Abst0927
Dr Irwin Lim _connectedcare ( View Tweet)
@rheumnow #ACR2019 ABS857 Stdy of 21 SLE pts received allogenic mesench stem cells IV ⬇️ inflamm through upregulation of periph tolerogenic CD1c+ DC, esp in LN. UC-MSCs express FLT3L that binds to FLT3 on CD1c+DCs to promote proliferat&inhibit apoptosis of tolerogenic CD1c+DCs
Olga Petryna DrPetryna ( View Tweet)
Over two years, there can be progression of facet joint ankylosis with most progression occurring in the thoracic spine. Whole spine low dose CT is a research tool to study progression of facet joint in radiographic axSpA patients. van Gaalen #ACR19 @rheumnow
Dr. Antoni Chan synovialjoints ( View Tweet)
#acr19 @rheumnow abstr#0849 #ACRbest
French database: Risk for CA in RA with biologics compared to traditional sDMARDS: n= 83,659
1. No ⬆️ risk solid malig
2. HR lymphoma 1.35. p value not sig
3. NO diff CA b/t biologic monoRx vs comb biologic + DMARD
*nonmelanomatous skin CA
k dao KDAO2011 ( View Tweet)