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Would be helpful for us (and pts) to better understand rimmunotherapy agent specific risk on subsequent GCA/PMR
AFTRER propensity matching of >7k pt on combo nivolumab/ipilimumab compared to pembrolizumab:
- PMR RR 3.8x N/I vs. P
- no diff in GCA risk
@RheumNow #ACR24 https://t.co/IF4Gh7Cumd
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
🔶Clinical Year in Review #ACR24 🔶
Talk By @MHPillingerMD
• Review some of the most impactful studies in Rheumatology from the past year!
#RheumTwitter #Rheumatology https://t.co/1ULDB2l4gX
Mithu Maheswaranathan, MD MithuRheum ( View Tweet)
Older RA patients in RISE with high disease activity show a higher incidence of hip and major osteoporotic fractures. Practice T2T and monitor bone health closely!
#ACR24 @RheumNow ABST#1748 https://t.co/7MCAIrfXhp
Jiha Lee JihaRheum ( View Tweet)
RCTs are the gold standard in drug research, but rising placebo (PBO) response rates with global recruitment could distort treatment effects. Limited access to care in less affluent countries may be a factor.
#ACR24 @RheumNow ABST#1746 https://t.co/fVeNcw5qwO
Jiha Lee JihaRheum ( View Tweet)
SURPASS trial of bio naïve axSpA at risk of radiographic progression:
1. Presence of syndesmophytes
2. Higher CRP levels
3. Higher ASDAS
4. Higher spinal MRI BME scores
Were predictors of spinal progression independent of ttnt
Abst#1759 #ACR24 @RheumNow https://t.co/QC9FMPufPY
Links:
Adela Castro AdelaCastro222 ( View Tweet)
How does #race & #ethnicity impact mortality in RA?
Study in CDC national mortality database
➡️RA mortality differed by race & ethnicity
➡️Highest premature mortality in Native Americans
Findings may be used to inform resource allocation & management
Ab1747 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
Andreasson et al. High intensity interval training provides greater improvements in exercise capacity than standard moderate intensity training in IIM. @RheumNow #ACR24 Abstr#1735 https://t.co/baj7Cq2QjO https://t.co/yiE1vuk2me
Links:
Richard Conway RichardPAConway ( View Tweet)
A#1748
Fracture incidence in RA - RISE registry
Incidence rate of MOF, hip Fx by disease activity
50% did not have CDAI available
IR 12 per 1000py hip, 43 for MOF
High activity worst, low/mod similar, remission is best
Supports remission is better than LDA
@RheumNow #ACR24 https://t.co/78FCLemfZD
Eric Dein ericdeinmd ( View Tweet)
Can we do more to routinely assess fracture risk in RA?
In RA pts ≥65, hip fracture & MOF are more common in pts with active disease, worse with higher disease activity
➡️Need better and more frequent bone health assessments in our RA pts
Ab1748 #ACR24 @RheumNow https://t.co/whfnLnkpLd
Mrinalini Dey DrMiniDey ( View Tweet)
A#1747
RA mortality by race/ethnicity
Database study
>200,000 pts had RA as contributing cause of death
5.1 ASMR in American Indian >>> all other groups
No decr over time in grp, unlike other grps
Odds of death 1.67 compared to white pop
10.8x higher in pts <44
#ACR24 @RheumNow https://t.co/nXLcQkQPu4
Links:
Eric Dein ericdeinmd ( View Tweet)
A#1746 companion for RA
Like plenary for PsA, PBO response incr w time 1%/yr
More trials in less affluent countries may be related to increasing PBO response in trials
Possible reason: access to health care improves PBO in less affluent areas
@RheumNow #ACR24 https://t.co/S3LffF8vPH
Eric Dein ericdeinmd ( View Tweet)
RA patients on TOF with h/o ASCVD have 4x higher risk of MACE without statin (vs. TNFi).
Prioritize statins for heart health in RA!
#ACR24 @RheumNow ABST#1745 https://t.co/jRqXNU2T6d
Links:
Jiha Lee JihaRheum ( View Tweet)
Wallace et al. Case control study. 648 cases 1241 controls. Cumulative glucocorticoid dose and risk MACE. Dose dependent increase in risk, OR 1.01 for 10% increase GC, 1.21 for 10-fold increase GC. @RheumNow #ACR24 Abstr#1719 https://t.co/wraiWOl1dv https://t.co/feht58RDNc
Links:
Richard Conway RichardPAConway ( View Tweet)
A#1744 AI for RA to improve scheduling in UK
39% pts meet quality metric for early intervention
Input: RF, CRP, CCP, gender, age -> 51% accuracy (compare to first appt clinical accur 46%)
Focusing on highest risk -> 88% accuracy -> 50% wait time for high-risk pts
#ACR24 @RheumNow
Eric Dein ericdeinmd ( View Tweet)
Strive for remission (CDAI ≤2.8) to achieve better functional outcomes in RA
#ACR24 @RheumNow ABST#1743 https://t.co/qpsTF54rmW
Jiha Lee JihaRheum ( View Tweet)
In a cohort of >17,000 European pts w/ axSpA:
-bDMARD naïve pts starting TNFi or IL-17Ai were more likely to achieve LDA than TNF-experienced.
-Higher time to achieve LDA and shorter durability in pts with prior TNFi use.
Abst#1756 #ACR24 @RheumNow
Adela Castro AdelaCastro222 ( View Tweet)
A#1743
Are there benefits of getting LDA to remission?
Remission CDAI <2.8, VLDA 2.8-6, LDA 6-10
After 1 yr f/u of LDA, 45% Rem, 40 VLDA, 16 LDA
Not in remiss - higher BMI, longer duration, higher resource utilization, worse PRO
No clear diff bw remission & VLDA
#ACR24 @RheumNow https://t.co/ut7c52JVDr
Links:
Eric Dein ericdeinmd ( View Tweet)
A#1694
To get one or two lungs for lung transplant? 🫁
Autoimmune related ILD transplant outcomes?
145 single (SLT), 461 double (DLT)
Similar 1 yr mortality - HR SLT 1.19 unadjusted, 1.49 adj - not statistically significance
@RheumNow #ACR24 https://t.co/uo8WbrNFAm
Links:
Eric Dein ericdeinmd ( View Tweet)
Chevet et al. What happens when you withdraw tocilizumab after 6 months in PMR? Follow up of SEMAPHORE study. 80.8% relapsed! Median time to relapse 15 weeks. @RheumNow #ACR24 Abstr#1698 https://t.co/9pJ88C05V2
Richard Conway RichardPAConway ( View Tweet)
#Gout attack is assoc w 1.5 X MI, MACE in next 30 days
@ACRheum @RheumNow #ACR24 https://t.co/7IeFbW6xW8
Janet Pope Janetbirdope ( View Tweet)
