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Myositis -- Ask for muscle biopsy when:
- high clinical suspicion w/ negative myositis specific antibodies
- high clinical suspicion of inherited muscle disease
- isolated elevated CPK
- recalcitrant to treatment
- atypical presentation
#ACR19 @RheumNow
Kanika Monga, MD DrKanikaMonga ( View Tweet)
Sjogrens RCT of Tocilizumab showed no benefit. Wonder re outcomes and pt selection. Maybe pick early pts with high inflammatory markers or other organ involvement #ACR @RheumNow #Sjogrens abstr1904
Janet Pope Janetbirdope ( View Tweet)
Tofacitinib works in Polyarticular JIA. Maybe new hope for kids with JIA and benefits of oral medication #ACR #ACR19 #JIA @RheumNow L23.
Janet Pope Janetbirdope ( View Tweet)
Myositis-specific autoantibodies (MSA): an important tool to support the diagnosis of myositis
#ACR19 @RheumNow https://t.co/vgW2wxkemr
Kanika Monga, MD DrKanikaMonga ( View Tweet)
Certrolizumab pegol decreases uveitis in open label study of SpA with past uveitis and HLAB27 group enriched for recurrence. Pre and post Rx rates of uveitis were compared. 80% reduction of uveitis but uncontrolled and unblinded. #ACR #ACR19 @RheumNow
Janet Pope Janetbirdope ( View Tweet)
1/3 of pts using apremilast with PsA/SpA from Corrona data base are using it in combination with bDMARDs. Not sure how they get reimbursement #ACR #ACR19 #psoriaticarthritis @RheumNow abstract 1481
Janet Pope Janetbirdope ( View Tweet)
2020 Gout Clinical Practice Guideline
❕Regardless of disease activity, conditionally recommend
- limit alcohol intake
- limit purine intake
- limit high-fructose corn syrup
- if overweight/obese, recommend weight loss
- against adding vitamin C supplementation
#ACR19 @RheumNow
Kanika Monga, MD DrKanikaMonga ( View Tweet)
@RheumNow 2020 Gout Clinical Practice Guideline
‼️ For allopurinol and febuxostat, strongly recommend starting at low dose with subsequent dose titration to target over starting at higher dose ( ≤ 100 mg/d for allopurinol, ≤ 40 mg/d for febuxostat)
#ACR19 @RheumNow
Kanika Monga, MD DrKanikaMonga ( View Tweet)
Gout guidelines make total clinical sense. Congrats ACR and Goit me@bers for a monumental job #ACR @RheumNow https://t.co/A0iwU0WPlZ
Janet Pope Janetbirdope ( View Tweet)
All the NEW Clinical Practice Guidelines for GOUT!
1. Allopurinol is 1st line
2. Start ULT during flare!
3. No tx for asymptomatic hyperuricemia
Seems pretty reasonable - surprised no rec for MTX w/pegloticase
#ACR19 @RheumNow Thank you to @philipcrobinson for posting slides! https://t.co/riwHGYNZ8T
Mike Putman EBRheum ( View Tweet)
2020 Gout Clinical Practice Guideline
42 recommendations (16 strong)
- 27 ULT management (13 strong)
- 5 Gout Flares (3 strong)
- 5 Lifestyle recommendations
- 4 Management of other medications
- 1 Asymptomatic Hyperuricemia #ACR19 @RheumNow
Kanika Monga, MD DrKanikaMonga ( View Tweet)
Pericarditis is an inflammatory condition that causes chest pain, pericardial friction rub, pericardial effusion.
#ACR19 @RheumNow
Jonathan Hausmann MD hausmannMD ( View Tweet)
MAXIMISE results in axial manifestations of PsA. SEC met primary phase 3b ASAS 20 endpoint after inadequate NSAID response. https://t.co/e1j03KOo1K #ACR19 @RheumNow abs#2880 https://t.co/UtSDJGAW2G
Dr. Rachel Tate uptoTate ( View Tweet)
The draft 2020 ACR #gout guidelines were presented at the last slot of the meeting. Big changes for ULT initiation #ACR19 @RheumNow [Slides attached] https://t.co/bHBzQ3xwX8
Philip Robinson philipcrobinson ( View Tweet)
“Health tech isn’t just the future, it is the present” - @gnayyar
Listen to the incredible Dr. Geeta Nayyar talk to us about health tech, and about her favorite sessions at #ACR19!
@RheumNow https://t.co/OcYBws7pFE
Kanika Monga, MD DrKanikaMonga ( View Tweet)
CAPS (cryopyrin-associated periodic syndrome) is a heterogeneous group of autoinflammatory conditions that causes intermittent fevers (typically after cold exposure), as well as an urticarial-like rash. #ACR19 @RheumNow
Jonathan Hausmann MD hausmannMD ( View Tweet)
Remission ever or sustained in RA is same on triple DMARDs Therapy bs biological Rx. From Swedish register. ?channeling bias ?differential access? Either way this supports triple therapy use as impt in RA #ACR #ACR19 @RheumNow Abstract 2908 https://t.co/T8fRPr5a2A
Janet Pope Janetbirdope ( View Tweet)
Haploinsufficiency 20 (HA20) is a newly-described autoinflammatory disease caused by mutations in TNFAIP3, encoding the NF-kB regulatory protein A20.
#ACR19 @RheumNow
Jonathan Hausmann MD hausmannMD ( View Tweet)
Gout guidelines Allopurinol over febuxostat, dose low &slowly increase, T2T for serum Uric acid. Only Febuxostat if allopurinol failure/hypersensitivity. Only if failing with flares &tophi use peguricase. flares: colchicine steroids or NSAIDs #ACR @RheumNow https://t.co/ec6bOs5Hxo
Janet Pope Janetbirdope ( View Tweet)
2020 DRAFT ACR #gout Clinical Guidelines strongly recommend setting a serum urate goal and an active strategy to reach that goal @RheumNow https://t.co/8A6iTJgRPJ
Gout Study Group GoutGroup ( View Tweet)
