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ACR23 – Day 1 Report

Jack Cush, MD

ACR 2023 is back in San Diego for its annual convergence of thousands of rheumatologists to partake, discover and learn from thousands of abstracts and hundreds of sessions and presentations. It was a big return for the Poster Hall with rows and rows of research, friends, fellows and poster tours.  Below are a few of my favorite presentations from the posters, Plenary and oral sessions on day one.

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#ACR BEST Abstracts from San Diego – Day 1

Jack Cush, MD

The RheumNow faculty reporters have been scouring the meeting for what they believe to be the best presentations from the first day at ACR 2023 in San Diego.  From hundreds of online presentations, the poster floor and the plenary podium, here are some of the best abstracts from Sunday Nov. 12th. You can spot these on Twitter by looking for the (#ACRbest) hashtag.

Aurelie Najm Tweet
Split dose oral MTX (15/10mg) versus single dose (25mg) in RA RCT 250pts EULAR good resp 16wks 22 vs 10% (sig) 24wks 37 vs 28% (ns) 50% more addition of 2nd csDMARD in single dose #ACRBest @RheumNow #ACR23 ABST1583 For more thoughts, have a read https://t.co/urA6X4rY0D 👇🏼
Eric Dein Tweet
SMART on MTX Ab#1583 @RheumNow #ACR23 Single dose MTX 25 mg v Split dose (same day 15/10 mg). FA 5 mg 2x/wk. 16w can add csDMARD Split 29% vs 22% - EULAR response improve - not signif. Better DAS28 Split: 35% added 2nd csDMARD vs. 54.5% in single dose No stat diff in sAE #ACRBest
Robert B Chao, MD Tweet
Should Methotrexate be prescribed as split dosing? Multi-center, RCT of RA pts showed split dosing of 25mg MTX resulted in higher efficacy + reduced need for additional DMARDs, compared to single dose MTX @RheumNow #ACR23 Abs#1583 https://t.co/zjjnzWUl5E
Dr. Rachel Tate Tweet
SMART study #ACR23 Plenary abs #1583: po split-dose MTX (vs single dose) once weekly in RA pts had ^^ efficacy & reduced need for add'l DMARDs. No major AE, but slight increase in frequency of persistent transaminitis in split-dose group. https://t.co/wHzjpSnfuA @rheumnow https://t.co/0hNTMGbt47
sheila Tweet
The SMART study by Dhir et al: once-weekly, oral split-dose MTX (10mg/15mg) in RA pts had⬆️efficacy & ⬇️need for addtl DMARDs vs. once-weekly, single-dose MTX Reassuring. . . . In my practice, pts tolerate MTX split dosing better esp w/⬆️doses #ACR23 ABST1583 @RheumNow https://t.co/F8p2aKmmH4
Robert B Chao, MD Tweet
Does NSAID use = CKD? Large Korean study on CKD in ankylosing spondylitis pts showed risk of CKD associated with comorbidities. Long term NSAID use not associated with increased risk of CKD. @RheumNow #ACR23 Abs#1394 https://t.co/m3kYI30gBc
Janet Pope Tweet
To remind us. Glory be! GLORIA a #RCT in elderly active #RA: MTX+10 mg daily #prednisolone which was better than MTX alone. But more infections and no comparison of inexpensive Rx such as adding #HCQ. Still debated as to benefit vs risk of this strategy @RheumNow #ACR23 @ACRheum https://t.co/slOmESbIOW
Mike Putman Tweet
EBRheum
Interesting abstract re:dx trajectories, I have a counter-intuitive take I expect pts w/high dx activity to respond BETTER than pts w/LDA at diagnosis More autoimmunity + less fibro = higher chance to respond to DMARD? Anyone else feel that way? @RheumNow #ACR23 Abstr1426 https://t.co/D6GU7tMcY6
Meral K. El Ramahi, MD Tweet
MeralElRamahiMD
ABS0155 @ #ACR23 Economic impact of switching from SQ MTX (Rasuvo) from oral MTX in U.S. RA pts?' ➡️ Rasuvo associated with significantly higher all cause total expenditure $4704 predominantly due to higher costs associated tin all cause pharmacy utilization $4,223! @Rheumnow https://t.co/ry8XxjvHRg
Meral K. El Ramahi, MD Tweet
MeralElRamahiMD
ABS0433: ⭐️Older adults w/ RA less likely to receive tx w/ DMARDs despite being well tolerated and effective ➡️Retrospect, obs using Medicare data ➡️At least 66 yo old w/ new dx of late-onset RA (LORA) 🚩If no contraindications, start DMARDs early in LORA! #ACR23 @RheumNow https://t.co/ChalcgtS2O
Meral K. El Ramahi, MD Tweet
MeralElRamahiMD
ABS0450 ⭐️Baricitinib non-inferior as well as superior to TNFi in terms of ACR50 response @ 12w in real world csDMARD refractory RA patients ➡️open-label, T2T w/ Baricitinib (n=102) vs TNFi (n=97) ➡️DAS28-CRP remission (<0.6) in 74% of Bari vs 47% of TNFi #ACR23 @RheumNow https://t.co/yydS20hNzM
Catherine Hill Tweet
CatherineL_Hill
Need to improve our conversations with young adults on methotrexate about alcohol and sexual activity. They are often uncomfortable and/or dishonest about telling. Great work from @McMasterU by undergrad Matthew Sholdice #transition @drgrainnemurray #ACR23 https://t.co/wwyZLQVA51
Paul Sufka, MD Tweet
psufka
Takeaways from #ACR23 #ReviewCourse session on SpA Update: Radiographic and Non-Radiographic AS - Dr. Alexis Ogdie 1. Workup of inflammatory back pain: History, exam, CRP, HLA-B27, SI joint films, MRI pelvis (STIR images, no need for contrast). Response to NSAIDs not actually… https://t.co/M0W6UNsPxF https://t.co/7k3xl1RXZz
Meral K. El Ramahi, MD Tweet
MeralElRamahiMD
ABS0538: ⭐️Characteristics of difficult-to-treat (D2T) axSpA pts: ➡️HLAB27(-) ➡️smokers ➡️shorter symptom duration ➡️more enthesitis ➡️IBD ➡️concomitant NSAID use ➡️Co-morbidities (HTN, HLD, fibro, depress/anxiety) #ACR23 @RheumNow https://t.co/TqEVBeaJpb
Dr. Antoni Chan Tweet
Yield of repeated assessments of SpA features in patients with CBP suspected of axSpA was modest for the increase of new definite axSpA diagnosis at 2y. Sacroilitis on MRI, good response to NSAIDs at BL most predictive of axSpA, ML Marques #ACR23 @RheumNow https://t.co/LQ5llML11M https://t.co/PYcCDypI7c
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