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Checkpoint Inhibitor-related Myositis – Something Different
As expected, this year’s ACR meeting saw an upswing in the number of abstracts on immune related adverse events from checkpoint inhibitor therapy compared to last year.
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Dr. Polly Ferguson
SAPHO dx criteria, Kahn 2003
including
-bone /joint involvement with psoriasis
-bone joint with severe acne
-isolated steroid hyperostosis/osteeitis
-CRMO (children)
-bone-joint with IBD
excluding:
-bone tumor
-non inflammatory
#ACR18 @RheumNow
Suleman Bhana, MD DrBhana ( View Tweet)
Common patient concern: Humira and pregnancy.
IgG does not cross the placenta until 12-15 weeks. Consider discontinuing in late second trimester or early third trimester to avoid high serum drug concentrations in the newborn 🤰🏻 #ACR18 #CleClinicRheum
Emily Littlejohn ELittlejohnDO ( View Tweet)
Dr. Kavanaugh: Abstract 826.
https://t.co/X0MKvAO3UV
Does Anti-Glomerular Basement (anti-GBM) Antibody Positivity Correlate with Relapse in Patients with Anti-GBM Disease? —Presence of ANCA predicts relapse. #ACR18 @RheumNow
Suleman Bhana, MD DrBhana ( View Tweet)
Dr. Cush
ABSTRACT 898
Efficacy and Safety of Tocilizumab for the Treatment of Systemic Sclerosis: Results from a Phase 3 Randomized Controlled Trial —missed RSSS outcome, but improved lung function #ACR18 @Rheumnow
https://t.co/E7LdBEfXWc
Suleman Bhana, MD DrBhana ( View Tweet)
Dr. Kavanaugh: Abstract 1068.
Role of Cannabinoid CB2 Receptor Agonist, in IL-1β-Induced Inflammation in RA Synovial Fibroblasts —CB2 therapeutic target
#ACR18 @RheumNow
https://t.co/fZoPnLKQcjβ-induced-inflammation-in-human-rheumatoid-arthr…
Suleman Bhana, MD DrBhana ( View Tweet)
Dr. Cush
abstract 428
Significant Pain Reduction with Oral Methotrexate in Knee Osteoarthritis; Results from a Randomised Controlled Phase III Trial of Treatment Effectiveness —improved pain but not clinically meaningful
#ACR18 @Rheumnow
https://t.co/S9wHaKjDLB
Suleman Bhana, MD DrBhana ( View Tweet)
Dr. Kavanaugh
Highlighting a Session: ACR Immunology update
B Cell directed therapy, Dr. R. John Looney from Rochester, NY
“Next Generation of B Cell and Plasma Cell Therapies” —looking for new targeted therapies
#ACR18 @RheumNow
Suleman Bhana, MD DrBhana ( View Tweet)
Dr. Kavanaugh
ABSTRACT: 1234
Incidence of Conversion of Screening Tests for TB (PPD, GIF-release assay) in Patients Treated with TNF-α Inhibitors —small no. of patients converted but in higher risk patients
https://t.co/k6nRyIGGlUα-inhibitors/
#ACR18 @RheumNow
Suleman Bhana, MD DrBhana ( View Tweet)
#Rheum roundup gives highlights from Reproductive Guidelines, draft presented at #ACR18:
-Ask early and often about pregnancy and contraception. These are important conversations.
-No MTX, leflunomide, CYC, MMF in pregnancy
-Healthy mom➡️healthy baby
Dr. Erin Tree DrTinyTree ( View Tweet)
Dr. Kavanaugh
Abstract 1175
(no link)
Sweedish study: ETA biosimilar rx habits and prices. Biosimilar usage increases until originator med price drops, then biosimilar usage drops
#ACR18 @RheumNow
Suleman Bhana, MD DrBhana ( View Tweet)
Dr. Cush
ABSTRACT: 2220
Gout, Flares and Allopurinol Use: A Population Based Study. —Australian study, large number of under treated with rate lowering therapy. Also, see abstracts: 1247, 1272. #ACR18 @Rheumnow
https://t.co/BJKqxFtuvG
Suleman Bhana, MD DrBhana ( View Tweet)
Dr. Kavanaugh
ABSTRACT: 404
Interleukin 17A– a Translational Target to Treat Supraspinatus Tendinopathy —found high IL17A in human SS tendinopathy. Then rodent model, IL17A blockade improves tendon structure/function
#ACR18 @Rheumnow
https://t.co/wa8R9UBplR
Suleman Bhana, MD DrBhana ( View Tweet)
Dr. Cush
ABSTRACT: 2788
The Effects of Plasma Exchange & Reduced Glucocorticoids during Remission-Induction for Treatment of Severe ANCA-Assoc Vasculitis —PE did not reduce risk of ESRD or death. Lower GC use did not inc death or ESRD
#ACR18 @Rheumnow
https://t.co/vI0s74b68T
Suleman Bhana, MD DrBhana ( View Tweet)
Dr. Kavanaugh
ABSTRACT: 2264
Methotrexate in the Treatment of Granulomatous Mastitis: A Retrospective Review of 19 Cases
—seen in multiparous Hispanic females, successfully treated with MTX
#ACR18 @Rheumnow
https://t.co/oGh8x1wgLg
Suleman Bhana, MD DrBhana ( View Tweet)
Dr. Cush
ABSTRACT: 837
Efficacy of High-Dose Versus Standard-Dose Influenza Vaccine in Seropositive Rheumatoid Arthritis Patients —improved immune response to HD vs. SD for its on DMARDS +/- Biologics (except RTX), no increase Dz activity #ACR18 @Rheumnow
https://t.co/pviGwSNeVK
Suleman Bhana, MD DrBhana ( View Tweet)
Dr. Cush
ABSTRACT: L11
Etanercept & MTX As Monotherapy or in Combination in Patients with Psoriatic Arthritis: A Phase 3, Double-Blind, Randomized Controlled Study —Addition of MTX to ETN did not improve efficacy compared with ETN alone. #ACR18 @Rheumnow
https://t.co/6y8OTEVgPB
Suleman Bhana, MD DrBhana ( View Tweet)
Great to see our review article, 'The Impact of #Fibromyalgia in #Spondyloarthritis: From Classification Criteria to Outcome Measures' published in @FrontiersIn https://t.co/FjsseFlj0R @alessia_alunno #rheumatology #rheum #dontdelay #connecttoday
Simon Stones SimonRStones ( View Tweet)
#ACR18 For some background reading on your journal home, check out our #NovemberIssue.
Covering hand #osteoarthritis, the IL-23-IL-17 pathway in #bone, genetics and epigenetics in #systemicsclerosis and environmental factors in osteoarthritis.
https://t.co/VjcHwD0rIG https://t.co/9Gi3PfUWMz
Links:
NatRevRheumatol NatRevRheumatol ( View Tweet)
Terrific thread increasing your influence #ACR18
—Knowing what your personal&institutional priorities are is a key first step
—Understanding culture of different organizations and fields also critical as we work in interdisciplinary teams @LonaMody @LFerranteMD @TideswellUCSF https://t.co/NIPbHpzMBP
Una Makris UnaMakris ( View Tweet)