All News
Rheumatology Round-Up 2020 Tonight!
Rheumatology Round-Up tonight 8:00pm EST, 7pm CST. Drs. Artie Kavanaugh and Jack Cush reprise their long-running end of ACR highlights. Rheums can watch by Zoom (Q&A too), everyone can watch on RheumNow.com or our YouTube channel. See you there!
Read Article
Late breaking: in older #rheumatoidarthritis patients, those taking MTX have 2x risk of #VTE compared to those on HCQ. Important to consider #thromboembolic risk factors when starting new RA treatment.
Abs#2000 #ACR20 @RheumNow
https://t.co/lt8xDT4Ne8
Mrinalini Dey DrMiniDey ( View Tweet)
Which DMARD would you use in an RA pt Rx naive pt with mod dz activity and who has RA lung dz?
#acr20 @RheumNow
k dao KDAO2011 ( View Tweet)
Large cohort of older RA pts newly rx w/HCQ or MTX:
👉~2-fold ⬆ risk of VTE – both PE and DVT- among patients newly treated with MTX vs. HCQ.
@RheumNow #ACR20 abs#2000 @DanielHSolomon https://t.co/ZnDuMhTMYF
sheila RHEUMarampa ( View Tweet)
HCQ not associated with ⬆ incidence of cardiac dse in this cohort of RA pts.
We should continue using it. Benefits >>>risks.
@RheumNow #ACR20 abs1999 https://t.co/zYpbX0CsR1
sheila RHEUMarampa ( View Tweet)
NEW ACR2020 Draft Guidelines for the Pharmacologic Treatment of RA
All the guidelines in 2 tables!
1. MTX 1st, oral > SC
2. Minimize GC!
3. TTT TTT TTT
4. Biologic/tsDMARD > Triple Tx
5. Taper MTX 1st
Close to my practice; suspect will be controversial!
#ACR20 #ACRambassador https://t.co/iFSlq1H65V
Mike Putman EBRheum ( View Tweet)
Abst#1717 confirms that early start of csDMARDs as 1st line tx & keeping ts/bDMARD as 2nd line tx (or more) is associated w/ a favorable outcome at 10 yrs in the ESPOIR cohort (a French multi-center cohort that followed patients w/ early RA). #ACR20 @RheumNow https://t.co/bzZiShCF97
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
@SSNaushon MTX remains backbone of therapy given low cost, safety profile, and long experience with it. Majority of pts do well on MTX and do not require TNFi @Rheumnow.
Eric Dein ejdein1 ( View Tweet)
Patient-physician discordance seen in ~30% #rheumatoidarthritis patients starting #DMARDs
- ↑Patient-reported pain & functional impairment assoc. w/ discordance
- Patient-centric treatment discussions needed to reduce discordance
Abs#1978 #ACR20 @RheumNow
https://t.co/CdlHrBOdy0
Mrinalini Dey DrMiniDey ( View Tweet)
Very strong push by #ACR20 to recc MTX in most RA patient scenarios including RA ILD, RA nodules, NAFLD in new RA guidance document @rheumnow
k dao KDAO2011 ( View Tweet)
You have a patient with RA on 25 mg MTX SQ, tolerating well without side effects. They have moderate disease activity. Your next step: @Rheumnow. #ACR20
Eric Dein ejdein1 ( View Tweet)
New #ACR RA guidelines is cost conscious:
1. DMARD naive: Preferred MTX over LEF>HCQ/SSZ and preferred MTX over biologic/tsDMARD
2. DMARD naive low DAS: HCQ or SSZ preferred >MTX>LEF
3. T2T goal LDA/remission
@rheumnow (thread)
k dao KDAO2011 ( View Tweet)
Switching or adding a DMARD in pts w/ moderate-high dz RA activity & hx of previous serious infection w/in the past 12 mos as opposed to starting/increasing GCs is conditionally recommended per draft recs of new ACR RA treatment guidelines. #ACR20 @rheumnow @CCalabreseDO
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Draft #ACR20 Rx Recs for RA: MTX is conditionally recommended with NORMAL LFTs and no advanced fibrosis. Role of HCQ for NALFD has been suggested at ACR, but not enough for mod-high disease activity @RheumNow. https://t.co/QFF3BK1NF0
Eric Dein ejdein1 ( View Tweet)
Draft #ACR20 Rx Recs for RA: on max tolerated MTX - add bio or tsDMARD conditional recommendation over triple therapy (MTX, HCQ, SSZ). @RheumNow. https://t.co/s6fKEW8czc
Eric Dein ejdein1 ( View Tweet)
Draft #ACR20 Rx Recs for RA: Use MTX, starting oral but remember MTX tricks to maximize success. Folic acid, split dosing, SubQ all keys per Dr. O'Dell to maximize @RheumNow. https://t.co/8K9BjotZha
Eric Dein ejdein1 ( View Tweet)
I am glad now that chloroquine is not available (permanent back order) in Canada as results of high retinal toxicity w chloroquine was sobering & changed my practice. I won’t use it long term @RheumNow #ACR20 @CRASCRRheum abstr#1825 https://t.co/1RQi41uV1B https://t.co/lc9za22Zw1
Janet Pope Janetbirdope ( View Tweet)
A large observat study showed no difference in risk of major CV events in RA pts that were newly started on either MTX or HCQ. A greater stroke risk but lower risk of MI & hospitalized HF was seen in MTX initiators. #Abst1993 #ACR20 @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Using a panel of urinary prtns, data from this study show transferrin, AGP1, ceruloplasmin, MCP1 & sVCAM1 are sig. ⬆in active LN pts.
More studies req'd for confirmation.
Utility in monitoring renal response to tx?
@RheumNow #ACR20 abs1796 https://t.co/3Zicpz3uDd
sheila RHEUMarampa ( View Tweet)
We need to work together with our patients to ensure medication adherence during this pandemic.
1⃣30% of 734 pts on DMARDs changed their med use during COVID
2⃣Med change without physician guidance
3⃣Changes resulted in ⬆️steroid use
@RheumNow #ACR20 Abs#L05 https://t.co/n18zqed4wC
Robert B Chao, MD doctorRBC ( View Tweet)