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Use of antiTNF in childhood does NOT appear to increase risk of malignancy in adults according to Medicare claims data, but possibly a malignancy signal seen related to underlying disease. #ACR18 #pedsinreview @rheumnow
Nicole Bitencourt NicoleBitencou5 ( View Tweet)
In pts with #dermatomyositis, extracellular vesicles (EVs, released from almost all cells) induce secretion of important pro-inflammatory cytokines. #ExtracellularVesicles are likely important in the #pathogenesis of DM. Abstract1335 Dr. Krisha Desai #ACR18 @RheumNow https://t.co/naMIRuq8JQ
Nicole Bitencourt NicoleBitencou5 ( View Tweet)
Lysinuric protein intolerance, a urea cycle disorder, can #mimic #SLE with #lupusnephritis and #MAS. #osteopenia also seen. Need high index of suspicion. #GeneticMimicsOfRheumaticDisease #ACR18 @RheumNow https://t.co/sx2cUPgH73
Nicole Bitencourt NicoleBitencou5 ( View Tweet)
#DownsArthritis (often an erosive polyarticular arthritis of small joints) is distict from poly #JIA by analysis of #synovialBx. More CD3+ cells, macrophages, and CD20 cells in joints of kids with Down's arthritis. Abstract2024 Dr. Charlene Foley #ACR18 @RheumNow
Nicole Bitencourt NicoleBitencou5 ( View Tweet)
45% of pts with #MAS and 62% of pts with #secondaryHLH carry a heterozygous variant of a gene generally associated with #primaryHLH. Having multiple variants assoc w worse and recurrent MAS or HLH. Abstract 2014 Drs. Passarelli and Bracaglia #ACR18 @RheumNow0 https://t.co/t0AGzQ8c7r
Nicole Bitencourt NicoleBitencou5 ( View Tweet)
Among 14 pts with #JIA #ERA (enthesitis related arthritis) who failed 1+ antiTNFs, #secukinumab led to some improvement in the JADAS 10 score at 6 months. The 300 mg dose required in over half of pts. Abstract2386 Dr. Ivan Foeldvari #ACR18 @RheumNow https://t.co/cnVBqreGEG
Nicole Bitencourt NicoleBitencou5 ( View Tweet)
Compunded triamcinolone hexacetonide (the steroid formerly know as #Aritospan) showed significantly lower rates of joint flares compared to triamcinolone acetonide in #JIA20% vs 72%. Abstract2387 Dr. April Bingham #considercompunding #ACR18 @RheumNow https://t.co/BMBa4Z2p3t
Nicole Bitencourt NicoleBitencou5 ( View Tweet)
Secondary tumoral calcinosis in #SLE. A benign condition characterized by massive periarticular #calcification and associated with CTDs. Image by Dr. Leslie Anne Cassidy #ACR18 @RheumNow https://t.co/gs9YwwFQ3a
Nicole Bitencourt NicoleBitencou5 ( View Tweet)
#GPA with vanishing retro-orbital mass in the nasopharynx compressing eyeballs. Image by Dr. Hiroiuki Yano. #ACR18 @RheumNow https://t.co/1irkBkFvLd
Nicole Bitencourt NicoleBitencou5 ( View Tweet)
In pts with #SystemicSclerosis, cardiac MRI with T1 mapping sequence revealed microscopic #MyocardialFibrosis in 53% of pts and was associated with #cardiovascular events (7 heart rhythm disorders, 2 heart failure, 1 unstable angina) Abstract2934 Dr.Terrier #ACR18 @RheumNow
Nicole Bitencourt NicoleBitencou5 ( View Tweet)
In #SystemicSclerosis, pts with esphageal erosions on EGD had a greater decline in FVC and progression of #ILD. Emphasizes role of micro-aspiration of gastric contents in #pathogenesis of #ILD in #scleroderma. Abstract 2936 Dr. Silvia Laura Bosello #ACR18 @RheumNow https://t.co/20hOAfS6rw
Nicole Bitencourt NicoleBitencou5 ( View Tweet)
Abstract 648 OptiRef self report questionnaire for early diagnosis of a spa - 19% had confirmed diagnosis vs 40% ref from Dr. Looks useful! #AS @rheumnow #ACR18
Philip Gardiner PhilipGardiner ( View Tweet)
Abst 651 Baraliakos MRI reports on SI joints in #AS differ between radiologists and rheumatologist: edema+erosion works best @RheumNow
Philip Gardiner PhilipGardiner ( View Tweet)
Abstr 837 Dr Colmegna: Should we use high dose Infleunza vaccine in #RA? Vaccines less effective in RA DB RCT low vs. High dose in 279 RApts. Showed sig. better immune response with high dose vaccine. #ACR18 @RheumNow
Philip Gardiner PhilipGardiner ( View Tweet)
#RA #ACR18 @RheumNow
Abstr 838: Anti-MDA5 pos DM-ILD has a poor prognosis. survival at 6mo 89% vs 33% with combo imsuppressive (Pred 1mg/kg/d tapering, IVCYC 500-1g/m2; Tacrolimus through 24 wk. 29 pts, historic controls. Hi risk of CMV activation #ACR18 #Myositis @rheumnow
Philip Gardiner PhilipGardiner ( View Tweet)
Plenary Abstract 839: Dr Schmukler Chicago. Can we use MDHAQ (multi-dimensional) to identify FM? 84% agreement with 2011 FMS questionnaire - so the answer is Yes! (But what is the ‘gold std’?) @RheumNow #FMS #ACR18
Philip Gardiner PhilipGardiner ( View Tweet)
Checkpoint inhibitors
explosion of papers in 2018
New and/or exacerbated arthritis, myositis, lupus, sarcoidosis, sjogrens, vasculitis
How to treat? - still unknown
Year in review - clinical
#ACR18 @RheumNow
D White WIRheum ( View Tweet)
Risk for infection with TNFi+MTX is NOT increased compared to triple DMARD Rx confirmed in large claims database of commercial insurance #ACR18 @RheumNow abst#218 https://t.co/p25QwUX3ZN
k dao KDAO2011 ( View Tweet)
Plenary session: High dose flu vaccine is safe and has better efficacy than standard flu vaccine in our adult RA patients abst#837 @RheumNow #ACR18 https://t.co/MzAB6mUnHS
k dao KDAO2011 ( View Tweet)
Q&A 'Over half the GCA patients had LVV+ on PET/CT' [note to self: need to insist on more PET/CT and push for Tocilizumb] #ACR18 @RheumNow #GCA
Philip Gardiner PhilipGardiner ( View Tweet)