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#IgG4 RD is an indolent disease but can present with severe weight loss (>20 pounds), largely due to pancreatic destruction.
#ACR18 @RheumNow
Brittany A MissbeeMD ( View Tweet)

Therapeutic potential of “glycoengineering" in autoimmune disease.
Alter glycoforms of endogenous IgG -> reduce pathogenic impact of antibodies.
Cell paper by Pagan JD et al
https://t.co/UbBsE1jV4L
Year in review basic science
#ACR18 @RheumNow
D White WIRheum ( View Tweet)

TLR8 aberrantly expressed on pDCs (cells that make type-I IFN) in SSc patients
Depletion ameliorates disease
https://t.co/SmDdpIU2I1
Ah Kioon et al
Year in review basic science
#ACR18 @RheumNow
D White WIRheum ( View Tweet)

Stop by the @RheumResearch booth to get your @alhkim autographed flyers!!! #acr18 #rheumrockstars https://t.co/kVR4XB6ynO
Mary J. Wheatley MaryJWheatley ( View Tweet)

Anti-GBM positivity did not predict relapse in Goodpasture's
(but ANCA did predict relapse in GBM disease)
Abs 826, Cleveland Clinic
Roundup - Cush, Kavanaugh
#ACR18 @RheumNow
D White WIRheum ( View Tweet)

Toci in SSc
failed to achieve primary endpoint (modified Rodman skin score)
Abs 898
Roundup - Cush, Kavanaugh
#ACR18 @RheumNow
D White WIRheum ( View Tweet)

Canabinoids in vitro
CB2 receptor drives inflammation
Set the stage for discovery/development of future antagonists?
Danger of over-interpretation on the street
Abs 1068
Roundup - Cush, Kavanaugh
#ACR18 @RheumNow
D White WIRheum ( View Tweet)

MTX for OA of the knee
12 months, 155 pts, endpoint=pain
statistically significant improvement, probably not clinically meaningful
consistent with prior reports
Abs 428
Roundup - Cush, Kavanaugh
#ACR18 @RheumNow
D White WIRheum ( View Tweet)

B cell immunology
New therapies directed at B cells
Overlap with therapies for myeloma
How to target long-lived (CD20 neg) plasma cells?
Session: ACR immunology update
Roundup - Cush, Kavanaugh
#ACR18 @RheumNow
D White WIRheum ( View Tweet)

Session on draft ACR reproductive health guidelines
Three manuscripts in preparation
This effort is a response to a tremendous need for info and guidance
Estimated half of pregnancies are unplanned, so ask patients often
Roundup - Cush, Kavanaugh
#ACR18 @RheumNow
D White WIRheum ( View Tweet)

MTB screening in patients on TNFi
When to re-screen?
Neg to pos conversion discovered in a small number of cases
Often in patients with risk factors
Cush: Annual testing “makes no sense at all"
Abs 1234, Rochester NY
Roundup - Cush, Kavanaugh
#ACR18 @RheumNow
D White WIRheum ( View Tweet)

DIP involvement in RA
12k patients in Japanese registry
2% incidence, 2-3 joints in each pt with involvement
associated with higher disease activity
Abs 221
Roundup - Cush, Kavanaugh
#ACR18 @RheumNow
D White WIRheum ( View Tweet)

Biosimilars in Sweden
Rx patterns (originator vs biosimilar) follow prices - back and forth
Abs 1175
Roundup - Cush, Kavanaugh
#ACR18 @RheumNow
D White WIRheum ( View Tweet)

Gout
Remains under-treated
Higher success when pharmacists and RNs manage ULT
Abs 2220, 1247, 1272
Roundup - Cush, Kavanaugh
#ACR18 @RheumNow
D White WIRheum ( View Tweet)

Enthesitis, in particular supraspinatus tendinopathy
IL-17A as a target of therapy
Abs 404
Roundup - Cush, Kavanaugh
#ACR18 @RheumNow
D White WIRheum ( View Tweet)

MTX helpful for granulomatous mastitis
Can be recurrent; sometimes seen by rheums
Rule out cancer, infection
Abs 2264
Roundup - Cush, Kavanaugh
#ACR18 @RheumNow
D White WIRheum ( View Tweet)

Chronic back pain in patients with a FHx of ank spond
More psoriasis and heel pain
Undiagnosed SpA?
Abs 637
Roundup - Cush, Kavanaugh
#ACR18 @RheumNow
D White WIRheum ( View Tweet)

High- vs standard-dose influenza vaccination in pts on DMARDs and biologics
High-dose quadrivalent version more effective (seroconversion) except in rituximab population
Abs 837
Roundup - Cush, Kavanaugh
#ACR18 @RheumNow
D White WIRheum ( View Tweet)

MTX vs etanercept vs combo in PsA
ACR20 at 24 wks: 50%, 60%, 65%
Contrast TEMPO study in RA where combo therapy was better than monotherapy
Also: MTX monotherapy effective
Abs L11
Roundup - Cush, Kavanaugh
#ACR18 @RheumNow
D White WIRheum ( View Tweet)

Plasma exchange in AAV (GPA or MPA) with severe disease
PLEx did not reduce ESRD or death
Reduced-dose glucocorticoids did not increase risk of death or ESRD (but did have fewer infections)
Abs 2788
Roundup - Cush, Kavanaugh
#ACR18 @RheumNow
D White WIRheum ( View Tweet)