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RheumNow Podcast – ACR Convergence Begins (11.5.2021)

Jack Cush, MD

Dr. Cush reviews the news, and kicks off ACR21 learning and how to take in the annual meeting.

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Prolonging the Controversy of Hydroxychloroquine

Kathryn H. Dao, M.D.

Since the start of the pandemic, hydroxychloroquine (HCQ) was forced into the limelight for the prevention/treatment of COVID-19.

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Industry Abstract Previews #ACR21 - Horizon, Aurinia, AstraZeneca

Jack Cush, MD

The pharmaceutical companies will feature the results of their pivotal clinical trials and data analyses at ACR Convergence 2021.  Below is a listing of some of their best studies for you to review and look for in the meeting.

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Blacks with Systemic Sclerosis May Have More Severe Disease

ACR

New research presented this week at ACR Convergence, the American College of Rheumatology’s annual meeting, shows that Black people living with systemic sclerosis may have more severe disease and worse prognosis than patients in other racial or ethnic groups, and these worrying disparities may be driven by several socioeconomic factors (Abstract #1854). This poster will be presented Tuesday morning,  November 9, 2021 in the Clinical Poster III (1836–1861) section on Systemic Sclerosis & Related Disorders.

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Serologically Active, Clinically Quiescent SLE

Jack Cush, MD

Lupus management is guided by assessment of both clinical and serologic features; but what happens with the patient with systemic lupus erythematosus (SLE) serologically active, but clinically quiescent (SACQ)?  A large cohort study shows that nearly one-third of such patients may flare

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"I don't want rheumatologist only use BLMB and nephrologist using only VCS." - Dr. M Petri on how we should work together with nephrologists on managing lupus nephritis. (She did give a final dig & added "BLMB can be used with any GFR") #ACR21 #GreatDebate @rheumnow

TheDaoIndex KDAO2011 ( View Tweet)

#GreatDebate: add on BLMB vs. VCS to MMF for LN Dr. Petri argues for BLMB b/c: 👉cost is less 👉better adherance 👉not good for class V 👉voclosporin had greater nephrotoxicity 👉insuff data in pregnancy, but not contraindicated like VSC #ACR21 @rheumnow https://t.co/mk2eXwkxcG
TheDaoIndex KDAO2011 ( View Tweet)
#ACR21 Great Debate Dr. Brad Rovin: Voclosporin: Combo with MMF is effective pts of diverse racial and ethnic backgrounds. ⭐️Big plus for a disease with large healthcare disparity issues @Rheumnow https://t.co/rMpCRPLLGQ
Eric Dein ericdeinmd ( View Tweet)
KL-6, Anti-Ku, anti-CENPB were assoc'd w/ #myositis &/or ILD in #lupus patients accdg to this study by Dr. T Cotton et al. This may help identify patients at risk for developing such. @RheumNow #ACR21 abs0330 https://t.co/p0uxBOTLZm
sheila RHEUMarampa ( View Tweet)
Great Debate on Voclosporin vs. Belimumab in Lupus Nephritis therapy. Dr. Petri argues Belimumab has less potential AE including infections, cardiovascular risk, malignancy potential. No drug-drug interactions. What would you choose? #ACR21 #ACRBest @RheumNow https://t.co/FywUp3zCj2
Robert B Chao, MD doctorRBC ( View Tweet)
@jhrheumatology Dr. Petri - if Lupus nephritis biopsy is very active start a dual therapy with MMF right away. ▶️ If not, continue to re-evaluate at 3 and 6 months for early combo therapy #ACR21 Great Debate @Rheumnow https://t.co/ctKdbWTMqy
Eric Dein ericdeinmd ( View Tweet)
How can we tell whether a patient already on rituximab will have an immunogenic response to Pfizer COVID-19 vaccination? Better chance of response if: - RA or SLE, not AAV or IIM - high serum IgG pre-last RTX - longer time since last RTX Israeli data #ACR21 ABST0437 @RheumNow https://t.co/yyuFd0eDH6
David Liew drdavidliew ( View Tweet)
@jhrheumatology Dr. Petri at #ACR21 Great Debate. Safety issues with Voclosporin: 1) Nephrotoxicity 2) Infection 3) CV Risk Factors 4) Malignancy 5) Neurologic toxicity 6) Osteoporosis 7) Drug interactions 8) Deaths 9) Pregnancy contraindication @RheumNow https://t.co/wjluivmKNt
Eric Dein ericdeinmd ( View Tweet)
Dr. Chambers review @MotherToBaby prospective data on HCQ use in pregnancy (n=279): 👉no major defects (regardless of dose) 👉no oral clefts 👉SGA slightly lower in exposed group b/c of underlying dz 👉no case of retinopathy in babies after 1 year f/u @rheumnow #Pregnancy https://t.co/vw2eryFgro
TheDaoIndex KDAO2011 ( View Tweet)
#Abstr0076 #ACR21 Can we predict #thrombosis in #lupus patients? Predictors of serology transition at 5yrs: ✅LAC+ to LAC-:Afro-American,HCQ and normal C3 ⛔️LAC+ to 🩸Clot:Obesity, low C3 and not on HCQ Data need in those with Triple Positivity @RheumNow https://t.co/byeL5NjVUS https://t.co/CchtZir2GN

Links:

Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Either we need to review the Yearly PAP cervical screening in SLE women or work hard to improve patient awareness. Suspect the latter as time between tests was over 4 years late 😱 and 2.7% developed cancer #ACR21 #Abstr0133 @RheumNow https://t.co/wm01MfoFjf https://t.co/blD8WafZsE

Links:

Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#ACR21 Year in Review. Caielli et al. showed in some patients with #lupus, red blood cells retained their mitochondria (Mito+ RBCs) and their frequency correlated with disease activity and blood⬆️IFN @RheumNow https://t.co/ZixgAbOWJ0 https://t.co/hkTWE4m7Ph

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
👉Voclosporin for SLE: rapid control of proteinuria (50% reduction over 29 days in UPCR w/o high side effects) @rheumnow #YearInReview #ACR21 Are you all starting to use this drug now? It has helped my patients; pretty well tolerated. https://t.co/zqJRsjnV4n
TheDaoIndex KDAO2011 ( View Tweet)
AURORA 1, Year in Review: Voclosporin as add-on therapy lupus nephritis. Approved in 1/2021 for active lupus nephritis, very positive data @rheumnow #ACR21 https://t.co/rudYD1OC59
Eric Dein ericdeinmd ( View Tweet)
ICYMI: Systematic review of dsDNA studies (byfluorescence immunoassay) included 1977 total patients, 47% with SLE == over all dsDNA had >90% for specificity and a pooled specificity of 94.7% (95% CI 91.67%-96.67%) https://t.co/Nk8h9fDYpE https://t.co/RcmewQpN7B

Links:

Dr. John Cush RheumNow ( View Tweet)
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