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ARIAA Study - Abatacept Reverses ACPA+ Subclinical Arthritis: Dr. Jack Cush discusses abstract #0455, a preclinical RA intervention trial - abatacept or placebo given to at risk individuals (arthralgias, CCP+, MRI+) for 6 months, presented at #ACR21.
https://t.co/fz1hPTleMn https://t.co/V4PsPZ0ZwF
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Dr. John Cush RheumNow ( View Tweet)
Glory to GLORIA trial? Low dose prednisone 2mg in active RA>65yrs, N=451 All Standard care. in 2yrs, ~40% drop out- same in each grp Better RA control but NNH 9.5 w steroids, mostly non severe infections. So, prednisone debate in RA continues #ACR21 @RheumNow #ACRBest abst#1678 https://t.co/emOaYSjYAa
Janet Pope Janetbirdope ( View Tweet)
Just worthwhile remembering:
in terms of TNFi anti-drug immunogenicity in autoimmune disease:
RA is top of the pops
(although dose spacing is worse)
data from NOR-DRUM A, TDM in infliximab #ACR21 ABST1525 @RheumNow https://t.co/wfcA72wcLP https://t.co/mHppH6qYdY
David Liew drdavidliew ( View Tweet)
Pirfenidone in RA-ILD, TRAIL-1 study. Long-awaited. Early termination due to COVID led to under-powering. Slowed decline in FVC, especially in UIP pattern. Seemed to have less adverse events than we see with nintedanib. Abstr#L10 #ACR21 @RheumNow https://t.co/sYRDhG3u4y
Richard Conway RichardPAConway ( View Tweet)
Adipokines in RA
⚡️Highest Quartile Adiponectin associated w/ ⬆️ all-cause mortality HR 1.46 ⬆️ CV mortality HR 1.85
⚡️Highest Quartile Leptine ⬆️ 25% all-cause mortality
#ACR21 #Abst1645 @RheumNow
https://t.co/O1NAbfMvif https://t.co/VVdgZHP1j5
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Aurelie Najm AurelieRheumo ( View Tweet)
How do RA pts go with ICI cancer therapy?
@VUMCRheum audit reflects overall prev experience:
- approx 50% flare (?some reflect DMARD W/H)
- flares overwhelmingly managable
- few (1/19 here) cease ICI due to RA flare
RA pts deserve best cancer Rx too!!
#ACR21 ABST1523 @RheumNow
David Liew drdavidliew ( View Tweet)
Dr. Despotovic shares general principles about ICU admissions in patients w/ #rheumatic disease.
🔺#SLE, RA, systemic #vasculitis, SSc, IIMs
🔺serologic testing useful but interpret w/n clinical context
@RheumNow #ACR21 https://t.co/jb3Mt31dZz
sheila RHEUMarampa ( View Tweet)
#ACR21 Thieves! TM11. Belly pain in patient with RA nodules:
⭐️ A: rheumatoid nodulosis of pancreas and duodenum.
Great case!
@Rheumnow https://t.co/PuO4tka3FJ
Eric Dein ericdeinmd ( View Tweet)
Sub-analysis of ICHIBAN study looking at adverse events in tocilizumab treated patients with/without steroids. Steroids associated with small increase in adverse events across board. Abstr#1693 #ACR21 @RheumNow https://t.co/ldiovirKpo
Richard Conway RichardPAConway ( View Tweet)
Meta-analysis of PUFA supplementation in RA. Apparent benefits across most measures, albeit often small. Abstr#1682 #ACR21 @RheumNow https://t.co/1rGhpqvJvp
Richard Conway RichardPAConway ( View Tweet)
GLORIA study of adding prednisolone 5mg to DMARDs over 2 years for RA in those >65 years. Mean DAS 0.37 points lower, Sharp score 1.7 lower (are either of these clinically significant?). NNH 9.5. To me causing harm chasing statistical benefit Abstr#1678 #ACR21 @RheumNow #ACRBest https://t.co/KYk1II3J3w
Richard Conway RichardPAConway ( View Tweet)
I don't know much about antifibrotics in RA-ILD, but these data emphasise that HRCT pattern matters
My simple mind, for any disease:
multiple subtypes with different trajectories➡️likely to be differing responses to Rx
TRAIL1: pirfenidone in RA-ILD
#ACR21 ABSTL10 @RheumNow https://t.co/v7HCO0ZBe1
David Liew drdavidliew ( View Tweet)
Comparative effects of abatacept in RA-ILD with UIP/NSIP. Appears equally effective in stabilising FVC, DLCO, and HRCT findings in both. Abstr#1683 #ACR21 @RheumNow https://t.co/l0Ia1D9c56
Richard Conway RichardPAConway ( View Tweet)
Sleep disturbance common and associated with disease activity (both PRO and physician-assessed) in RA. Need further studies to evaluate causal directions, but may well be bidirectional? Abstr#1666 #ACR21 @RheumNow https://t.co/eK65I92wPg
Richard Conway RichardPAConway ( View Tweet)
#ACR21 Ab#1683: ABA for RA-ILD
⭐️Stabilization of DLCO, FVC, HRCT in UIP and NSIP in 106 UIP, 84 NSIP patients
⭐️Stabilization or improvement of dyspnea in 91% UIP, 95% NSIP pts
@Rheumnow https://t.co/qfgDmooGOj https://t.co/gz6Jk15nUs
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Eric Dein ericdeinmd ( View Tweet)
#ACR21 Ab#1699: ITIS diet:
⭐️Fatigue ⬇️ in 20 pts on ITIS trial, didn't correlate with final DAS28CRP
⭐️Fatigue responders (50% improvement) had different fecal microbiome changes & anti-inflamm compounds, than non-responders
@Rheumnow https://t.co/UvE2ZpxCDU
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Eric Dein ericdeinmd ( View Tweet)
☄️Late breakingTRAIL1 RCT Pirfenidone on RA-ILD.
✨Primary outcome on incidence of decline of >10% FVC or death not met 11% PIR vs. 15% PBO OR=0.67 p=0.48
BUT
✨underpowered
✨reduces decline in FVC(ml) over 52wk (-66 vs. -146, p=0.0082)
✨safety ok
#ACR21 #AbstL10
@RheumNow https://t.co/IxYDE3lN1s
Aurelie Najm AurelieRheumo ( View Tweet)
Safety update for #filgotinib in #RA over ~2.2yrs treatment
👉🏼Well-tolerated with no ne safety concerns since 2020
👉🏼AE incidence rates decreased or remained stable
👉🏼Slight incr rates of NMSC & non-NMSC malignancies
Abs#1698 #ACR21 @RheumNow
https://t.co/0jbZFVgiyN https://t.co/yOlntLwQlU
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR21 Ab#1655. Respiratory Ifn in RA on bDMARD
▶️1 group was initiated into vaccination program vs usual care
⭐️Vaccinated group had ⬇️ admissions from respiratory ifns. 44% ⬇️ severe resp ifn
💉programs work!
@Rheumnow https://t.co/pljR6DbAtU https://t.co/goSHGID8qG
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Eric Dein ericdeinmd ( View Tweet)
#Multimorbidity in women with #rheumatoidarthritis is increased compared to men with RA. However, women and men without RA have similar levels of multimorbidity.
Abs#1656 #ACR21 @RheumNow
https://t.co/iXhXOldTy0 https://t.co/CsOM7odE69
Mrinalini Dey DrMiniDey ( View Tweet)