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Methotrexate and hepatic fibrosis: we must be doing something right
Methotrexate may be a rheumatologist’s best friend, but a key part of counselling any patient about its use has always been the risk of hepatotoxicity.
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Dr McDermott @jeffsparks on risk factors for RA-bronchiectasis. Seropositivity, older age at RA onset, and lower BMI⬆️risk. Abstr#0288 #ACR21 @RheumNow https://t.co/7d2ZVWLzn6
Richard Conway RichardPAConway ( View Tweet)
Dr O'Brien on co-existent AAV and RA. Not something I'm used to seeing, but maybe we need to think about it more? 25 cases with RA+AAV, 52 with RA + ANCA but no AAV, not sure what the denominator is here though. Abstr#0428 #ACR21 @RheumNow @profgayecunnane https://t.co/fN3BRpc7UJ
Richard Conway RichardPAConway ( View Tweet)
Dr Adachi presents ⬆️BMD gain with denosumab than risedronate in RA. Non-significant reduction in fractures (very small numbers) Interesting, but need to see fracture benefit in larger study to justify dmab as first line Abstr#0445 #ACR21 @RheumNow https://t.co/GgaS9JZGzb
Richard Conway RichardPAConway ( View Tweet)
Diabetes puts you at risk of cardiovascular disease, right?
What about RA?
Look at this graph and compare the pair.
"already it was impossible to say which was which” - George Orwell, Animal Farm
#ACR21 ABST0287 @RheumNow https://t.co/r0yaeC530l https://t.co/mKJhoyJ2Cn
David Liew drdavidliew ( View Tweet)
Year 2 f/u on PsA, axSpA, or RA using CT-P13, an infliximab (IFX) biosimilar. Pts either naive to IFX or switched from IFX:
💠IFX-naive: improved disease activity
💠IFX-switched: maintained stable disease
💠No new safety concerns
https://t.co/VGBicnq15w
#ACR21 Abst#0817 @RheumNow
Pedro Castillo _Castillo_Pedro ( View Tweet)
Interesting question came up: why would you change a RA patient from JAKi to JAKi?
The main reason I can think of would be if the first JAKi worked a bit (but not enough to continue, or AEs got in the way).
That would clearly favour to better survival
#ACR21 ABST1442 @RheumNow https://t.co/kDiJVbJfit
David Liew drdavidliew ( View Tweet)
Loved this session on: Preclinical Rheumatoid Arthritis- Can we stop RA? As a patient advocate living with RA, my providers have always ran tests on my microbiome. The findings have correlated with my disease flares, and was a big trigger overall. #ACR21 @ACRheum Thank you! https://t.co/6hm6hr85JS
Effie Koliopoulos RisingAboveRa ( View Tweet)
MRI Imaging in RA and SpA: Dr. Sheila Reyes ( @RHEUMarampa)
Dr. Sheila Reyes discusses abstracts #0468 and #0469, presented at the #ACR21 annual meeting.
https://t.co/MeVia60BNa https://t.co/WRgCifpioQ
Links:
Dr. John Cush RheumNow ( View Tweet)
Alcohol and MTX don't go along!
In a cohort of 1000+ early RA
Factors associated w/
1️⃣Nausea
Female OR 2
🍺 Alcohol OR 1.44
DAS28CRP OR 1.16
2️⃣Alopecia
Age OR 4.87
🍺 Alcohol OR 1.98
HAQ score OR 1.62
#Abst1444 #ACR21 @RheumNow https://t.co/zZG6aFR1SX
Aurelie Najm AurelieRheumo ( View Tweet)
Rheumatology Research Foundation Lecture: Learning lessons from @Google to harness #omics to better understand #RA
#ACR21 @RheumNow @RheumResearch https://t.co/NVAe2Rqo1O
Mrinalini Dey DrMiniDey ( View Tweet)
@NamrataRheum on outcomes in RA patients on RTX who get COVID-19. ⬆️hospitalisation, ICU, mech ventilation, but not mortality (in this cohort) Abstr#1445 #ACR21 @RheumNow https://t.co/8RcrzTdEb0
Richard Conway RichardPAConway ( View Tweet)
Yup, another large database shows more #hospitalizations with #RheumatoidArthritis with #rituximab but NOT higher mortality in matched analysis. Abst#1445 #ACR21 @RheumNow https://t.co/9XV8iX10sA
Janet Pope Janetbirdope ( View Tweet)
You can <but not as frequently> treat to target in #RheumatoidArthritis with virtual v in person visits. 45 docs in 18 practices comparing in person to virtual. In person wins but not by a large gap! Abst#1448 @dansolomon @RheumNow #ACR21 #ACRBest session today coming up https://t.co/8lcuMW0bwb
Janet Pope Janetbirdope ( View Tweet)
Does #baricitinib affect #fatigue in RA patients?
👉🏼Results from RA-BEAM and RA-BEACON
👉🏼4mg baricitinib significantly reduced fatigue, starting week 16, compared to placebo
👉🏼Effect independent of disease activity in active RA
Abs#1235 #ACR21 @RheumNow
https://t.co/0SKhUKJHd7 https://t.co/R76wc56u6I
Mrinalini Dey DrMiniDey ( View Tweet)
What predicts response to MTX in RA?
👉🏼DAS28-ESR
👉🏼RA duration
👉🏼Pt global assessment
👉🏼Swollen joint count
Abs#1227 #ACR21 @RheumNow
https://t.co/s942zvFiZ1
Mrinalini Dey DrMiniDey ( View Tweet)
Plenary Abs#1428 #ACR21
👉🏼Long-term #steroid use is common in RA incl in pts with high risk of #MACE
👉🏼30days of steroids ➡️ 15% increased odds of MACE
@RheumNow
https://t.co/fCM3m04ruS https://t.co/FWGmAatYu5
Mrinalini Dey DrMiniDey ( View Tweet)
26K Veterans data with RA #ACR21 plenary abst#1428
30 days on glucocorticoids - ⬆️15% odds of Major Adverse Cardiovascular events @RheumNow @BethIWallace https://t.co/BOram4o2rp
Bella Mehta bella_mehta ( View Tweet)
Role of GC on MACE in RA:
US database analysis 26000+pts
23% on GC >90d/6mo
Each 30days of GC dispensed ⏭15% increase in odds of MACE in the following 6month period!
Adjustment on several confounders but not disease activity.
#Abts1428 #ACR21 @RheumNow https://t.co/prdA7D5fLz https://t.co/F3wCcRAfuf
Aurelie Najm AurelieRheumo ( View Tweet)
Plenary Abs#1427 #ACR21
👉🏼#Statins assoc w/ reduced #CVD & all-cause mortality, outweighing
modest #T2DM risk increase in RA pts
👉🏼Reduction in all-cause mortality greater in RA than gen population
👉🏼Incr in T2DM risk is NOT greater in RA compared to gen population
@RheumNow https://t.co/WcF11B0C2s
Mrinalini Dey DrMiniDey ( View Tweet)