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#ACR21 Abst#0456. Fxnal connectivity, ⬆️ blood-brain barrier (BBB) leakage & cognitive impairment (CI) in SLE
⭐️SLE pts ⬆️♀️, older, caucasian, ⬇️ edu than controls
⭐️CI in longer disease, APS
▶️ SLE CI:⬇️Brain-wide connections, BBB permeability
https://t.co/fen9OYhWhC @Rheumnow https://t.co/DMQfWCqUhh
Links:
Eric Dein ericdeinmd ( View Tweet)
Functional MRI eval neuro-connectivity in 78 SLE pts
Cognitive impairment occurred in 48%; pts had:
👉longer disease duration
👉likely +LAC
👉abnormal fMRI
👉>blood brain barrier permeability
#ACR21 #Plenary Abstr# 0456 @rheumnow https://t.co/WI5CD73rvM
TheDaoIndex KDAO2011 ( View Tweet)
How about lipoprotein a as a potential biomarker for poor renal outcomes in #lupus?
Results of this study by Dr @CaoilfhionnMD and her group show that ⬆Lp(a) is strongly associated w/ proteinuria, ⬇ eGFR and ⬆PGA.
Interesting🤓
@RheumNow #ACR21 abs0327 https://t.co/MLgJ1tPJMp
sheila RHEUMarampa ( View Tweet)
#ACR21
Many faces of cell death
Netosis in APS and #SLE
NETs and APS
🕸️NETs are prothrombotic🕸️ https://t.co/FG3VNbQPzh
Dr. Laura Lewandowski LauraLewMad11 ( View Tweet)
Plenary I
0454 LN mortality in the US & disparities using CDC WONDER data 1999-2019
"LN mortality exhibited profound disparities by race/ethnicity and place of residence"
https://t.co/UtMzaiL14D
#ACR21 https://t.co/C3fuq8anvR
Rheum Cat rheum_cat ( View Tweet)
Dr. Petri et al showed transition between lupus anticoagulant (-) to (+), (+) to (-), and (+) or (-) to thrombosis could be estimated by multistate Markov model.
#ACR21 Abst#0076 @RheumNow https://t.co/oIvbak4lV4
Pedro Castillo _Castillo_Pedro ( View Tweet)
Machine learning predicted lupus nephritis in #SLE patients in real world data #ACR21 @RheumNow #abst0324 https://t.co/67HBT7F2GO
Bella Mehta bella_mehta ( View Tweet)
Don't wait!
DR. Petri wants us to change paradigm of how we treat aggressive lupus nephritis: early, aggressive, and multimodal. Does not matter if you add on VCS or BLMB, just don't treat LN with MMF monotherapy.
#ACR21 #GreatDebate @rheumnow https://t.co/ebSiic095h
TheDaoIndex KDAO2011 ( View Tweet)
"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
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
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
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
