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The Fallacy of Biologic Treatment to Prevent Rheumatoid Arthritis

Richard Conway, MBBChBAO, PhD

The window of opportunity concept in RA shifted our focus to trying to treat disease earlier and more aggressively to improve long term outcomes. A natural development of this was to reconsider the possibility of therapeutic interventions aimed at the prevention of rheumatoid arthritis.

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Pulmonary Manifestations of Rheumatic Disease in Asymptomatic Patients

Meral K. El Ramahi, MD, FACP, FACR

In clinical practice, pulmonary manifestations of rheumatic medical diseases such as rheumatoid arthritis (RA), psoriatic arthritis (PsA), and peripheral spondyloarthritis (pSpA) are typically not screened for upon diagnosis of a rheumatic disease in patients without any signs or symptoms suggest

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Towards Personalised Care in Rheumatoid Arthritis

Antoni Chan, MD, PhD

Since the millennium, we have seen an expansion in the number of advanced treatments both biologic and targeted synthetic disease modifying anti-rheumatic drugs for rheumatoid arthritis. The challenge remains on how best to characterise the subtypes of RA in order to choose the best drug to ensure optimal outcome for patients. 

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Rheumatoid Synovium Characterized by Six Cell Type Phenotypes

Jack Cush, MD

Research work from the Accelerating Medicines Partnership (AMP: RA/SLE) Network, was published in Nature and more specifically characterizes RA synovium into several cell-type abundance phenotypes (CTAPs). Could CTAPs known disease features or more effective future therapies? 

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Arthritis Increased Amongst US Veterans

CDC

A recent CDC reports estimates that in 2019–2021, 21% of U.S. adults (53.2 million) have physician diagnosed arthritis. Now, an updated report shows a larger number (~33%) of U.S. veterans having diagnosed arthritis. Compared to nonveterans, this prevalence was double in men, and 60% higher in women.

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Contributing Factors for Difficult-to-Treat RA using Natural Language Processing (NLP): joint erosions (OR 2.97 CI95% [2.17; 4.08], p< 0.001) , higher disease activity (median DAS28 3.16 vs 2.89) associated with D2T, Bergier Abst#0383 #ACR23 @RheumNow https://t.co/KARxoa2Z7H

Dr. Antoni Chan  ( View Tweet)

COVID boosters in RA patients: getting the job done (versus healthy controls, irrespective of non-withheld DMARDs excluding ritux) @UChicagoMed #ACR23 ABST0416 @RheumNow https://t.co/HVRjC4dauw
David Liew drdavidliew ( View Tweet)
Can a picture tell a RA swollen joint? (would be super useful for telehealth/remote monitor if so) It's not prime time yet, but following with interest: using photos to pick up on skin folds/joint swelling Fascinating, but let's see it vs MRI, clinical #ACR23 ABST0402 @RheumNow https://t.co/TFKiD5J4c8
David Liew drdavidliew ( View Tweet)
Year in Review by Dr. P Seo NORD-STAR trial: ⭐️Abatacept or Certolizumab >> Tociluzumab > triple therapy in tx of 812 early RA patients based on clinical & radiographic results ➡️tx-naive, all got MTX ➡️mod-sev dz activity ➡️randomized to 48 wks therapy #ACR23 @RheumNow https://t.co/vy2uYuyOse
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
NAFLD a real issue in RA Does DMARD choice matter? National Taiwanese data newly dx RA n=41791 HCQ reduced NAFLD risk: adjHR 0.75 (other RF: obesity, NSAIDs, even low-dose PNL; but not DM, MTX) Can HCQ improve liver health in RA? Authors: ?adiponectin #ACR23 ABST0396 @RheumNow https://t.co/9VMJpImFKs
David Liew drdavidliew ( View Tweet)
PROs are useful for tracking RA disease activity over time outside of the clinic setting for patients initiating new treatments without clinician-derived measures. Correlations in follow-up CDAI and PROs were 0.38 – 0.56, Nowell Abst#0380 #ACR23 @RheumNow https://t.co/LepCZ7sPY8 https://t.co/UYcZzIFEsx
Dr. Antoni Chan  ( View Tweet)
Low-grade troponin rises in RA: ignore, or meaningful? @BrighamWomens RA pts n=329 baseline hs-cTnT Trops actually predict MACE: HR 6.62 independent of traditional CV risk, CRP Traditional CV RF not enough in RA Maybe smoke does predict future fire? #ACR23 ABST0387 @RheumNow https://t.co/33ZCgzYIl4
David Liew drdavidliew ( View Tweet)
Let’s talk about SEX! >30% of pts wished their rheums asked them about sexual health, >50% pts with sexual dysfunction have RA. The presence of menopause, younger age, and children were assc with sexual dysfunction. presenter Dr D Flores Abstr#0145, #abst#0146 #ACR23 @RheumNow https://t.co/9AdoTtEwFp
TheDaoIndex KDAO2011 ( View Tweet)
Patient reported outcomes between clinic visits: worth doing? RA pts starting ADA/UPA, n=150 ArthritisPower/PatientSpot app for PROs between visits 52% of CDAI change explained by PROs Maybe a helpful tool in prioritising RA clinic reviews? @RADoctor #ACR23 ABST0380 @RheumNow https://t.co/oTttAlIxQR
David Liew drdavidliew ( View Tweet)
Join us tonight at 6pm PT/ 9pm ET for our daily #ACR23 recap. https://t.co/0RDwTdzhwS
Dr. John Cush RheumNow ( View Tweet)
Does the weather affect synovitis? Abstract this suggested so! Low wind speed & temp rise associated w/joint u/s findings in a large prospectove cohort Full disclosure: I'm super skeptical of this, whole lotta p values. Still, love "fun" science😂🤣 @RheumNow #ACR23 Abstr407 https://t.co/JkqdUbM8YK
Mike Putman EBRheum ( View Tweet)
Pregnancy is complicated for women with rheumatic diseases. There's a pathway to healthy mothers & babies, but it takes: - planning - the right meds - the right disease control. @drbags71 #ACR23 Review Course @RheumNow https://t.co/epdDIVGPye
David Liew drdavidliew ( View Tweet)
Habitually Noncompliant Seronegative RA - No Show, Won't Go, prn Patient QD Clinics are sponsored by RheumNows Coverage of #ACR23 live from San Diego https://t.co/jeD3H9RHvs https://t.co/zIEkecPEu0

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Dr. John Cush RheumNow ( View Tweet)
AI Can Predicts Radiographic Change in RA The ACR has published a preview of new research from #ACR23 showing that AI & a deep learning system could accurately identify & predict joint space narrowing and erosions in hand radiographs of patients w/ RA. https://t.co/GGplIcyZLk https://t.co/CVhZfR4gCj

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Dr. John Cush RheumNow ( View Tweet)
Retrospective study(2016-2019) of referred newly, suspected (#RA) pts found no value in initial Xrays. Only 32/724 patients (4.4%) had RA like erosions, with Erosions leading to a Dx in only 2 pts (0.3%) & changed prognostic classification in 3 pts (0.4%) https://t.co/fi48WiBgIc https://t.co/skObArXYr6

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Dr. John Cush RheumNow ( View Tweet)
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