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Can tender and swollen joint counts work in a telemedicine world?
In a world where telemedicine and virtual care are not going away, is there value in patients assessing their own tender and swollen joints?
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After failing a JAK inhibitor, can you still hit a JAK-pot?
Januse kinase (JAK) inhibitors are targeted synthetic disease modifying anti-rheumatic drugs (tsDMARDs) that have risen in popularity as earlier treatment options for rheumatoid arthritis.
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Statins in RA - plenary at #ACR21 UK Clinical
Practice Research Datalink 1989-2018 @RheumNow
Reduction in CVD risk, All cause mortality
INCREASE in Type 2 DM risk🧐 - need to make sure we look into it for RA patients!
Great work @UNMC_Rheum by Gulsen Ozen! https://t.co/YmTO0xcdjj
Bella Mehta bella_mehta ( View Tweet)
RA and CVD: take your statins!
Obs UK study
Statins ⬇️CVD HR=0.46
⬇️All cause death HR=0.68
w/ mild ⬆️ T2DM risk HR=1.33
(but not more than in general population)
⭐️NNT to prevent CVD 102
⭐️NNT to prevent death 46
⭐️NNH 127
#ACR21 #Abst1427 @RheumNow https://t.co/v6TinuklNv https://t.co/r0rD4jMmuh
Aurelie Najm AurelieRheumo ( View Tweet)
In a telemedicine world where you can't palpate joints virtually, how can we use pt self-joint counts well?
Patients & rheums might not always rate the same, but:
when RA pts say their joints are up or down,
rheum exam usually agrees👍
@earlyarthritis #ACR21 ABST1203 @RheumNow https://t.co/spUNTlMnDY
David Liew drdavidliew ( View Tweet)
#ACR21 Abst#1205- Discordance bw pt and MD global assessment in RA?
⭐️15% discordance (>30 mm difference in GA score)
⭐️⬆️ in LDA and mod disease, ⬇️ remission/high disease
⭐️♂️ sex, pain VAS, normal CRP, less TJC&SJC predictive
@Rheumnow https://t.co/N2qAaDiBE5
Links:
Eric Dein ericdeinmd ( View Tweet)
#ACR21 Abs#1210: Frequency of anterior atlanto-axial sublux in RA
⭐️Anterior atlanto-axial subluxation (aAAS) = 3+ mm, frequency = 25%
⭐️Radicular pain 20%, surgery 6%
▶️Longer disease duration, ⬆️ frequency of extra-articular manifestations
https://t.co/BfjCTlRJbt @Rheumnow https://t.co/xd9h5e9cDH
Links:
Eric Dein ericdeinmd ( View Tweet)
#clinicalpearls Cervical involvement in RA: is it underestimated? Cohort of 240pts: anterior atlantoaxial subluxation (aAAS) found in n=25 10.4 % patients, 1/3 with no neck pain! Joint restriction OR: 5.8 hx arthroplasty OR:3.6
#Abst1211 #ACR21 @RheumNow
https://t.co/KRkDP4ETMu https://t.co/soKTMPiMwy
Aurelie Najm AurelieRheumo ( View Tweet)
#RA pts on #baricitinib less likely to discontinue treatment & more likely to achieve remission than pts receiving biologic /other tsDMARD.
👉🏼Results from RA-BE-REAL observational study
👉🏼Bari(2 or 4mg) vs biologic/other tsDMARD
Abs#1223 #ACR21 @RheumNow
https://t.co/WRN1OCX9Bq https://t.co/UCFF6hAY7G
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR21 Abs#1224. ⬇️ CD39 expression on B cell predicts occurrence of anti-drug Ab in RA on RTX
⭐️13/23 pts on RTX became ADAb+. No diff in concomitant MTX usage
⭐️Baseline CD73 similar, but lower CD39 predictive of ADAb
https://t.co/QzbAmXtTmZ @Rheumnow https://t.co/CLtEev69YD
Links:
Eric Dein ericdeinmd ( View Tweet)
#ACR21 Abs#1225: B/L Extracell Matrix Biomarkers predict ABA response in MTX-naive, +ACPA early RA
⭐️ECM biomarkers predict SDAI remission or DAS28 w ABA+MTX vs PBO+MTX.
⭐️⬆️CTX1 biomarker predicts efficacy endpts for ABA+MTX
https://t.co/7wHQefb5D4 @Rheumnow
Links:
Eric Dein ericdeinmd ( View Tweet)
Wk 12 disease activity predicts wk 24/26 remission/low disease activity with #upadacitinib 15mg in MTX-naïve or inadequate responders to MTX and/or TNFi pts.
≥50% improvement in SJC/TJC at Wk 12 was assoc with wk 24/26 remission/low disease activity.
Abs#1237 #ACR21 @RheumNow https://t.co/PAaCe5MAcu
Mrinalini Dey DrMiniDey ( View Tweet)
Ultrasound in CSA patients:
Retro US cohort 110pts
28.2% w/ 💥Power Doppler synovitis. 36.8% at 6mo evolved to RA among which 100% PD+ vs 25% PD-
PD + predicts evolution to clinical RA (OR 13.1; CI 1.07-161.04)
Easier and less invasive than MRI!
#Abstr1525 #ACR21 @RheumNow https://t.co/MkhWTvnv3L
Aurelie Najm AurelieRheumo ( View Tweet)
#ACR21 Abs#0819. RheumTAP real-world cohort of pts tapering Rx in remission on RA
▶️ Pts tapering 7.6x ⬆️ likely to flare in f/u
Great convo soon on @Rheumnow re: tapering studies. @davidliew asks how many more times do we need to see drug w/d fail?
https://t.co/BiZSM7yp7o https://t.co/iDXGVpFZzB
Links:
Eric Dein ericdeinmd ( View Tweet)
Abst 0789
Baker & colleagues examined adipokine levels in association with disease activity in RA patients
- Patients with high levels of adipokines less likely to achieve low disease activity & remission
- These patients more likely to escalate to b/tsDMARDs
#ACR21 @RheumNow https://t.co/1xlO4W9q9v
Akhil Sood MD AkhilSoodMD ( View Tweet)
Another exciting day at #ACR21 and covering for @RheumNow
Also presented my poster (Abstr 0587) DMARD Use in Medicare Patients with #RheumatoidArthritis and Risk of Long-Term Opioid Use
- DMARD users showed lower odds of long term opioid use compared to non-DMARD users https://t.co/2XZgYY8ORg
Akhil Sood MD AkhilSoodMD ( View Tweet)
We know we're all not as great at treat-to-target in RA as we should be.
If we want to get fit, we join a group class.
If we want to study, we join a study group.
Why not the same with TTT, to motivate us to our best?
Virtual learning collaboratives 👏
#ACR21 ABST0815 @RheumNow https://t.co/siVOyKjPNx
David Liew drdavidliew ( View Tweet)
Dr. R Thomas note that even if you have RA, it's not too late to improve your lifestyle to be healthier. This will help with the mgment of the dz. 2/2 @rheumnow #ACR21
TheDaoIndex KDAO2011 ( 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/KUoO88dEhQ https://t.co/10R4jC5p0y
Links:
Dr. John Cush RheumNow ( View Tweet)
Ethnic disparities in pts with RA & CVD - paucity of evidence in published lit
Need to improve study inclusion, diversity to improve quality of care
#ACR21 https://t.co/sWKcHugU9W
Rheum Cat rheum_cat ( View Tweet)