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Googling rheumatic diseases. On average google search lacked essential information to guide patient decisions. Websites on AS scored the highest on the DISCERN and RA scored the highest on JAMA @RheumNow #ACR21 Abst#0742 https://t.co/k2o2AqYEeh https://t.co/ZKljvA2f4O
Dr. Antoni Chan synovialjoints ( View Tweet)
🌞😎🍣 Vitamin D and Omega-3 FA ⬇️ Risk of developing autoimmune disease
1st prospective, randomized, double blind, placebo controlled trial
Vit D 2000IU and/or Omega 3-FA 1000mg ⬇️autoimmune disease by 25-30%
#ACR21 #ACRBest @RheumNow
Abs#957
https://t.co/7dODuplg7e https://t.co/GUKhYXbSXU
Robert B Chao, MD doctorRBC ( View Tweet)
ORAL Surveillance: MACE events higher in TOFA vs TNFi. Independent risk factors: smoking, aspirin use, age ≥ 65 yrs, and male sex; TOFA vs TNFi tx in these pts assoc'd w/ numerically higher MACE incidence. Plenary Abs 0958 #ACR21 #ACRbest @RheumNow https://t.co/44af1KujqP
Dr. Rachel Tate uptoTate ( View Tweet)
Do you order EKGs in everyone starting HCQ? Do you avoid HCQ in patients with heart failure? Will these abstracts impact your practice? Click on link to read more....#ACR21 @rheumnow #HCQ https://t.co/fvUZAvNWa8
TheDaoIndex KDAO2011 ( View Tweet)
Abstr 0584
Patients in GLORIA Study noted to have
- High number of comorbidities (median 6)
- Multiple medications notably HTN and GI protection
Findings represent medical reality of elderly RA patients (>65 years old)
#ACR21 @RheumNow
https://t.co/2cOtO9MLNM
Akhil Sood MD AkhilSoodMD ( View Tweet)
Awesome presentation today from Dr. Cristina Ruiz-Romero on lipidomic profiles in RA vs PsA. Using mass spectrometry, found differences in both synovial bx and fluid. Potentially useful lipid markers, more studies to follow.
#ACR21 #ACRBest Abst#0946 @RheumNow https://t.co/KmWCPKijSx
Pedro Castillo _Castillo_Pedro ( View Tweet)
Tofacitinib vs TNF inhibitors in #RA patients +50yrs with >1 CV risk factor; the data from ORAL Surveillance that we have all been waiting for! #ACR21
Risk of MACE related largely to baseline CV risk https://t.co/SpuKTtP8ql
The Lancet Rheumatology TheLancetRheum ( View Tweet)
#ACR21 #ACRAmbassador
Fascinating analysis of rheum dx from the (negative!) VITAL study (https://t.co/aMtMCIf1F1)
Very few pts 278/25,871 (1.1%) but HR 0.78, p = 0.045 for vitamin D preventing autoimmune disease
Do you believe it? If so, what's your public policy advice? https://t.co/ZkO5nHAJz9
Mike Putman EBRheum ( View Tweet)
ORAL-Surveillance, an open label Phase 3b/4 RCT of tofacitinib (JAKi) vs TNFi in RA
Numerical elevations in MACE and MI, highest among pts w/hx of CAD or high 10-year risk for MACE
I have been considering baseline CVD / VTE / CA risk when prescribing these since this broke https://t.co/8DAx8IgnZM
Mike Putman EBRheum ( View Tweet)
ORAL surveillance TOFA vs. TNFi:
in patients with > 50yo > 1 CV risk MTX IR
-# ⬆️ in MACE and MI (not stroke)
-MACE risk factors on TOFA smoking, >65 male gender
-# ⬆️ MACE in its w/ any of these RF
What are you going to tell your patients? #Abtr0958 #ACR21 #ACRBest @RheumNow https://t.co/81kVTH63bb
Aurelie Najm AurelieRheumo ( View Tweet)
MACE risk Tofa vs TNFi ORAL surveillance: age 50+ w/1 additional CV risk, MTX-IR
👉higher # MACE, MI in Tofa 5 or 10 mg bid (no increase in stroke)
👉risks for MACE w/tofa: tobacco, ASA, age 65+, male sex
👉counsel high risk pts (?avoid use)
Abst#0958 #Plenary #ACR21 @rheumnow https://t.co/tg35cts9tw
TheDaoIndex KDAO2011 ( View Tweet)
Oral Surveillance outcomes in a nutshell Tofacitinib two doses vs TNFi event driven trial more AEs of interest in Tofa groups MACE Malignancy SIE in older groups VTE esp #tofacitinib 10 mg BID @RheumNow #ACR21 #ACRBest abst#0958 https://t.co/j39g7yVVFB
Janet Pope Janetbirdope ( View Tweet)
1133 MACE events in Oral Surveillance study - Tofa use in high risk pts had more MACE events than TNFi use. Abstr# 0958 #ACR21 Problems with the gimmish are:
- Older patients, w/ Hi CV Risk
- 50% prednisone use
- Use of TNFi as comparator (effective at lowering CV risk) https://t.co/lzIyhgzvRe
Dr. John Cush RheumNow ( View Tweet)
⭐️IR for MACE, MI, non-fatal MI numerically ⬆️ in Tofa vs. TNFi
⭐️HR for MACE/MI/stroke >1 for Tofa vs. TNFi
⭐️Risk factors: Smoking, ASA use, Age>65, men
⭐️Pts without risk factors, IR for MACE were similar
Abs#958
#ACR21 @RheumNow #ACRBest
https://t.co/xA3aGu5Sqi https://t.co/VnPHBhrmdx
Robert B Chao, MD doctorRBC ( View Tweet)
okay, so let's look at the #ACR21 plenary as we go
so a reminder - FDA-mandated phase 3b/4 safety endpoint study
specifically looking at patients >50yo with at least one other CV risk factor
today we're looking at MACE: that's CV death (excl PE), MI, stroke
ABST0958 @RheumNow https://t.co/9U8Sahb9Q7
David Liew drdavidliew ( View Tweet)
Abst#0946 shows a distinct lipid profile in RA vs PsA synovium + synovial fluid.
Sphingomyelins & phosphatidyl-cholines/ethanolamines had the greatest separation power to classify RA + PsA samples. These lipid markers may have clinical utility if validated.
#ACR21 @Rheumnow https://t.co/ktKRypTtlE
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Outcomes of COVID-19 in Patients with Rheumatoid Arthritis.
Dr. Akhil Sood ( @AkhilSoodMD) shares the studies presented #ACR21.
https://t.co/yrs8N8XSiS https://t.co/EKHuTS5aDr
Links:
Dr. John Cush RheumNow ( View Tweet)
VITAL RCT of Omega-3 and Vit D in preventing autoimmune diseases in 25,871 individuals. They both work! Reducing incident autoimmune disease by 25-30%. This is game-changing! Abstr#0957 #ACR21 @RheumNow #ACRBest https://t.co/BaeZDTTnQf
Richard Conway RichardPAConway ( View Tweet)
#ACR21 Abst#0836. TCZ switch from IV▶️SC in RA
⭐️11/37 ineffective on SC (30%)
⭐️TCZ IV >8mg/kg, no MTX, h/o ABA failure ass w/ risk of flare on SQ switch
🔥Very relevant w shortages, want more data re: confounders (adherence, disease control)
https://t.co/E9pD4SrXqz @Rheumnow
Links:
Eric Dein ericdeinmd ( View Tweet)
#ACR21 Abs#0834: CorEvitas Registry TNFi vs IL-6 in RA
⭐️IL6 pts older, longer h/o RA, higher CDAI, more prior Rx
▶️ No difference in outcomes bw IL6 and TNFi (monotherapy or combo w MTX).
▶️1/3 of pts achieved LDA
Limits: real-world, unblinded
https://t.co/AJtzeMuj1T @Rheumnow
Links:
Eric Dein ericdeinmd ( View Tweet)