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Itaconate - A Potential New Immunosuppressive
EurekAlert!
Researchers have revealed the modulatory effect of the anti-inflammatory metabolite itaconate (ITA) on T helper and T regulatory cells, which may lead to new therapeutic approaches to treating some autoimmune diseases.
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Cost-Effective Use of Biological and Targeted Synthetic DMARDs
An international task force of 13 European experts have developed evidence-based points to consider regarding the cost-effective use of biological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in the treatment of inflammatory rheumatic diseases (including rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis).
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@RheumNow Live #RNL2023
Stanley Cohen, MD:
Use of JAK inhibitor in patients with known ASCVD: Number needed to harm 16
ASCVD is biggest risk factor for MACE events with JAKi https://t.co/gXNUOO8seG
Eric Dein ericdeinmd ( View Tweet)
Dr Brenner at #RNL2023
Excellent description on how fibroblasts are major producers of IL-6 producers
Clinically presents a target for blocking the fibroblasts, upstream the inflammatory cascade in RA
@RheumNow https://t.co/TserFZtvhV
Eric Dein ericdeinmd ( View Tweet)
JAKinib safety takeaways
- avoid in older population > 65 yo, malignancy, CV risk, VTE risk
- appropriate in younger pts without VTE/CVD risk factors
#RNL2023 @RheumNow https://t.co/5i1bRqqr7g
Robert B Chao, MD doctorRBC ( View Tweet)
Dr. Deanne reminds us that RA is worth preventing for many reasons. #RNL2023 @RheumNow https://t.co/va0RmdhUQR
Dr. Rachel Tate uptoTate ( View Tweet)
Dr. Kevin Deane on preclinical-RA
Very complex history on development of RA with multiple phases before detectable RA shows up in your clinic.
#RNL2023 @RheumNow https://t.co/vzQFhik0aK
Robert B Chao, MD doctorRBC ( View Tweet)
#RNL2023:
Kevin Deane: Anti-CCP positive leads to a 20-30% risk for articular clinical RA within 3-5 years
@RheumNow https://t.co/skp1K4r1hF
Eric Dein ericdeinmd ( View Tweet)
STOP-RA study on HCQ preventing RA...
HCQ did NOT prevent RA development in pre-RA pts
@RheumNow #RNL2023 https://t.co/Vv3szkqxWh
Robert B Chao, MD doctorRBC ( View Tweet)
#RNL2023 @RheumNow
Kevin Deane presents his STOP RA Trial
HCQ is safe and easy - can you use it in pre-clinical RA to prevent disease?
NO EVIDENCE of decreased progression of RA in HCQ compared to placebo https://t.co/1OSVubd9rO
Eric Dein ericdeinmd ( View Tweet)
Treatment with MTX in early CCP+ RA thought to be effective in slowing disease however StopRA study did not show a difference between HCQ and PBO in patients. We need to know more about HCQ vs MTX in this space! #RNL2023 @RheumNow https://t.co/7asmvVfXiC
Dr. Rachel Tate uptoTate ( View Tweet)
The holy grail. How to stop #rheumatoid #arthritis in at risk Pts. Who to treat, when to stop? Many RCTs but no home run-NNT is high. #MTX and a diff study #Abatacept that work while on Rx and #Rituximab, most don’t work esp after stopping Rx @kevindeane #RNL23 @RheumNow https://t.co/BkIxxS0ecn
Janet Pope Janetbirdope ( View Tweet)
Dr. Deane's current management of "pre-RA" pts
- carefully eval for synovitis
- lifestyle factors - stop smoking, diet, dental hygiene
- educate pt on ~30% risk
- annual in-person follow up
@RheumNow #RNL2023 https://t.co/Z0t0Yibyri
Robert B Chao, MD doctorRBC ( View Tweet)
How do you prevent RA in at-risk patient?
Smoking cessation! Healthy weight and exercise! Diet! Periodontal health! 🚭🏋️🥕🦷
Education & follow-up!
Not robustly proven to prevent/delay RA, but may be more important than early DMARD intervention!
Kevin Deane, MD
#RNL2023 @RheumNow
Eric Dein ericdeinmd ( View Tweet)
Natural history of RA by Kevin Deane #RLN23 @RheumNow https://t.co/ab0cafDblz
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
Dr. Stanley Cohen on JAKinibs:
Very concise and informative timeline on the multiple JAKinibs approved for multiple conditions
@RheumNow #RNL2023 https://t.co/3ZZHr0akrR
Robert B Chao, MD doctorRBC ( View Tweet)
JAKi cycling, likely something we all do/consider in clinic. Dr. S. Cohen reviews the JAK-pot study which shows good, expected results between cycling in patients. #RNL2023 @RheumNow https://t.co/qBau79o0VQ
Dr. Rachel Tate uptoTate ( View Tweet)
Transcriptomic studies of Rx Refractory #RA pts shows increased gene expression of plasmacytoid dendritic cells (pDC) (reflecting expansion of pDC precursors) correlated well w/ Rx resistance. Type I IFN negatively correlated w pre-DC gene expression https://t.co/japvTnuTNu https://t.co/ad6ofbg3cO
Links:
Dr. John Cush RheumNow ( View Tweet)
Cost-Effective Use of Biological and Targeted Synthetic DMARDs
An international task force of experts have developed evidence-based points to consider regarding the cost-effective use of b/tsDMARDs in the treatment of inflammatory rheumatic diseases.
https://t.co/jpxQggd89T https://t.co/zjer5QTN3C
Links:
Dr. John Cush RheumNow ( View Tweet)
Geo-epidemiology of Autoantibodies in Rheumatoid Arthritis
A multinational study of RA patients shows a variety of post-translationally modified AMPA. While AMPA differed in different ethnic populations, their levels correlated with total serum IgG.
https://t.co/QuA980svOO https://t.co/M7706bqxtl
Links:
Dr. John Cush RheumNow ( View Tweet)
