All News
Outcomes of COVID-19 in Patients with Rheumatoid Arthritis
Patients with rheumatic diseases – requiring lifelong immunosuppressants— are at high risk for respiratory and viral infections. Over the past decade, an armamentarium of biologic and targeted therapies has led to better control of disease activity in patients with rheumatoid arthritis. Whether these patients, especially those receiving newer biological and targeted therapies such as JAK inhibitors, are at an increased risk of severe COVID-19 outcomes remains uncertain.
Read Article
Dr McDermott @jeffsparks on risk factors for RA-bronchiectasis. Seropositivity, older age at RA onset, and lower BMI⬆️risk. Abstr#0288 #ACR21 @RheumNow https://t.co/7d2ZVWLzn6
Richard Conway RichardPAConway ( View Tweet)
#ACR21 Abst#0170:
↑ epicardial adipose tissue volume predicts new coronary plaque development in the following RA patients:
⋆ <10 yrs dz (OR 5.75)
⋆ 1 cardiac risk (OR 3.4)
⋆ statin < 1 yr (OR 3.3)
⋆ w/o calcification at b/l (OR 2.65)
@Rheumnow
https://t.co/tnyWRVSger https://t.co/uhak4kdbll
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Interesting study on 5yr CV event risk in early #rheumatoidarthritis pts who received T2T mgt shows no difference in CVE risk in ERA grp vs control
ERA cohort:
> Longer remission = protective for CVE
> ⬆ HAQ = predictive of CVE
Tighter control, ⬇ CVEs
@RheumNow #ACR21 abs0282 https://t.co/GG7HPvWd0r
sheila RHEUMarampa ( 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)
Abst#271 #ACR21. RA activity predicts left ventricular mass change in pts without CVD
⭐️35% had abnormal LV geometry at baseline TTE
⭐️55% at f/u TTE 3-6 years later
⭐️Increase in concentric remodeling on LV
@Rheumnow https://t.co/uHnqITcTy9 https://t.co/KmV8volVwd
Links:
Eric Dein ericdeinmd ( View Tweet)
#ACR21 Abst#0276:
Pulse pressure (PP) = Systolic BP - Diastolic BP, measures arterial compliance
⭐️RA: higher PP than controls
⭐️PP was independent risk factor for subclinical atherosclerosis
▶️ Look at the vitals, we have this at every pt visit!
@Rheumnow https://t.co/KZaf1AwO6Q https://t.co/kN4xGxWiV9
Links:
Eric Dein ericdeinmd ( View Tweet)
It's what's below the surface that's most scary.
see: RA & the heart
- why do RA pts without cardiovasc dx/Sx get LV remodelling over time
- why is it worse with worse RA control?
RA goes deeper than the joints & our pts need to hear that!
@Columbia #ACR21 ABST0272 @RheumNow https://t.co/NDHLZwoEjy
David Liew drdavidliew ( View Tweet)
Despite >20y of bDMARDs, our patients still have a 50% greater risk of cardiovascular issues
(similar to family history or abdominal obesity)
Cardiovascular disease in RA is not historic, it's today's reality we too often ignore.
2020 data @VUamsterdam #ACR21 ABST0286 @RheumNow https://t.co/Az4wHNUOGe
David Liew drdavidliew ( View Tweet)
#ACR21 Abst#0284. RA and Dementia?
⭐️1366 pts with RA, retro pop-based cohort
⭐️Risks: older age, diabetes, CVD.
⭐️Large joint swelling swelling HR 2.2 (1.2-3.9). No significance by RF/CCP/ESR/erosions/nodules
▶️CVD risks appear > RA activity
https://t.co/2uN2lBs4tr @Rheumnow https://t.co/HEOXPosE5Z
Links:
Eric Dein ericdeinmd ( View Tweet)
Diabetes puts you at risk of cardiovascular disease, right?
What about RA?
Look at this graph and compare the pair.
"already it was impossible to say which was which” - George Orwell, Animal Farm
#ACR21 ABST0287 @RheumNow https://t.co/r0yaeC530l https://t.co/mKJhoyJ2Cn
David Liew drdavidliew ( View Tweet)
Study by @BethIWallace @Tuhina_Neogi shows that we seem to treat fibromyalgia symptoms with steroids in RA patients. Its a bad idea in fibromyalgia, and has got to be bad practice in RA too. Abstr#0120 #ACR21 @RheumNow
Richard Conway RichardPAConway ( View Tweet)
#ACR21 Abst#0271. ⬆️ Risk of carotid atherosclerosis in first few years of RA diagnosis. Authors recommend routine carotid screening in pts at time of diagnosis.
Q: would you routinely screen all patients at time of diagnosis?
@Rheumnow
https://t.co/A9akqyVRGF https://t.co/SYGkJHQzWf
Links:
Eric Dein ericdeinmd ( View Tweet)
Abst#0276:
Pulse Pressure (PP) can predict carotid plaque in RA!
➡️PP (SBP – DBP) assoc w/ subclinical CVD in gen populat. How about in RA?
⭐︎ RA pts had higher PP than controls
⭐︎ PP = only independent RF for subclinical athero
#ACR21 @Rheumnow https://t.co/esLDW8iggf https://t.co/6d2D9hXC1i
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Abst#0269: Autoabs confer risk of incident CVD in US ⚦ veterans w/ RA
⭐︎ MACE risk: ↑ concentrations of RF (HR 1.15) & malondialdehyde acetaldehyde (anti-MAA) (HR 1.2)
⭐︎ CVD Death: ↑ concentrations of CCP (HR 1.27) & anti-MAA
#ACR21 @Rheumnow
https://t.co/UeOz91Bh3P https://t.co/PJwP1H4eNk
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
#ACR21 Abst#0269
⭐️TCZ: ⬆️cholesterol, LDL, TG. ⬇️ hsCRP compared to TNFi. No ⬆️ risk of Reynold risk score (RRS)
Take-away: good data on TCZ effect on lipids, but I wouldn't use RRS to calculate CVD risk on med that ⬇️ CRP @Rheumnow https://t.co/zMltktfHkS https://t.co/bwKXiGIi8a
Links:
Eric Dein ericdeinmd ( View Tweet)
Abst#0268
➡️Do lipids change w/ some bDMARDs in RA? YES!
⭐︎ TCZ: ↑ TC, LDL, TG & ↓ in hsCRP relative to initiating TNFi.
➡️Does this lipid ↑ confer risk for CVD? Not necessarily as it may not be atherogenic per Reynolds Risk Score!
#ACR21 @Rheumnow
https://t.co/Gy62mg6GhZ https://t.co/5uC8Zy0Lbr
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
RheumNow Podcast – ACR Convergence Begins (11.5.2021)
Dr. Cush reviews the news, and kicks off ACR21 learning and how to take in the annual meeting.
Read Article
Prolonging the Controversy of Hydroxychloroquine
Since the start of the pandemic, hydroxychloroquine (HCQ) was forced into the limelight for the prevention/treatment of COVID-19.
Read Article
ACR21 Previews from Creaky Joints
CreakyJoints will present 11 posters and two oral presentations at ACR 2021. COVID-19 research revealed significantly high levels of anxiety, anger, depression, and social isolation, which were linked to medication interruptions and associated flares suggesting during the pandemic, patients often felt unsupported by all levels of the healthcare system.
Read Article