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2024 In Memorium
Sadly, in 2024, Rheumatology lost many of our greatest brethren, mentors, do-gooders and clinicians. These clinicians were responsible for the care of hundreds of thousands with MSK problems, while driving the scientific advances that will shape the lives of millions in the future. They did the painstakingly hard work of caring for the most complex patients and did so with zeal, wonder and love for their patients. Remember them, honor them, and invoke their names and memories frequently as they are the foundation upon which we rheumatologists stand.
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Best of 2024: Good Clinical Practice Recommendations on Glucocorticoid Withdrawal and Adrenal Insufficiency
Glucocorticoids are widely prescribed as anti-inflammatory and immunosuppressive agents. This results in at least 1% of the population using chronic glucocorticoid therapy being at risk for glucocorticoid-induced adrenal insufficiency. This risk is dependent on the dose, duration and potency of the glucocorticoid, route of administration, and individual susceptibility.
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Have a rheumatology question or case for Dr. Cush? Record it here and we'll feature it on an upcoming podcast. Tell us your name and where you practice rheumatology.
https://t.co/UMrunimVv6 https://t.co/yZNdnAWCy2
Dr. John Cush RheumNow ( View Tweet)
TAPIR study of continuing vs stopping steroids in ANCA vasculitis in remission. Relapse at month 6 in 16% vs 4%. OR 4.22, but low rate in either group. If treated Rituximab, no difference! Merkel et al. @RheumNow #ACR24 Abstr#0774 #ACRbest https://t.co/F9DOBLrjVq https://t.co/BtphAuEopA
Dr. John Cush RheumNow ( View Tweet)
Why should rheumatologists care about aging?
As a herald to what was to come in Washington, the publication of the Lancet Rheumatology series on aging coming just days before #ACR24 set the stage for the “grey tsunami” of geriatric rheumatology that was to follow.… https://t.co/XfB7ykV0Xs https://t.co/51Cjz3EGyn
Dr. John Cush RheumNow ( View Tweet)
#PAH in #SSc still has a poor #prognosis
👎
Esp #ILD with PAH - a double whammy
But also
group 1 PAH
And
Some are unclassifiable ▶️also bad px
Need
Earlier detection
More interventions
?prevention
Abst#0678 #ACR24 @RheumNow @ACRheum @sclerodermaUM https://t.co/AEQsTC1pzQ
Links:
Janet Pope Janetbirdope ( View Tweet)
Diagnostic work up for neuropsychiatric SLE. Zahi Touma MD @RheumNow #ACR24 https://t.co/zLX1QHCaSu
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Cardiology is on!
Dr. Olin discusses Fibromuscular Dysplasia findings on imaging
Definite: string of beads and/or focal narrowing in right setting / location
Possible but nonspecific: dissection, ecstasia, aneurysm, and tortuously
@RheumNow #ACR24 https://t.co/Dr81KQfLSf
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Updated ACR guidelines on management of lupus nephritis (LN). Consider early biopsy. Focus on triple therapy in LN. From the panel discussion, Tacrolimus can be an alternative to CNI (Voclosporin) where there is no access to this. Manage comorbidities such as CV risk, bone… https://t.co/4R02YnRXDP https://t.co/3J7YcF5ucQ
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Applying the guidelines to Cases- Dr M Dall’Era for a pt wit extrarenal lupus and active LN. #ACR24 @rheumnow https://t.co/lvOUWjEdEz
Links:
TheDaoIndex KDAO2011 ( View Tweet)
3D management of Sscl from @delgaldoFrances
-Time
-Severity
-Type of organ involvement
*Identify phenotypes: fibrotic vs vascular damage.
*Raynaud’s red flags: +ANA, puffy fingers, abn capillaroscopy.
*Early ttnt of of digital ulcers delays onset of PAH.
*High IFN-I =marker of… https://t.co/ByfuV0MJds https://t.co/GdRVwuRf4E
Links:
Adela Castro AdelaCastro222 ( View Tweet)
The TAPIR study presented at #ACR24 may not be as attention grabbing as others like SELECT-GCA, but in my opinion it is arguablyone of the most important ANCA-vasculitis studies ever. I've shared some further thoughs in an article on @RheumNow https://t.co/mImAE8ezSQ
Richard Conway RichardPAConway ( View Tweet)
What a result!!!
Crowed split 49% against and 51% for MCTD as a unique disease entity
Given pre-debate poll of >70% for MCTD, looks like an overall win for the “NOT” group
Fantastic session from all the presenters
@RheumNow #ACR24 https://t.co/GgTVQ1VNWP
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Choose Rheum!
Hart & Kumar interviewed trainees about picking rheumatology... major themes:
▶️ exposure prior to medical training
▶️ mentorship/sponsorship
▶️ long-term self-reflection
▶️ chance!
How can we optimize first 3 to build our workforce?
@RheumNow #ACR24 Abst 1738
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
A#1692
Single cell RNA-seq identifies double-negative-2 (DN2) B-cell population ass w progressive SSc-ILD
IgD- CD27- cluster is highest risk
CD21 low B cells are distinct subset associated with sclerosis, pHTN
DN2 B cells as potential biomarkers for SSc-ILD
@RheumNow #ACR24 https://t.co/IbnOGS8C3t
Eric Dein ericdeinmd ( View Tweet)
A#1690 fibroblast activation protein inhibitor (FAPI)-PET in SSc ILD
Introduces FAPI quantification algorithm
FAPI uptake predicts greater rate of FVC decline. Trend for DLCO, not statistically signif
FAPI volume & intensity both predict accel lung decline
#ACR24 @RheumNow https://t.co/YA2ptLDaMy
Links:
Eric Dein ericdeinmd ( View Tweet)
At "Envisioning a Steroid Free Future" talk
Angelo Gaffo at the mic: "Are there any situations you would do induction therapy for AAV without steroid?"
John Stone: [pause] "No." 😄
#ACR24 @RheumNow
Mike Putman EBRheum ( View Tweet)
A framework for critical conversations with patients
(because the big decisions deserve high quality counselling, otherwise the consequences are real)
#ACR24 16S17 @RheumNow https://t.co/fiwYY1DuMq
David Liew drdavidliew ( View Tweet)
"Do not fear RPF." - John Stone
Retroperitoneal fibrosis certainly feels challenging at times, and radiologic features might stay even after functional improvement
but we've come a long way
(although, despite B cell depletion, there's plenty more to do)
#ACR24 16S26 @RheumNow https://t.co/2Y3buXrAFY
David Liew drdavidliew ( View Tweet)
"If you want an argument, put two rheumatologists in a room and ask them about steroid tapers. Add a third and you'll have a fight"
-P. Merkel at UPA plenary session
#ACR24 @RheumNow
Mike Putman EBRheum ( View Tweet)
