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signs treat

Why treatment of pre-RA isn't ready for prime time

Janet Pope, MD, MPH, FRCPC

The ACR Great Debate was on "To treat or not to treat in pre-RA?". What is the clinician to do?

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ACR 2022 Appraisal, Praise & Critique (11.18.2022)

Jack Cush, MD

It was great to be back at an ACR annual meeting, this one in Philadelphia - Philly was great. A walking town, rich in culture, history and good places to meet and mingle. 



I loved the city, but not the convention center (not easy to navigate). 

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Lungs breathing

RA-ILD takes centre stage

Richard Conway, MBBChBAO, PhD

Interstitial lung disease is common in RA, occurring in approximately 8% of RA patients. It is associated with a poor prognosis, and a median survival of 3 years. This important condition has often been neglected within the spectrum of RA research. That is changing, with excellent research initiatives presented at ACR22. I am going to highlight two select abstracts from Monday’s dedicated RA-ILD session.

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Best of

ACR Best Abstracts - Day 3

Jack Cush, MD

The last day was jammed with important reports and research including the late breaking abstracts. 



 

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tumeric

The spicy topic of turmeric in rheumatoid arthritis

David Liew, FRACP

Curcumin, the active constituent of turmeric extract, has increasingly been promoted as a potential rheumatoid arthritis therapy, but data presented at ACR22 suggests that even in ideal situations, it is unable to do any better than placebo in replacing conventional RA therapies.

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RA Topic Panel RheumNow recaps the best & most interesting data presented at #ACR22 in RA. Panelists: Drs.Conway, Najm, Liew, Pope, Segan Follow: @RichardPAConway @AurelieRheumo @drdavidliew @Janetbirdope @JulianSegan https://t.co/6SAlQwcPS0 https://t.co/kSZgTQs6Ns

Links:

Dr. John Cush RheumNow ( View Tweet)
Infections in pre-RA: a cause or a consequence? Dr. Aurelie Najm ( @AurelieRheumo) discusses oral presentation abstract #0535 from #ACR22. https://t.co/ajI2zo4KRA https://t.co/cHkzNshVcn

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Dr. John Cush RheumNow ( View Tweet)
Avoid Abatacept in RA patients with a history of cancer? Dr. Richard Conway ( @RichardPAConway ) discusses abstracts #0267 and #0255 presented at #ACR22. https://t.co/1lC33XlBt7 https://t.co/ttUQaTVF43

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Dr. John Cush RheumNow ( View Tweet)
Curtis et al. Primary non-adherence to csDMARDs and b/tsDMARDs in RA/PsA/SpA. Medicare and commerically-insured patients. 20-44%! of new prescriptions not filled by 6 months. Higher for csDMARDs than b/tsDMARDs @RheumNow #ACR22 Abstr#2199 https://t.co/Pwg6GKu7Gg https://t.co/wPF0pu1UDa

Links:

Richard Conway RichardPAConway ( View Tweet)
Which is better for CV risk in RA: triple therapy DMARDs or TNFi? TARGET study n=159 using PET/CT surrogate (endpoint responsiveness👀) - either led to benefit - both equally good - benefit *not* linked to change in DAS28 A direct CV effect of RA Rx? ABST2215 #ACR22 @RheumNow https://t.co/4FPvSbfGsD
David Liew drdavidliew ( View Tweet)
Singh @NamrataRheum et al. Frailty in patients treated bDMARD/tsDMARD assoc serious infections aHR 1.34, any infection aHR 1.18, hospitalisation aHR 1.34 (all relative non-frail). @RheumNow #ACR22 Abstr#2218 https://t.co/ONsTBq8ehB https://t.co/iTVANh5flk

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Richard Conway RichardPAConway ( View Tweet)
💤cognitive behavioural therapy 2 hours/wk for 6 wks for insomnia improves RA PROs at 26 wks Insomnia Severity Index -9.8 RAID -1.4 PGA -13 Small sample size wk6 trend improvement sleep efficiency 89% vs84% p=0.07 but not wk26 https://t.co/rpKdtbREYs Abs#2188 #ACR22 @RheumNow https://t.co/kEBcPAdIKW

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Aurelie Najm AurelieRheumo ( View Tweet)
Peresolimab humanized IgG1 mab ➢ stimulates PD-1 & physiological immune inhibitory pathways ➢ In RA phase 2 study, superior to placebo at Week 12 DAS28/CDAI ➢ safety events were similar between treatment groups Emery P #L03 https://t.co/4Jd79CW5RA #ACR22 #ACRBest @RheumNow https://t.co/PSuLQgjYuz

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Dr. Antoni Chan synovialjoints ( View Tweet)
Tonight at 7pm ET! Join our RA Topic Panel with panelists: Drs. Richard Conway, Aurelie Najm, David Liew, Janet Pope, Julian Segan @RichardPAConway @AurelieRheumo @drdavidliew @Janetbirdope @JulianSegan #ACR22 https://t.co/hIH4WghLwN https://t.co/oKQbBnMiqQ

Links:

Dr. John Cush RheumNow ( View Tweet)
Sometimes your RA pts are eligible for ICI cancer immunotherapy, but there’s hesitancy because of autoimmune risk/bad irAEs @DanaFarber @MassGenBrigham: more RA flares but similar mortality, severe irAEs rates Give them what they need! ABST1667 @jeffsparks #ACR22 @RheumNow https://t.co/WdDP8IeIYG
David Liew drdavidliew ( View Tweet)
Fletcher et al. Epidemiology RA-ILD 2004-18 in VA. Incidence increased from 340 to 970/100,000PY. Prevalence increased 1.7% to 4.5%. More common males (4.81% vs 2.53%) and over 60 @RheumNow #ACR22 Abstr#1638 https://t.co/AbPgLUPoDz https://t.co/V25xDUwLbu

Links:

Richard Conway RichardPAConway ( View Tweet)
Peresolimab PD-1 agonist in RA Phase 2 RCT Primary endpoint met w/ > improvement DAS28CRP Wk12 Also greater improvement of CDAI in both treated grps TEAEs PBO 37% PER 300mg 40% PER 700mg 35%, 1 serious AE in PER 700mg https://t.co/QtclWIWAw9 Abs#L03 #ACR22 @Rheumnow https://t.co/bLHP4JuNjt

Links:

Aurelie Najm AurelieRheumo ( View Tweet)
Wipfler et al. Characteristics refractory RA. Associations at baseline (A) and follow-up (B) @RheumNow #ACR22 Abstr#1952 https://t.co/4PJtrDp3Ba https://t.co/x1NCq07Y1h

Links:

Richard Conway RichardPAConway ( View Tweet)
Systemic Inflammation Index (neutrophils*platelet count/lymphocyte count) predicts survival in RA in 1000+ pts All cause mortality OR 2.64 CV-mortality OR 3.03 Another proof (if needed) of asso inflammation & mortality in RA https://t.co/A77iPTTfTM Abs#1650 #ACR22 @RheumNow https://t.co/8aHYAZEg6v

Links:

Aurelie Najm AurelieRheumo ( View Tweet)
Tuttle et al. Phase 2 RCT of Peresolimab (PD-1 stimulator) in DMARD-IR RA. Evidence of efficacy. No new safety signals @RheumNow #ACR22 Abstr#L03 https://t.co/vhrmtGTjw1 https://t.co/k1LLk95bv1

Links:

Richard Conway RichardPAConway ( View Tweet)
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