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Janet Pope Tweet
#Precision #Medicine in RA RCTs. Treat w right drug at right time? Possible problems -sample variation on synovial #bx, some won’t respond ex fibrotic phenotype variable drug distribution/resistance. AI is helping to separate Pts #ACR23 ⁦@ACRheum⁩ ⁦@RheumNow⁩ 13M140 https://t.co/D7NxpM4YNw
Richard Conway Tweet
Michaud et al. RA patients with long COVID had more fibromyalgia pre-COVID (41% vs 13%), higher rates of pain, depression, and worse PROs pre-COVID. Authors suggest long COVID may partially reflect pre-existing illness Abstr#1629 #ACR23 #ACRbest @RheumNow https://t.co/mrcGWrSD6c https://t.co/YiGCbvBDtn
sheila Tweet
Do you discuss HPV vax & cervical CA screening w/SLE & RA pts? In this study, more women w/SLE discussed cervical CA screening w/their rheums(33.3% vs. 11.4% p<0.01) & more likely to have persistent abn paps on ffup Similar HPV vax status for both grps #ACR23 ABST1356 @RheumNow https://t.co/Vbu8hbZ1uh
Richard Conway Tweet
Karpouzas et al. MTX reduces IHD in males but not females with RA. 4362 patients. 66% lower risk MACE and 55% lower risk any ischaemic CVE. Abstr#1627 #ACR23 @RheumNow https://t.co/MC4W0dinUv https://t.co/1hkBoawt4b
Aurelie Najm Tweet
RA males 81% increase MACE & 58% ischemic CVE 2 folds Males>Females in MTX non users Makes MTX users reduction 66% & 55% risk MACE & ischemic CVE and no diff w/ females MTX use not assoc w/ reduction MACE in females @RheumNow #ACR23 ABST1627 https://t.co/qbAc2bWdcM
Mike Putman Tweet
EBRheum
SMART study in RA, splitting MTX Split dosing better at wk 16 but ~similar at wk 24 Caveat: wonky design from wk16-wk24 makes it hard to interpret? Surprsingly, adverse events ~similar but smallish sample Mostly supports my practice of splitting? @RheumNow #ACR23 #ACRBest https://t.co/g7s4EUHeCW
Richard Conway Tweet
SMART study - MTX split into morning and evening once weekly vs all together. 253 patients. Split dosing better efficacy (DAS28 4.1 vs 4.5, p=0.03), more LFT elevation but less neutropenia. Abstr#1583 #ACR23 @RheumNow https://t.co/tkrds4uqQP
Aurelie Najm Tweet
Split dose oral MTX (15/10mg) versus single dose (25mg) in RA RCT 250pts EULAR good resp 16wks 22 vs 10% (sig) 24wks 37 vs 28% (ns) 50% more addition of 2nd csDMARD in single dose #ACRBest @RheumNow #ACR23 ABST1583 For more thoughts, have a read https://t.co/urA6X4rY0D 👇🏼
Eric Dein Tweet
SMART on MTX Ab#1583 @RheumNow #ACR23 Single dose MTX 25 mg v Split dose (same day 15/10 mg). FA 5 mg 2x/wk. 16w can add csDMARD Split 29% vs 22% - EULAR response improve - not signif. Better DAS28 Split: 35% added 2nd csDMARD vs. 54.5% in single dose No stat diff in sAE #ACRBest
Robert B Chao, MD Tweet
Should Methotrexate be prescribed as split dosing? Multi-center, RCT of RA pts showed split dosing of 25mg MTX resulted in higher efficacy + reduced need for additional DMARDs, compared to single dose MTX @RheumNow #ACR23 Abs#1583 https://t.co/zjjnzWUl5E
Aurelie Najm Tweet
What is frailty? How does it affect RA outcomes? Pop based cohort study 13000+ RA vs. 26000+ matched ctrl Over 2x more frailty 5.6% vs 2.6% OR frailty in RA 2.3 Adjusted for rurality, neighborhood income quartiles AND BL comorbidities index @RheumNow #ACR23 ABST1275 https://t.co/ZkOpgHPSE0
Dr. Rachel Tate Tweet
SMART study #ACR23 Plenary abs #1583: po split-dose MTX (vs single dose) once weekly in RA pts had ^^ efficacy & reduced need for add'l DMARDs. No major AE, but slight increase in frequency of persistent transaminitis in split-dose group. https://t.co/wHzjpSnfuA @rheumnow https://t.co/0hNTMGbt47
Robert B Chao, MD Tweet
Large VA study of >1k RA-ILD pts No difference in risk of respiratory hospitalization or death in RA-ILD pts using TNFi vs. nonTNFi/JAKi Data does not support avoiding TNFi in RA-ILD @RheumNow #ACR23 Abs#1582 https://t.co/LTNLXEIAPo
Eric Dein Tweet
Ab#1582 @RheumNow #ACR23 RA-ILD outcomes of TNFi v non-TNF b/tsDMARD VA Data, propens match emulation study No incr risk of death in TNFi vs non-TNFi But are TNF safe? - Don't support systematic avoidance. But are there specific pops - unsure. Don't answer if efficacy in RA-ILD https://t.co/AApEjZs4DM
Mike Putman Tweet
EBRheum
Important plenary session, RA-ILD outcomes in VA cohort study No difference in death/hospitalization for TNF vs non-TNF treated patients. Jives w/my priors; I do NOT avoid TNF in RA-ILD Encouraging if you (like me) prefer RA-active tx for RA-ILD 😉😆 @RheumNow #ACR23 #ACRBest https://t.co/TIDzMLOfs4
Richard Conway Tweet
Non TNFi b/tsDMARDs vs TNFi in RA-ILD. New-User, Propensity Score Matched Study. 454 patients. No difference! resp-related hospitalisation aHR 1.22 [0.92, 1.60] No difference mortality. Abstr#1582 #ACR23 #ACRbest @RheumNow https://t.co/HzzVo9dJHi https://t.co/mZuHq4GShU
sheila Tweet
The SMART study by Dhir et al: once-weekly, oral split-dose MTX (10mg/15mg) in RA pts had⬆️efficacy & ⬇️need for addtl DMARDs vs. once-weekly, single-dose MTX Reassuring. . . . In my practice, pts tolerate MTX split dosing better esp w/⬆️doses #ACR23 ABST1583 @RheumNow https://t.co/F8p2aKmmH4
Aurelie Najm Tweet
Long term follow up T2T in RA 12 yrs BeST & 20yrs IMPROVED studies 50% recalled 68% remission 91% LDA HAQ 0.5 These are GOOD outcomes Especially considering setup before we had several MoAs What’s lacking: current ttmt & number of bioD, ctrl group @RheumNow ABST1273 #ACR23 https://t.co/9KcsHLupJc
Aurelie Najm Tweet
RA-ILD is an heterogeneous condition Different risk factors identified dep/ on radiographic pattern RA-UIP: -male sex OR 2.7 -ACPA+ OR 2.2 -male + ACPA + smoking OR 13 RA-NSIP: -RF+ OR 3.2 Likely to support different pathological mechanisms @RheumNow #ACR23 ABST1269 https://t.co/rC2F9YAceQ
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