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Infections in pre-RA: a cause or a consequence?
Rheumatoid arthritis is known to be associated with a higher risk of infections. In abstract 0535, Porter and colleagues have assessed infection rates in the pre-RA and early RA phases as defined by antibiotics prescription and hospital admissions with an infection main diagnostic code in the UK National database.
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Survival and Mortality in RA: time to move away from “one-size fits all”?
Patients with RA are known to have a higher mortality risk than the general population.
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Can we use sputum to identify progression to RA in at-risk individuals?
Sputum anti-CCP-IgA anti-CCP-IgG & RF-IgM positivity = 4-fold increase risk of classified RA in IgG CCP+ at-risk individuals.
Sens 67% Spe 80%
https://t.co/o6PCvxgYGM
Abs #0533 #ACR22 #ACRBest @Rheumnow https://t.co/CxDjanjBKT
Aurelie Najm AurelieRheumo ( View Tweet)
@erasmusmcintl @RheumNow Data here from @earlyarthritis (CATCH Canada cohort), similar results.
It's not just pain differences - but that's real too. It's lots of things, but whatever the case we ignore sex and gender's impact in RA at our peril.
ABST0532 #ACR22 @Janetbirdope @TheLancetRheum @RheumNow https://t.co/27uQmNAlPF
David Liew drdavidliew ( View Tweet)
Emerging and exciting treatments in RA: #ACR22 preview
https://t.co/5JtblF9MxE https://t.co/oYSiLguLkJ
Links:
Dr. John Cush RheumNow ( View Tweet)
Are DNA methylation marks the new seronegative RA biomarkers?
Riskedal et al. propose a new model based on whole-blood DNAm profiles
Sens 90%, Spe 88%, Accuracy 89% for classification of RA
Accuracy RA Sero+ 100%, RA Sero- 75%
https://t.co/3occAQPZ1u Abs#0531 #ACR22 @Rheumnow https://t.co/QXhMxyWC8g
Aurelie Najm AurelieRheumo ( View Tweet)
18mo data of ARIAA study (6mo ABA in pre-RA):
12mo after discontinuation
Progression to RA ABA 35% vs PBO 57% p=0.008
Improvement in synovitis, osteitis & tenosynovitis ABA 57% vs. 29% PBO
Enough to move into clinical application?
https://t.co/2CDN9M31mB
Abs#0530 #ACR22 @Rheumnow https://t.co/R54AokGSiK
Aurelie Najm AurelieRheumo ( View Tweet)
Rates of MACE and VTE with upadacitinib were infrequent and consistent with background rates in RA, PsA and AS patients. Factors associated with MACE/VTE: age>65, HTN, DM, smoking, history CV event/VTE
Abs#0510 @RheumNow #ACR22 https://t.co/AjtJF0p3QK
Robert B Chao, MD doctorRBC ( View Tweet)
England et al. Influence of FVC on choice of b/tsDMARD in RA-ILD. FVC predicts hospitalisation and mortality. However, it did not appear to influence choice of b/tsDMARD. Overall 67% of RA-ILD patients initiated TNFi, weird! @rheumnow #ACR22 Abstr#245 https://t.co/swuNHv96WD https://t.co/vy5FUPnNjo
Richard Conway RichardPAConway ( View Tweet)
Difficult to treat #rheumatoidarthritis - phenotypes need to be defined and order of Rx may be v Impt. Well, it is really difficult @RheumNow #ACR22 session 12S127 https://t.co/x3bkUP590A
Janet Pope Janetbirdope ( View Tweet)
BIOBADASAR study of cancer risk in RA patients with prev cancer treated with b/tsDMARD. No increased risk, but yet again abatacept numbers are making me slightly nervous! @rheumnow #ACR22 Abstr#0267 https://t.co/H8gYm9STT3 https://t.co/sEIS6Ljwao
Richard Conway RichardPAConway ( View Tweet)
Kunishita et al Abatacept in those with RA and prev cancer (or not). Equally effective. No significant difference in 5-year malignancy but those curves look like they are diverging to me! @rheumnow #ACR22 Abstr#0255 https://t.co/1E2SXMGbqD https://t.co/gTvOOnuzo0
Richard Conway RichardPAConway ( View Tweet)
What do you do if a person with #rheumatoidarthritis was great on 1st JAKi. It was 1st line advanced Rx @RheumNow #ACR22
Janet Pope Janetbirdope ( View Tweet)
@ericdeinmd is moderating a great session, difficult to treat RA at #ACR22 right now! #rheumpix @RheumNow https://t.co/R5yg3eme6v
Dr. Rachel Tate uptoTate ( View Tweet)
OPAL data is a gem! Large Australian data studying JAKi use in #rheumatoidarthritis N=5900 Switching JAKi~JAKi-common. As in TNFi 1st line Rx had longer retention & better efficacy than 2nd & subsequent. Median 1st advanced Rx - same in all JAKs 34 MOA @RheumNow #ACR22 abst0274 https://t.co/FQU4AKXwe9
Janet Pope Janetbirdope ( View Tweet)
OPAL dataset 🇦🇺: 55000+ RA pts, 1/10 first line JAKi. Persistence > if 1st line,< x2 if 3rd line.
1/2 switch JAKi->TNFi
1/3 switch JAKi ->JAKi
Why high proportion of JAKi cycling, when AE reason for switch low?
https://t.co/APdWW7fzJE
Abst #0274 #ACR22 @Rheumnow @ClaireDeakin10 https://t.co/3xM3lQO1wI
Aurelie Najm AurelieRheumo ( View Tweet)
ACR Year in review J. Varga
What drives TNF superproduction in RA?
Study mice 🐁 model grafted w/ human synovial tissue suggests
important role of mitochondrial stress through aspartate deficiency
A potential new therapeutic target 🎯 RA?
@RheumNow #ACR22 #ACRyearinreview https://t.co/lKrOn05sFp
Aurelie Najm AurelieRheumo ( View Tweet)
Tissue-resident memory T cells (Trm):
☝️Do not recirculate by blood or lymphatics
☝️Can drive recurrent inflammation
☝️Fixed-drug eruption is an example
CD8Trm - abundant in late stage non-inflamed RA synovium
#ACR22 @RheumNow #yearinreview #RheumTwitter https://t.co/LfTI0LamkN
sheila RHEUMarampa ( View Tweet)
New 2022 EULAR Recommendations for the Management of RA
The updated '22 EULAR recommendations for the mgmt of RA were initially presented at EULAR '22, and are now in press delineating the most recent developments and perspectives in RA treatment.
https://t.co/xnpOUnpgvy https://t.co/OWcRq7nZ57
Links:
Dr. John Cush RheumNow ( View Tweet)
A group of older patients w/ multimorbidity (5+) drives higher mortality risk in RA.
Crowson et al. stratification 4 clusters. Each cluster = different outcome, younger cluster w/ few comorbidities = no > mortality
https://t.co/IYccicjcyy
Abstr #0246 #ACR22 @Rheumnow #ACRBest https://t.co/ee9sgG3g0l
Aurelie Najm AurelieRheumo ( View Tweet)
