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ACR Best Abstracts - Day 2
Day two at ACR 2022 was full of great sessions on imaging, vasculitis, lupus, vasculitis, spondyloarthritis, COVID, pregnancy, microbiome, economics and more.
Here are the RheumNow faculty selections for #ACRbest abstracts today:
Do you think you need a #steroid sparing Rx in #polymyalgia #rheumatica? +data in #sarilumab w 14 wk ped taper. No diverticulitis, ?Stacking comparator grp to flare as past steroid tapering caused a flare. But that is an unmet need after long pred Rx Abst#1543 #ACR22 @RheumNow https://t.co/Q1bhYs7LEz
Janet Pope Janetbirdope ( View Tweet)
Intersting discussion post Plenary this AM
- Agree w/RS that we should taper steroid
- Is there a disease modifying benefit? I think not
- When should this be used? Disagree w/RS, I would not use unless relapsing/refractory and requiring >10mg pred
#ACR22 @RheumNow https://t.co/ylGXk2sca7
Mike Putman EBRheum ( View Tweet)
Are your SpA pts planning on conceiving? Be careful with NSAID use
French study found age and NSAID use associated with longer time-to-conception.
Factors not associated: smoking, BASDAI score, DMARD use
#ACRBest Abs#1673 @RheumNow #ACR22 https://t.co/D63XTY7IB8
Robert B Chao, MD doctorRBC ( View Tweet)
Ab1674 #ACR22 HCQ in pregnancy is SAFE and Standard of Care!
In Utero Exposure to HCQ does NOT ass w/ ocular toxicity: OCTs 5 yrs after birth đź‘€
PATCH study of HCQ to reduce CHB in pregnancy
18% CHB (historical) -> 7% treated risk
OCT: retinal thickness nml at 5 yrs
@RheumNow
Eric Dein ericdeinmd ( View Tweet)
Are TNFi or IL-6Ri safe in rheumatic irAEs from ICI Rx?
Multiple big US centers retrospective:
TNFi, IL-6Ri vs MTX
p>0.05, but may be approx 2x risk of cancer progression
Has made me more cautious about TNFi, IL-6Ri - use MTX when you can
Lovely work! ABST1669 #ACR22 @RheumNow https://t.co/cfAT1pQZ7I
David Liew drdavidliew ( View Tweet)
Maya Buch on major adverse CV events in tofa vs TNFi. Post-hoc analysis of phase 3b/4 data looking at cohort enriched for CV events.
@RheumNow #ACR22 #LateBreaking
Julian Segan JulianSegan ( View Tweet)
L06 #ACR22 ORAL Surveillance Updates!
Composite of all ischemic CV events and HF did NOT show difference b/w TOFA vs TNFi
But, MACE numerically higher with Tofa w/ h/o ASCVD
Highest CV risk in TOFA 10 mg BID, 2/2 VTE risk
Most important risk is pt's individual risks
@RheumNow https://t.co/jPPX7f5GRE
Eric Dein ericdeinmd ( View Tweet)
Across extended MACE endpoints risk was numerically higher with tofacitinib vs TNFi in pts with a history of artherosclerotic CV disease (ASCVD). CV risk (MACE-8 with HF +VTE) was higher in the Tofa 10mg bd vs TNFi. Buch M #L06 https://t.co/lFXl2ywbZe #ACR22 @RheumNow
Dr. Antoni Chan synovialjoints ( View Tweet)
Nestor et al. HCQ <5mg/kg day assoc increased hospitalisation for SLE flare. aOR 4.41 (95% CI 1.50-12.98) @RheumNow #ACR22 Abstr#1654 https://t.co/I4bTu2DWaR https://t.co/jpOwHUTenk
Richard Conway RichardPAConway ( View Tweet)
Are we giving enough HCQ?🤔
Findings from the study of Dr J Nestor show that ⬇️dose HCQ (</= 5mkd or <400mg/day) is associated w/ ⬆️hospitalizations for #lupus (adj. OR 4.41; 3.48)
#ACR22 @RheumNow ABST#1654 @rheumarhyme #ACRBest https://t.co/XCoZgbdOim
sheila RHEUMarampa ( View Tweet)
Ozen et al. Safety Opioids vs NSAIDs in RA. Similar risks except 2-fold increase in VTE with opioids. @RheumNow #ACR22 Abstr#1646 https://t.co/kWBf8t4TFh https://t.co/dxKoilOhFX
Richard Conway RichardPAConway ( View Tweet)
Castrejon et al. Cancer risk with b/tsDMARD in BIOBADASER. Again not looking great for abatacept, Rate ratio vs TNFi 2.2 (1.4-3.2). Age-adjusted HR 1.6 (1.0-2.6) @RheumNow #ACR22 Abstr#1752 https://t.co/PvBq2O9qPv https://t.co/XBfistBMhW
Richard Conway RichardPAConway ( View Tweet)
Low dose #glucocorticoids in rheumatic diseases can lower bone mass and increase # even 2.5 mg #prednisone. The change in #BMD was more predictive of fracture not absolute BMD. L01 #ACR22 #ACRBest @RheumNow https://t.co/MbTk0L4DoK
Janet Pope Janetbirdope ( View Tweet)
NSAIDs and CV risk in Inflammatory Arthritis
Dr. Richard Conway discusses abstract 1207, being presented #ACR22 meeting.
https://t.co/CjU2YbA3tk https://t.co/bHE4xw2IRF
Links:
Dr. John Cush RheumNow ( View Tweet)
In a prospective cohort where MTX was withheld for 1 week post COVID vaccine, antibodies higher than other DMARDs which were continued (mostly RTX/MMF).
Good to see more direct data rather than having to extrapolate from flu.
@RheumNow ABST0913 #ACR22
https://t.co/YphKywNJfA
Julian Segan JulianSegan ( View Tweet)
Hidekawa et al. HCQ use assoc reduced severe infection in LUNA SLE registry, HR 0.26. ?due to better disease control rather than anti-infectious role, but HR 0.32 in multivariable model including SLEDAI. @RheumNow #ACR22 Abstr#2059 https://t.co/EgTJOAymoF https://t.co/gmchk9ZS5L
Richard Conway RichardPAConway ( View Tweet)
Uggh!
What would you do if your pt gets pregnant while on MTX & loses her baby, are you liable for accidental abortion? Should you advise termination if a pregnant pt’s health is deteriorating? @GreerDonley (#law professor) on theoretical risks #ACR22 @rheumnow https://t.co/L4FBWcKZnE
TheDaoIndex KDAO2011 ( View Tweet)
Stop MTX and increase folic acid to 5 mg/day for pts who find themselves with an unintentional #pregnancy. -@CuoghiE #ACR22 @rheumnow https://t.co/uChPU6zrwv
TheDaoIndex KDAO2011 ( View Tweet)
Corriere et al Duloxetine and gabapentin have similar rates of MI and stroke in non-cancer pain. There was some theoretical concern that duloxetine could increase risk but not evident here @RheumNow #ACR22 Abstr#1195 https://t.co/E3S9Md5XWq https://t.co/8KMtcU6d1B
Richard Conway RichardPAConway ( View Tweet)
