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The RheumNow faculty reporters have been scouring the meeting and online presentations to find the best abstracts from ACR22. Here are some of their choice abstracts reported today on day 1 of ACR 2022 (#ACRbest).
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Recently the FDA approved deucravacitinib, a highly selective TYK2 inhibitor for psoriasis. Trials are positive in psoriatic arthritis and a phase II study in SLE. What about the effects? Presentations from the ACR22 meeting may provide answers.
TheDaoIndex
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Most rheums round down on dosing because of the weight based recc's, but hydroxychloroquine dosing less than 5 Mg/kg/day leads to increased hospitalizations for #SLE flares abst#1654 #ACR22 #PressConference @rheumnow https://t.co/GGnnl14cy9
Olga Petryna
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#abs0948 #acr22 @rheumnow perception on fertility&ART in pts w/rheum Dx: 60% believe their Dx affects fertility/25% believe meds do: most cited MTX, steroids, TNFi, HCQ, NSAIDs. 92% heard of ART but unsure if safe or successful w/their Dx. Hx of infertility 29%/only 52% go w/ART https://t.co/lmaM773gP5
sheila
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Did you know?
Teratogens may take the form of:
✳️Drugs & chemicals
✳️Physical agents
✳️Infections
✳️Metabolic conditions
#ACR22 @Rheumnow #MedTwitter https://t.co/GfHL28RYjm
Catherine Sims, MD
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Early TNFi use and cardiovascular events in AS
Abstract #0415 #ACR22 @RheumNow
📍17.6k patients, 91% male, 80% white
📍TNFi initiators were younger with lower prev. of HTN and DM
📍TNFi was associated with higher risk of incident CVD, CVA, and MACE https://t.co/7bCkfk7EYY
Mike Putman
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I questioned HCQ dose reducing in my recent newsletter & podcast; more evidence!
Receiving less HCQ = more damage and more CVD
Observational, not clearly causal, but should make you wonder...
Are we sure we should be shooting for <5mg/kg/day?
#ACR22 @RheumNow #0982 https://t.co/SuAwSumgu1
Dr. Rachel Tate
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In non-renal SLE, BEL associated w/ a lower risk of severe infection and hospitalizations due to severe infection compared to MTX, AZA, MMF. Abs 0349 #ACR22 @RheumNow https://t.co/0EBpCMPOqF https://t.co/vdxKVJSaZA
Md Yuzaiful Md Yusof
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#ACR22 Abstr#0783. Rituximab impacts on humoral immunity. Our study on 400 RMD pts showed:
Breakthrough infection 30% mostly mild; Severe 4%; 1 death
Poor outcomes predicted by comorbidities & low IgG
Risk reduced by 50% with each vac dose
OK for RTX if vaccinated @RheumNow https://t.co/xyJsukm1Rh
Richard Conway
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Broder et al. HCQ alone vs steroid alone as maintenance in ESKD due to SLE. HCQ less cardiac events, less infection. @RheumNow #ACR22 Abstr#0539 https://t.co/mb3Eof2Uiv https://t.co/3i3ZTY25ru
sheila
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How can we differentiate statin-assoc autoimmune necrotizing myopathy from toxic statin #myopathy?🔎
Remember this important slide👇
#ACR22 @Rheumnow #acrreview https://t.co/hKMJuGDJWt
sheila
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Statin therapy may exacerbate underlying neuromuscular disorders.
‼️REMEMBER☝️The only ABSOLUTE contraindication to statins are pts who are HMGCR+
#ACR22 @RheumNow #acrreview https://t.co/A3XGHlrm0X
sheila
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How long do we hold meds for live-attenuated #Vaccines? ACR 2022 vax guidelines:
💉Pre-vax:
💊csDMARDs - hold time 4 wks
💊bDMARDs -hold time of one dosing interval
💉Post-vax: hold DMARDs for 4 wks
#ACR22 @rheumnow @rheumarhyme @doktora_ging https://t.co/MGc422EtIC
Richard Conway
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Patel @NaomiRheumMD et al. HbA1c in GiACTA. Tocilizumab assoc HbA1c reduction independent of steroids. Daily steroid dose assoc HbA1c @rheumnow #ACR22 Abstr#0461 https://t.co/9Nbewrpww8 https://t.co/NyeTyWICF6
Patricia Harkins
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🪞MIRROR RCT🪞
💊MTX ⬆️ response of Pegloticase in resistant gout pts (60% vs PBO 30.8%)
🦶Tophus resolution wk 52 >24 (cont. benefit💪🏻)
🧪⬇️ drug Ab with MTX
✅ No new IRs
Abst#0001 #ACR22 @RheumNow #plenary https://t.co/8lPKQ0VGqC
Eric Dein
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Ab0349 #ACR22 BEL vs AZA ifn risks in non-renal SLE
BEL: lower risk of severe ifn (HR 0.81) and hospitalization for ifn (HR 0.73) through 5 yrs
Challenge to interpret data as 56% of patients were on glucocorticoids and other anti-rheumatic meds
@RheumNow https://t.co/a0tNFn5Wqr
Dr. Rachel Tate
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MIRROR results showed 12-month safety/efficacy support MTX co-therapy w/ pegloticase. No IRs after 6mo of tx and increased resolution of tophi at wk 52. I use MTX in my gout pts on Pegloticase. Are you #rheumtwitter? Abs 0001 #ACR22 @RheumNow https://t.co/FLwOmAYrS4
TheDaoIndex
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Study of IV tocilizumab for GCA that led to FDA approval of intravenous TCZ this year (2/2022) -one of Dr. C Langford's pick for #YearinReview
@rheumnow #ACR22 https://t.co/luxDDluddM
Janet Pope
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Is it the medication or behaviour that increases mortality? #SLICC grp showed in #SLE severe non-adherence to #HCQ in Yr 1 of #lupus = 3 poor outcomes -more 1 flares, 2 damage, 3 5yr-death. Surrogate of other poor health behaviours and/or HCQ? abst#0343 #ACR22 #ACRBest @RheumNow https://t.co/tTRdyti0sf
Eric Dein
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Ab0343. #ACR22 Severe non-adherence of HCQ associated with FLARES, DAMAGE and DEATH
7.3% had "severe non-adherence" by HCQ levels
Hazard ratio of flare 3.3, damage 4.26, and death 5.4
Not surprising, but very useful for pt discussion
Checking HCQ levels are helpful!
@Rheumnow https://t.co/S7P9oTPRGJ
