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Eating for Rheumatoid Arthritis
The majority of practicing rheumatologists at RheumNow Live were unaware of the new ACR guidelines issued in 2022 regarding dietary and lifestyle recommendations for patients with Rheumatoid Arthritis. Dr. Monica Guma reviewed these guidelines during her lecture on the impact of diet on disease activity and therapeutic response.
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Five Takeaways in PsA/SpA at RNL 2024
Continuing with the theme of clinical pearls, the PsA and SpA speakers also provided a wealth of information. Here are my five key takeaways and clinical pearls.
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ARIAA Trial: Abatacept Delays the Onset of RA
The ARIAA trial tested the utility of IV abatacept in individuals ACPA+ arthralgia patients with subclinical inflammation and showed abatacept to decrease MRI inflammation, clinical symptoms, and risk of future rheumatoid arthritis (RA) development.
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Cochrane Review: How Good is Ultrasound Diagnosing GCA?
Is temporal artery ultrasound equivalent or superior to the reference standard of temporal artery biopsy when diagnosing giant cell arteritis (GCA)?
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EMG fibrillation potentials (insertional activity) & positive sharp waves (Fib/PSW) are found in 95% study of 75 pts dx w/ idiopathic inflammatory myositis (44 PM, 17 DM, 7 ADM, 11 IBM); but also in 4 pts not meeting EULAR criteria https://t.co/VsrNjDMGnC https://t.co/OQYnUPJD5o
Dr. John Cush RheumNow ( View Tweet)
False positive COVID tests (+Rapid Ag; neg PCR) are rare, 1.7% of 11,297 tests; Persistent false positives seen in 13/191 and usually in women, with autoimmune dz (6/13; RA, SLE etc) & using the Quidel QuickVue rapid antigen test https://t.co/Pqkk7uBVcO https://t.co/m6ylQz00Ih
Dr. John Cush RheumNow ( View Tweet)
Join our experts, Drs Liebowitz and Mehta, as they provide insights on the differential diagnosis and management concepts in autoinflammatory diseases.
https://t.co/r5WjYIdmaT https://t.co/gGdhyDKqtC
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Dr. John Cush RheumNow ( View Tweet)
Week 52 outcomes of 180 lupus nephritis pts (IV, VI, III) from AMP academic centers (rx w/ standard of care) showed 22% complete resp, 22% partial resp, 42% non-responder& 14% undetermined. 8/180 (4.4%) had CR sustained Wk 12 to 52; 10% PR. An unmet need! https://t.co/UfYDKqHq1D https://t.co/zUIgvsZY6m
Dr. John Cush RheumNow ( View Tweet)
Cochrane Review: How Good is Ultrasound Diagnosing GCA?
Is temporal artery ultrasound (US) equivalent or superior to the reference standard of temporal artery biopsy (TAB) when diagnosing giant cell arteritis (GCA)?
https://t.co/BWzP3K8dCo https://t.co/DMu19sPMQv
Dr. John Cush RheumNow ( View Tweet)
Orismilast is a novel oral phosphodiesterase-4 (PDE4) B/D inhibitor studied in phase 2b RCT in 202 moderate-to-severe psoriasis pts vs PBO. At wk 16, Orismilast was better at PASI 75 (40%-49% vs PBO 16.5%; P <.05) and PASI90 (22%-28% vs 8%; P <.05) https://t.co/wSmiO2Hr5W https://t.co/gMiQUfT6EG
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Dr. John Cush RheumNow ( View Tweet)
Mayo study of 1643 #RA pts (Dzduration 7 yrs) found 4 clusters based on # of comorbidities (Cluster 1 [42%] few comorbidities & cluster 4 [7%] > 10). Cluster 1 w/ good prog/survival; but cluster 4 was older, less DMARDs/biologics https://t.co/NTJvuBujdp https://t.co/wZycwYDfFS
Dr. John Cush RheumNow ( View Tweet)
Vasculitis Pearls
Once again RheumNow Live 2024 really delivered with high impact learning packed into short sessions. As someone with an interest in vasculitis it was fantastic to see four of my favorite speakers in the Vasculitis Mavens and STEP talks
https://t.co/RnaHa54F2T https://t.co/aRpAdz1o8y
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Dr. John Cush RheumNow ( View Tweet)
How do you manage enthesitis?
Enthesitis can be a challenge for clinicians to identify, evaluate, and manage in patients with psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA).
https://t.co/9SHM5aZAly https://t.co/KWYnhymsVr
Dr. John Cush RheumNow ( View Tweet)
IV zoledronic acid (ZA) of PBO was given to 222 pts with symptomatic knee osteoarthritis (without severe joint space narrowing) and after 7 yrs of F/U, ZA had no effect on Knee OA progression w/ similar TKR Rates (39% vs 30%) https://t.co/P09EvRmApO https://t.co/s5fL1unM45
Dr. John Cush RheumNow ( View Tweet)
Retrospective analysis of the Australian Scleroderma Cohort Study, finds 43% of SSc pts have evidence of myopathy. From 1786 participants, 155 had prox. weakness, 24% CK elevation & 4% prox weak+CK^ (latter in more severe SSc) https://t.co/cB4Ul6VMB2 https://t.co/uAIMaotPdv
Dr. John Cush RheumNow ( View Tweet)
Long-Term, open-label study enrolled EGPA (MIRRA study) required prednisolone ≥5 mg/d, pts cont mepolizumab 300 mg Sc q 4 wks +SOC. 100 pts - 71% completed, 3% d/C due to AEs. Exposure~38 mos; 38% serious AEs (30/100PYs) (worsening of asthma, EGPA https://t.co/8qrbFigc9T https://t.co/7QP8qGfsSm
Dr. John Cush RheumNow ( View Tweet)
Top 5 Clinical Pearls in RA Management
#RNL2024 provided a wealth of clinical insights, particularly in the realm of rheumatoid arthritis (RA) management. Here are the top five clinical pearls from the event's opening session, "Success in RA."
https://t.co/QrtnbeLxRZ https://t.co/5K2YRzvzcp
Dr. John Cush RheumNow ( View Tweet)
Serious infx (SIE) is prevalent in SLE given RTX. TOtal of 174 SLE pts on RTX -- SIE rate was high at 51/100 PYs (Pneumonia 30/100 PYs; PJP in 6.1/100 PYs).12 deaths. SIE risk factors were CKD (HR 2.9), Pred ≥15 /day (HR 3.5). HCQ decreased SIE (HR 0.35) https://t.co/8GcSQx8nxh https://t.co/oZvMgTxKVI
Dr. John Cush RheumNow ( View Tweet)
APIPPRA Trial: Abatacept in at-risk rheumatoid arthritis patients
Abatacept has been studied in seropositive clinically suspect arthralgia patients (at risk for rheumatoid arthritis) and shows the potential to delay or prevent the disease.
https://t.co/w944yaXNOd https://t.co/UvTVRTK1er
Dr. John Cush RheumNow ( View Tweet)
TLL-018 (oral dual JAK & TYK2 inhibitor) studied in chronic urticaria unresponsive to H2 blockers and was well tolerated and showed high efficacy in moderate-to-severe patients https://t.co/FDa60c5H24 https://t.co/BhHfPaLbfE
Dr. John Cush RheumNow ( View Tweet)