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Which DMARD would you use in an RA pt Rx naive pt with mod dz activity and who has RA lung dz?
#acr20 @RheumNow
k dao KDAO2011 ( View Tweet)
Which JAKi will you use after MTX failure? #acr20 @rheumnow
k dao KDAO2011 ( View Tweet)
Which biologic will you use after MTX and TNF failure for RA pts? #acr20 @rheumnow
k dao KDAO2011 ( View Tweet)
Large cohort of older RA pts newly rx w/HCQ or MTX:
👉~2-fold ⬆ risk of VTE – both PE and DVT- among patients newly treated with MTX vs. HCQ.
@RheumNow #ACR20 abs#2000 @DanielHSolomon https://t.co/ZnDuMhTMYF
sheila RHEUMarampa ( View Tweet)
HCQ not associated with ⬆ incidence of cardiac dse in this cohort of RA pts.
We should continue using it. Benefits >>>risks.
@RheumNow #ACR20 abs1999 https://t.co/zYpbX0CsR1
sheila RHEUMarampa ( View Tweet)
NEW ACR2020 Draft Guidelines for the Pharmacologic Treatment of RA
All the guidelines in 2 tables!
1. MTX 1st, oral > SC
2. Minimize GC!
3. TTT TTT TTT
4. Biologic/tsDMARD > Triple Tx
5. Taper MTX 1st
Close to my practice; suspect will be controversial!
#ACR20 #ACRambassador https://t.co/iFSlq1H65V
Mike Putman EBRheum ( View Tweet)
Rheum Now shares Day 3 highlights from #ACR20.
https://t.co/xNv1fG97ib https://t.co/Psa8bRqlVh
Links:
Dr. John Cush RheumNow ( View Tweet)
Abst#1717 confirms that early start of csDMARDs as 1st line tx & keeping ts/bDMARD as 2nd line tx (or more) is associated w/ a favorable outcome at 10 yrs in the ESPOIR cohort (a French multi-center cohort that followed patients w/ early RA). #ACR20 @RheumNow https://t.co/bzZiShCF97
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
This - very cool.
Not as impressive as the implanted vagal stimulation pilot data, but once a day and well tolerated. Very early days but enticing, we will see!
#ACR20 ABST1995 @RheumNow https://t.co/QZ8npob2H9 https://t.co/fRlFwIHqky
David Liew drdavidliew ( View Tweet)
Wonder if you can predict development of clinical RA in those at risk either w/ a
- +RF or +CCP
- Relevant sxs w/ or w/o abs
- 1st deg relatives do RA pts?
Abst#1722 shows patterns of pain or degree of jt swelling from SPARRA Qnairre can do so. #ACR20 @RheumNow https://t.co/bQ4ZmSYhBe
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Interesting Swedish abstract 1997 at #ACR20. Adjuvant #herpeszoster vaccine (Shingrix) not effective for 25% of JAKi-treated RA pts (n=40) for antibody response (T cell response usually worse, not reported). Is better than nothing good enough? Maybe we need to hold JAKi briefly?
Jeffrey Curtis RADoctor ( View Tweet)
Fantastic session about the 2020 guidelines for management of RA! Soon to be published.
One major difference from 2015 guidelines ➡️ Conditional recommendation to choose a Biologic over Triple Therapy in MTX-inadequate responders (Discussion about patient preference is key!) https://t.co/s016piIN7Q
Dr. Tina Mahajan drtinamahajan ( View Tweet)
Very strong push by #ACR20 to recc MTX in most RA patient scenarios including RA ILD, RA nodules, NAFLD in new RA guidance document @rheumnow
k dao KDAO2011 ( View Tweet)
You have a patient with RA on 25 mg MTX SQ, tolerating well without side effects. They have moderate disease activity. Your next step: @Rheumnow. #ACR20
Eric Dein ejdein1 ( View Tweet)
New #ACR RA guidelines is cost conscious:
1. DMARD naive: Preferred MTX over LEF>HCQ/SSZ and preferred MTX over biologic/tsDMARD
2. DMARD naive low DAS: HCQ or SSZ preferred >MTX>LEF
3. T2T goal LDA/remission
@rheumnow (thread)
k dao KDAO2011 ( View Tweet)
Hepatitis B infexn in RA? Below is the ACR 2020 draft treatment guidelines in this patient population: @RheumNow #ACR20 https://t.co/C3zw4TWOpg
sheila RHEUMarampa ( View Tweet)
Here is rationale for this recommendation away from triple therapy even though it has not shown to be inferior treatment, but works better/better adherence #ACR20 @Rheumnow. https://t.co/fQPOjLEjoA https://t.co/XrimgQW7oH
Eric Dein ejdein1 ( View Tweet)
Switching or adding a DMARD in pts w/ moderate-high dz RA activity & hx of previous serious infection w/in the past 12 mos as opposed to starting/increasing GCs is conditionally recommended per draft recs of new ACR RA treatment guidelines. #ACR20 @rheumnow @CCalabreseDO
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Draft #ACR20 Rx Recs for RA: MTX is conditionally recommended with NORMAL LFTs and no advanced fibrosis. Role of HCQ for NALFD has been suggested at ACR, but not enough for mod-high disease activity @RheumNow. https://t.co/QFF3BK1NF0
Eric Dein ejdein1 ( View Tweet)
New #ACR20 draft guidelines for RA treatment @RheumNow https://t.co/j8jUdgM4dD
Dr. Rachel Tate uptoTate ( View Tweet)