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Dr. Despotovic shares general principles about ICU admissions in patients w/ #rheumatic disease.
🔺#SLE, RA, systemic #vasculitis, SSc, IIMs
🔺serologic testing useful but interpret w/n clinical context
@RheumNow #ACR21 https://t.co/jb3Mt31dZz
sheila RHEUMarampa ( View Tweet)
#ACR21 Thieves! TM11. Belly pain in patient with RA nodules:
⭐️ A: rheumatoid nodulosis of pancreas and duodenum.
Great case!
@Rheumnow https://t.co/PuO4tka3FJ
Eric Dein ericdeinmd ( View Tweet)
Sub-analysis of ICHIBAN study looking at adverse events in tocilizumab treated patients with/without steroids. Steroids associated with small increase in adverse events across board. Abstr#1693 #ACR21 @RheumNow https://t.co/ldiovirKpo
Richard Conway RichardPAConway ( View Tweet)
Meta-analysis of PUFA supplementation in RA. Apparent benefits across most measures, albeit often small. Abstr#1682 #ACR21 @RheumNow https://t.co/1rGhpqvJvp
Richard Conway RichardPAConway ( View Tweet)
GLORIA study of adding prednisolone 5mg to DMARDs over 2 years for RA in those >65 years. Mean DAS 0.37 points lower, Sharp score 1.7 lower (are either of these clinically significant?). NNH 9.5. To me causing harm chasing statistical benefit Abstr#1678 #ACR21 @RheumNow #ACRBest https://t.co/KYk1II3J3w
Richard Conway RichardPAConway ( View Tweet)
I don't know much about antifibrotics in RA-ILD, but these data emphasise that HRCT pattern matters
My simple mind, for any disease:
multiple subtypes with different trajectories➡️likely to be differing responses to Rx
TRAIL1: pirfenidone in RA-ILD
#ACR21 ABSTL10 @RheumNow https://t.co/v7HCO0ZBe1
David Liew drdavidliew ( View Tweet)
Comparative effects of abatacept in RA-ILD with UIP/NSIP. Appears equally effective in stabilising FVC, DLCO, and HRCT findings in both. Abstr#1683 #ACR21 @RheumNow https://t.co/l0Ia1D9c56
Richard Conway RichardPAConway ( View Tweet)
Sleep disturbance common and associated with disease activity (both PRO and physician-assessed) in RA. Need further studies to evaluate causal directions, but may well be bidirectional? Abstr#1666 #ACR21 @RheumNow https://t.co/eK65I92wPg
Richard Conway RichardPAConway ( View Tweet)
#ACR21 Ab#1683: ABA for RA-ILD
⭐️Stabilization of DLCO, FVC, HRCT in UIP and NSIP in 106 UIP, 84 NSIP patients
⭐️Stabilization or improvement of dyspnea in 91% UIP, 95% NSIP pts
@Rheumnow https://t.co/qfgDmooGOj https://t.co/gz6Jk15nUs
Links:
Eric Dein ericdeinmd ( View Tweet)
#ACR21 Ab#1699: ITIS diet:
⭐️Fatigue ⬇️ in 20 pts on ITIS trial, didn't correlate with final DAS28CRP
⭐️Fatigue responders (50% improvement) had different fecal microbiome changes & anti-inflamm compounds, than non-responders
@Rheumnow https://t.co/UvE2ZpxCDU
Links:
Eric Dein ericdeinmd ( View Tweet)
☄️Late breakingTRAIL1 RCT Pirfenidone on RA-ILD.
✨Primary outcome on incidence of decline of >10% FVC or death not met 11% PIR vs. 15% PBO OR=0.67 p=0.48
BUT
✨underpowered
✨reduces decline in FVC(ml) over 52wk (-66 vs. -146, p=0.0082)
✨safety ok
#ACR21 #AbstL10
@RheumNow https://t.co/IxYDE3lN1s
Aurelie Najm AurelieRheumo ( View Tweet)
Safety update for #filgotinib in #RA over ~2.2yrs treatment
👉🏼Well-tolerated with no ne safety concerns since 2020
👉🏼AE incidence rates decreased or remained stable
👉🏼Slight incr rates of NMSC & non-NMSC malignancies
Abs#1698 #ACR21 @RheumNow
https://t.co/0jbZFVgiyN https://t.co/yOlntLwQlU
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR21 Ab#1655. Respiratory Ifn in RA on bDMARD
▶️1 group was initiated into vaccination program vs usual care
⭐️Vaccinated group had ⬇️ admissions from respiratory ifns. 44% ⬇️ severe resp ifn
💉programs work!
@Rheumnow https://t.co/pljR6DbAtU https://t.co/goSHGID8qG
Links:
Eric Dein ericdeinmd ( View Tweet)
#Multimorbidity in women with #rheumatoidarthritis is increased compared to men with RA. However, women and men without RA have similar levels of multimorbidity.
Abs#1656 #ACR21 @RheumNow
https://t.co/iXhXOldTy0 https://t.co/CsOM7odE69
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR21 Ab#1658 - Autoimmune Risks in Relatives of RA pts. 1st degree relatives have risk of:
▶️ AI thyroid (OR 1.3)
▶️ Celiac (1.5)
▶️ SLE (1.3)
▶️ IBD - no ⬆️ risk
⭐️1st, 2nd, 3rd degree relativ: ⬆️ risk of RA
⭐️2nd degree: ⬆️ risk SLE
https://t.co/ATHdemoF45 @Rheumnow #ACRbest https://t.co/JcuZmg9L8E
Links:
Eric Dein ericdeinmd ( View Tweet)
GLORIA RCT: 400+ pts. Low dose Pred in RA >65yo on top of other treatments 2yrs.
Authors conclude benefit/risk balance in favour of GCs 🧐
2 thoughts:
1️⃣ CV risk linked to GCs ⬆️ over time and cumulative dose: Follow up= short!
2️⃣ Small # for CV events
#ACR21 #Abst 1678 @RheumNow https://t.co/QECJR68ZJu
Aurelie Najm AurelieRheumo ( View Tweet)
What is the likelihood of developing an #autoimmunedisease in first-degree relatives of pts with #RA?
Genealogical & phenotypic data suggests lower threshold for screening for autoimmune thyroiditis, #coeliac & #SLE in FDRs.
Abs#1658 #ACR21 @RheumNow
https://t.co/PdSZ05elsf https://t.co/AkIXDkWCM8
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR21 Ab#L02 - #COVID19 vax in rheumatic pts:
❌No ⬆️ in disease activity scores post-vaccination
❌No serious adverse event
▶️Vax response 88% in RA, 78% in SLE, 87% other rheum diseases after 2 shots vs 100% controls
⭐️RTX and MMF ⬇️ responses
@Rheumnow https://t.co/BChhmW0jpy https://t.co/2q8IKRoYqW
Links:
Eric Dein ericdeinmd ( View Tweet)
Dr Coras on "ITIS" anti-inflammatory diet in RA. Improves fatigue after 2 weeks. Fatigue response dissociated from disease activity response. Open label, but promising. Fatigue remains one of our biggest challenges in RA. Abstr#1699 #ACR21 @RheumNow @ElenaNikiUK https://t.co/tBMqmWAy8m
Richard Conway RichardPAConway ( View Tweet)
#Depression is associated with a 3x increased mortality risk in patients with incident #RA.
👉🏼Results from #DANBIO
👉🏼~11000 RA pts, ~1000 starting antidepressants
Abs#1659 #ACR21 @RheumNow
https://t.co/SsEjmLzacP https://t.co/1GiFE0KLjK
Mrinalini Dey DrMiniDey ( View Tweet)
