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Are we overprescribing because guidelines may be skewed to favor the pharmaceutical industry? Interesting questions posed by Dr. A Kavanaugh #RNL2024 @rheumnow https://t.co/wEwHaWNY5k
TheDaoIndex KDAO2011 ( View Tweet)
Dr. A Kavanaugh discussed Ethics #RNL2024: publication bias where positive results are likely to be published compared to those with no effects -- this is a sham study with made up data submitted to 2 different ortho journals. @rheumnow https://t.co/j6gVgA67nC
TheDaoIndex KDAO2011 ( View Tweet)
Kavanaugh on Medical Ethics
#RNL2024 @RheumNow
Bias in research for ++ outcomes leads to fudging/biased interpretations of results
Fabricated study results submitted to orthopedic journals:
- 97% acceptance for positive result, 80% for no-difference result. Bias towards +outcome https://t.co/x7JJabSs4z
Eric Dein ericdeinmd ( View Tweet)
Kavanaugh on Medical Ethics
#RNL2024 @RheumNow
How do we informed consent?
- How to fully inform pts in complex research?
- Or paternalistic to not provide detailed info
- How deep to disc risk/ben?
- Easier to study in countries w/o good SoC
Prior hx: prisoners, Nazi, Tuskegee
Eric Dein ericdeinmd ( View Tweet)
@drcassysims recommends @NIH resource: https://t.co/ebtvc2zYbE to guide lactation- updated and run by pharmacists. #RNL2024 @rheumnow
TheDaoIndex KDAO2011 ( View Tweet)
MTX and cyclophosphamide are the two drugs @DrCassySims recommends holding during breast feeding in our vasculitis patients. #RNL2024 @RheumNow
Dr. Rachel Tate uptoTate ( View Tweet)
Do you get extra-cranial imaging in your GCA patients? #rheumtwitter #RNL2024 @RheumNow @anisha_dua @DrCassySims @philseo
Dr. Rachel Tate uptoTate ( View Tweet)
Dr P Seo answers audience questions…he does not check ANCA levels regularly as results do not impact his actions but may induce anxiety #Vasculitis #RNL2024 @RheumNow https://t.co/GV62DF7s3y
TheDaoIndex KDAO2011 ( View Tweet)
@DrCassySims checks APS ab on ALL pregnant (vasculitis) patients. "HCQ decreases neonatal lupus risk by half, meaning great reward for little risk." CS at #RNL2024 @RheumNow
Dr. Rachel Tate uptoTate ( View Tweet)
Dr. P Seo's summary slide on management of #vasculitis #RNL2024 @rheumnow https://t.co/cZLI6iz1sL
TheDaoIndex KDAO2011 ( View Tweet)
How Dr. P Seo manages #vasculitis patients with nonrespiratory manifestations #RNL2024 @rheumnow https://t.co/sjTXulDZ3a
TheDaoIndex KDAO2011 ( View Tweet)
#RNL2024 vasculitis mavens answering questions. @RheumNow https://t.co/Lm1N666SlS
Dr. Rachel Tate uptoTate ( View Tweet)
While #dupilumab can be used for #EGPA, be careful about using it in pts with high eosinophilia; don't taper steroids too rapidly if you use this drug. - Dr P Seo @rheumnow #RNL2024 https://t.co/YKQdtvCS0M
TheDaoIndex KDAO2011 ( View Tweet)
Consider using IV Benralizumab (also an IL5 inhibitor) for #EGPA in pts where insurance won't approve SQ mepolizumab - Dr. P Seo #RNL2024 @rheumnow https://t.co/VFE76Uzb2S
TheDaoIndex KDAO2011 ( View Tweet)
EGPA - Peanut butter and Jelly
@philseo
Respiratory symptoms and systemic disease
Respiratory: non-systemic (inhalers, steroids, irrigation) IL-5 inhibs
Non-respiratory: eosinophilic (myocarditis, urticaria, EE), vasculitis (MM, GN, DAH, purpura, arthralgias)
#RNL2024 @RheumNow https://t.co/KTlvZ1cnfH
Eric Dein ericdeinmd ( View Tweet)
"EGPA is a lot like peanut butter and jelly, two separate things showing up at the same time (in terms of respiratory and systemic manifestations.)" Dr. @philseo at #RNL2024 @RheumNow https://t.co/l0WgG1caN0
Dr. Rachel Tate uptoTate ( View Tweet)
“Patients with EGPA are like peanut butter and jelly … 2 different manifestations: respiratory manifestations and systemic manifestations” - Dr. P Seo with lunch on his mind. #RNL2024 @rheumnow https://t.co/y7SLEG9qRt
TheDaoIndex KDAO2011 ( View Tweet)
Dr. P Seo's Pearls for #Vasculitis:
1. Weekly or q2weeks SC TCZ is fine for newly diagnosed patients, but if pts relapse, use weekly TCZ.
2. oral steroids perform fine (no need to do IV pulse) even in pts with vision changes
3. taper steroids over 3-4 months
@rheumnow #RNL2024
TheDaoIndex KDAO2011 ( View Tweet)
The great unknown with tocilizumab in GCA, do you stop, how do you stop, etc. @philseo approach. I'm not as brave! Usually park at every other week dosing @RheumNow #RNL2024 https://t.co/y7mg57mWND
Richard Conway RichardPAConway ( View Tweet)
Do you have GCA patients on low dose prednisone? Feel reassured.
Dr. @philseo provides data showing that low dose prednisone may be helpful in remission maintenance. #RNL2024 @RheumNow https://t.co/oyOsczfkfv
Dr. Rachel Tate uptoTate ( View Tweet)