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Can tender and swollen joint counts work in a telemedicine world?
In a world where telemedicine and virtual care are not going away, is there value in patients assessing their own tender and swollen joints?
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After failing a JAK inhibitor, can you still hit a JAK-pot?
Januse kinase (JAK) inhibitors are targeted synthetic disease modifying anti-rheumatic drugs (tsDMARDs) that have risen in popularity as earlier treatment options for rheumatoid arthritis.
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Day 1 Report from ACR21
The first full day of Abstracts and Presentations from ACR Convergence, was full of highly engaging sessions, quality posters and unique presentations. To hear more about the best of the best, I would encourage you to look at our Day 1 Recap Video and Day 1 ACR Best Abstracts. Here are a few of my favorites from the first day.
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#ACR21 Abs#1224. ⬇️ CD39 expression on B cell predicts occurrence of anti-drug Ab in RA on RTX
⭐️13/23 pts on RTX became ADAb+. No diff in concomitant MTX usage
⭐️Baseline CD73 similar, but lower CD39 predictive of ADAb
https://t.co/QzbAmXtTmZ @Rheumnow https://t.co/CLtEev69YD
Links:
Eric Dein ericdeinmd ( View Tweet)
#ACR21 Abs#1225: B/L Extracell Matrix Biomarkers predict ABA response in MTX-naive, +ACPA early RA
⭐️ECM biomarkers predict SDAI remission or DAS28 w ABA+MTX vs PBO+MTX.
⭐️⬆️CTX1 biomarker predicts efficacy endpts for ABA+MTX
https://t.co/7wHQefb5D4 @Rheumnow
Links:
Eric Dein ericdeinmd ( View Tweet)
Wk 12 disease activity predicts wk 24/26 remission/low disease activity with #upadacitinib 15mg in MTX-naïve or inadequate responders to MTX and/or TNFi pts.
≥50% improvement in SJC/TJC at Wk 12 was assoc with wk 24/26 remission/low disease activity.
Abs#1237 #ACR21 @RheumNow https://t.co/PAaCe5MAcu
Mrinalini Dey DrMiniDey ( View Tweet)
Ultrasound in CSA patients:
Retro US cohort 110pts
28.2% w/ 💥Power Doppler synovitis. 36.8% at 6mo evolved to RA among which 100% PD+ vs 25% PD-
PD + predicts evolution to clinical RA (OR 13.1; CI 1.07-161.04)
Easier and less invasive than MRI!
#Abstr1525 #ACR21 @RheumNow https://t.co/MkhWTvnv3L
Aurelie Najm AurelieRheumo ( View Tweet)
#ACR21 Abs#0819. RheumTAP real-world cohort of pts tapering Rx in remission on RA
▶️ Pts tapering 7.6x ⬆️ likely to flare in f/u
Great convo soon on @Rheumnow re: tapering studies. @davidliew asks how many more times do we need to see drug w/d fail?
https://t.co/BiZSM7yp7o https://t.co/iDXGVpFZzB
Links:
Eric Dein ericdeinmd ( View Tweet)
Abst 0789
Baker & colleagues examined adipokine levels in association with disease activity in RA patients
- Patients with high levels of adipokines less likely to achieve low disease activity & remission
- These patients more likely to escalate to b/tsDMARDs
#ACR21 @RheumNow https://t.co/1xlO4W9q9v
Akhil Sood MD AkhilSoodMD ( View Tweet)
Another exciting day at #ACR21 and covering for @RheumNow
Also presented my poster (Abstr 0587) DMARD Use in Medicare Patients with #RheumatoidArthritis and Risk of Long-Term Opioid Use
- DMARD users showed lower odds of long term opioid use compared to non-DMARD users https://t.co/2XZgYY8ORg
Akhil Sood MD AkhilSoodMD ( View Tweet)
We know we're all not as great at treat-to-target in RA as we should be.
If we want to get fit, we join a group class.
If we want to study, we join a study group.
Why not the same with TTT, to motivate us to our best?
Virtual learning collaboratives 👏
#ACR21 ABST0815 @RheumNow https://t.co/siVOyKjPNx
David Liew drdavidliew ( View Tweet)
Dr. R Thomas note that even if you have RA, it's not too late to improve your lifestyle to be healthier. This will help with the mgment of the dz. 2/2 @rheumnow #ACR21
TheDaoIndex KDAO2011 ( View Tweet)
MRI Imaging in RA and SpA: Dr. Sheila Reyes (@RHEUMarampa )
Dr. Sheila Reyes discusses abstracts #0468 and #0469, presented at the #ACR21 annual meeting.
https://t.co/KUoO88dEhQ https://t.co/10R4jC5p0y
Links:
Dr. John Cush RheumNow ( View Tweet)
Ethnic disparities in pts with RA & CVD - paucity of evidence in published lit
Need to improve study inclusion, diversity to improve quality of care
#ACR21 https://t.co/sWKcHugU9W
Rheum Cat rheum_cat ( View Tweet)
In pts w/o RF, liver bx prev suggestd if lifetime cumulative MTX dose was 1-1.5g, then 3.5-4g.
All pts in centre offered Fibroscan
liver stifness associations:
- age, BMI
- not cumulative MTX dose
maybe survival bias, but what we're doing now is fine!
#ACR21 ABST0786 @RheumNow https://t.co/I6IhS3jhmC
David Liew drdavidliew ( View Tweet)
Does concomitant SJS affect tx effectiveness in RA?
Abst#0839 suggest yes!
➡️RA+SjS have an inferior response to TNFi than RA patients w/o SjS
BUT, RA/SJS pts w/ longer RA dz duration & ↑ DAS28 + HAQ-scores.
What's your clinical experience with this?
#ACR21 @Rheumnow https://t.co/TIc3raMOSJ
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Abst#0572: In US veterans w/ RA followed for 17 yrs, several cytokines+chemokines
⭐️Associated w/ ↑ risk of incident MACE independent of typical CVD RF & RA activity
&
⭐️Predicted MACE even if in LDA/remission
WOW! We need to do better @ CVD risk strat!
#ACRBest @RheumNow https://t.co/J74rRa9EQE
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
⭐️2 polyunsaturated fatty acid lipid mediator profiles are significantly associated w/ incident inflammatory arthritis in ACPA+ pts
➡️If validated, this would be of great utility in determining which pts w/ pre-clinical sero+ should be treated!
Abst#0590 at #ACR21 @RheumNow https://t.co/KGEwiY6G2Q
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Abstr 0983 mRNA SARS-CoV-2 Vaccine in RA Patients
Rubbert-Roth and colleagues found:
- RA patients developed anti-S1 antibodies slower and lower compared to controls
- Reduced titers among Abatacept & JAKi users
#ACR21 @RheumNow https://t.co/sXW8d53O8m
Akhil Sood MD AkhilSoodMD ( View Tweet)
Post-Hoc of ASCORE trial:
➡️RA w/ mod-high dz on SQ ABAtacept as 1st line tx w/ better retention vs receiving it as 2nd line tx independent of b/l duration of dz
➤Do you use ABA as 1st line treatment for RA, when/if insurance allows? Comment below!
Abst#0816 #ACR21 @RheumNow https://t.co/TRJga4OfiW
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
