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NORD-STAR Trial: outcomes in tx-naïve, early RA pts after 48w of csDMARDs+GC vs bDMARD (ABAtacept, CerToliZumab, or ToCiluZumab)+MTX
➡️ Superior CDAI remission rates w/ ABA+MTX & CZP+MTX but not TCZ+MTX vs csDMARD+GC
➡️Imaging progression low in all
Abst#0825 #ACR21 @RheumNow https://t.co/QaFIF4WNEG
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
⭐️RA pts w/ high adipokines (fat-secreted proteins) have lower rates of LDA + remission independent of b/l dz activity & BMI
⭐️↑ adipokines esp adiponectin, then more likely to need b/tsDMARD
➡️Adipokines may be prognostic biomarkers 4 refractory dz.
Abst#0789 #ACR21 @RheumNow https://t.co/AFT22TzTFp
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Abst 0981
Interesting study by Singer & colleagues examining economical and clinical burden of herpes zoster in patients with RA
- RA + HZ --> higher odds health resource utilization
- RA + HZ --> higher costs $$$
#ACR21 @RheumNow https://t.co/6Oc7ymbKHQ
Akhil Sood MD AkhilSoodMD ( View Tweet)
TOFA Post hoc analysis on 2000pts:
⬆️ Paraoxonase PON1 activity associated w/
⬇ risk of malignancies (not NMSC) in RA pts treated w/ TOFA, Adj on RA duration, age, and smoking.
A promising biomarker! #Abst980 @RheumNow #ACR21 https://t.co/fOILnAyDN9
Aurelie Najm AurelieRheumo ( View Tweet)
#Abs0588 Effectiveness of TNFi vs non-TNFis in obese patients with #rheumatic disease @MilenaGianfran:
👉🏼>16000pts @ACRheum RISE
👉🏼Abatacept➡️larger decreases in CDAI in obese pts
👉🏼Tocilizumab➡️larger decreases in CDAI in non-obese pts
@RheumNow #ACR21
https://t.co/bL5xnG1iNh
Mrinalini Dey DrMiniDey ( View Tweet)
B cell repertoire: the new 🔮?
An algorithm associating baseline CDAI to BCR sequencing outcomes w/
✨Isotypes frequency
✨Somatic Hypermutations
predicts MTX 12mo response w/ 78% sens & spe
#Abstr982 #ACR21 @RheumNow
https://t.co/SZaip6xUaO https://t.co/fbWq34gtzc
Aurelie Najm AurelieRheumo ( View Tweet)
Had the pleasure of interviewing @MyasoedovaElena from Mayo Clinic on Cognitive Function and RA
#ACR21 @RheumNow
https://t.co/SuXeMhUvk0
Akhil Sood MD AkhilSoodMD ( View Tweet)
My video take on this from yesterday for @RheumNow:
'11 Ways to Stay Away From RA' #ACR21
https://t.co/ELZaL1A20i https://t.co/bynPNibk3q
Links:
David Liew drdavidliew ( View Tweet)
#ACR21 Abst#0588. TNF vs non-TNFi in obese RA pts
⭐️TNFi use ⬆️ disease activity vs ABA in obese pts
⭐️TNFi use ⬆️ activity vs TCZ in non-obese pts
⭐️No diff w RTX, Tofa
▶️Further research needed: Wt-based dosing? SC vs IV?
https://t.co/K8WycPTgxW @Rheumnow #ACRBest
Links:
Eric Dein ericdeinmd ( View Tweet)
ORAL Surveillance MACE conclusions:
So this is fair: tofacitinib acts as a CV risk factor, there are many others, we need to address CV risk in RA pts.
Nevertheless, in terms of MI risk, tofa vs TNFi, if I had one CV risk factor, I know what I'd do.
#ACR21 ABST0958 @RheumNow https://t.co/4Z79XtTzl9
David Liew drdavidliew ( View Tweet)
For what it's worth, I'm struck by my conversation last week with one RA patient in clinic with stents.
3y ago post-MTX/HCQ had asked for a JAKi first line, immaculate RA response.
Listened, no blinking, okay thanks doctor - I'm happy where I am. Next question.
#ACR21 @RheumNow
David Liew drdavidliew ( View Tweet)
“For many patients, it doesn’t matter if there’s an increased risk, because they don’t want to go to the alternative” - Christina Charles-Schoeman, presenting ORAL Surveillance MACE data in the #ACR21 plenary
Discussions with pts needed, these data justify that need.
@RheumNow
David Liew drdavidliew ( View Tweet)
Googling rheumatic diseases. On average google search lacked essential information to guide patient decisions. Websites on AS scored the highest on the DISCERN and RA scored the highest on JAMA @RheumNow #ACR21 Abst#0742 https://t.co/k2o2AqYEeh https://t.co/ZKljvA2f4O
Dr. Antoni Chan synovialjoints ( View Tweet)
🌞😎🍣 Vitamin D and Omega-3 FA ⬇️ Risk of developing autoimmune disease
1st prospective, randomized, double blind, placebo controlled trial
Vit D 2000IU and/or Omega 3-FA 1000mg ⬇️autoimmune disease by 25-30%
#ACR21 #ACRBest @RheumNow
Abs#957
https://t.co/7dODuplg7e https://t.co/GUKhYXbSXU
Robert B Chao, MD doctorRBC ( View Tweet)
ORAL Surveillance: MACE events higher in TOFA vs TNFi. Independent risk factors: smoking, aspirin use, age ≥ 65 yrs, and male sex; TOFA vs TNFi tx in these pts assoc'd w/ numerically higher MACE incidence. Plenary Abs 0958 #ACR21 #ACRbest @RheumNow https://t.co/44af1KujqP
Dr. Rachel Tate uptoTate ( View Tweet)
Do you order EKGs in everyone starting HCQ? Do you avoid HCQ in patients with heart failure? Will these abstracts impact your practice? Click on link to read more....#ACR21 @rheumnow #HCQ https://t.co/fvUZAvNWa8
TheDaoIndex KDAO2011 ( View Tweet)
Abstr 0584
Patients in GLORIA Study noted to have
- High number of comorbidities (median 6)
- Multiple medications notably HTN and GI protection
Findings represent medical reality of elderly RA patients (>65 years old)
#ACR21 @RheumNow
https://t.co/2cOtO9MLNM
Akhil Sood MD AkhilSoodMD ( View Tweet)
Awesome presentation today from Dr. Cristina Ruiz-Romero on lipidomic profiles in RA vs PsA. Using mass spectrometry, found differences in both synovial bx and fluid. Potentially useful lipid markers, more studies to follow.
#ACR21 #ACRBest Abst#0946 @RheumNow https://t.co/KmWCPKijSx
Pedro Castillo _Castillo_Pedro ( View Tweet)
Tofacitinib vs TNF inhibitors in #RA patients +50yrs with >1 CV risk factor; the data from ORAL Surveillance that we have all been waiting for! #ACR21
Risk of MACE related largely to baseline CV risk https://t.co/SpuKTtP8ql
The Lancet Rheumatology TheLancetRheum ( View Tweet)
#ACR21 #ACRAmbassador
Fascinating analysis of rheum dx from the (negative!) VITAL study (https://t.co/aMtMCIf1F1)
Very few pts 278/25,871 (1.1%) but HR 0.78, p = 0.045 for vitamin D preventing autoimmune disease
Do you believe it? If so, what's your public policy advice? https://t.co/ZkO5nHAJz9
Mike Putman EBRheum ( View Tweet)
