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Dementia is ⬆️in #RheumatoidArthritis says Elena Myasoedva but #RA has more DM &CV disease which ⬆️dementia. Need to separate vascular dementia from Alzheimer’s. When I trained we thought less dementia in RA -likely not true. More work is coming. 9T213 aging hub #ACR21 @RheumNow
Janet Pope Janetbirdope ( View Tweet)
Post-Hoc of the ASCORE trial showed the following b/l characteristics were most likely associated with remission (per DAS28, SDAI, CDAI) in mod-severe RA patients treated w/ SQ Abatacept:
⭐️Seropositivity
⭐️no prior bMDARD use
⭐️low HAQ-DI
⭐️low BMI
Abst#1228 #ACR21 @Rheumnow https://t.co/NvJoSWScZs
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Fibromyalgianess Glucocorticoid Persistence in RA Patients: Dr. Sheila Reyes ( @RHEUMarampa) discusses abstract #0120 presented at the #ACR21 annual meeting.
https://t.co/9yOM5rSARv https://t.co/Gq2YxbxkmM
Links:
Dr. John Cush RheumNow ( View Tweet)
Post-Hoc of the ASCORE trial showed the following b/l characteristics were most likely associated with remission (per DAS28, SDAI, CDAI) in mod-severe RA patients treated w/ SQ Abatacept:
⭐️Seropositivity
⭐️no prior bMDARD use
⭐️low HAQ-DI
⭐️low BMI
Abst#1228 @ACR21 @Rheumnow https://t.co/LRd1HVbm5B
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Abst 1661
Scheir & colleagues identified patterns of multimorbidity and association w/ disability in patients w/ early RA
- In women: Depression significantly associated w/ disability
- In men: HTN & Lung Disease significantly associated w/ disability
#ACR21 @RheumNow https://t.co/0qkn1TcvOi
Akhil Sood MD AkhilSoodMD ( View Tweet)
Hair Loss due to Methotrexate from RCTs in RA estimated at 6.9%.
It's an understandable source of concern for those taking the medication
#ACR21 https://t.co/GymV2RC7jT
Dr Irwin Lim _connectedcare ( View Tweet)
French study shows more than 75% of RA/SpA pregnancies resulted in a live-birth, BUT 50% of pts had at least one unfavorable pregnancy outcome! However, miscarriage prevalence lower than in reported literature. Abs 1724 #ACR21 #RheumNow @RheumNow https://t.co/64PspIKPTu https://t.co/LyfHVARAgd
Dr. Rachel Tate uptoTate ( View Tweet)
ARIAA Study - Abatacept Reverses ACPA+ Subclinical Arthritis: Dr. Jack Cush discusses abstract #0455, a preclinical RA intervention trial - abatacept or placebo given to at risk individuals (arthralgias, CCP+, MRI+) for 6 months, presented at #ACR21.
https://t.co/fz1hPTleMn https://t.co/V4PsPZ0ZwF
Links:
Dr. John Cush RheumNow ( View Tweet)
Glory to GLORIA trial? Low dose prednisone 2mg in active RA>65yrs, N=451 All Standard care. in 2yrs, ~40% drop out- same in each grp Better RA control but NNH 9.5 w steroids, mostly non severe infections. So, prednisone debate in RA continues #ACR21 @RheumNow #ACRBest abst#1678 https://t.co/emOaYSjYAa
Janet Pope Janetbirdope ( View Tweet)
Just worthwhile remembering:
in terms of TNFi anti-drug immunogenicity in autoimmune disease:
RA is top of the pops
(although dose spacing is worse)
data from NOR-DRUM A, TDM in infliximab #ACR21 ABST1525 @RheumNow https://t.co/wfcA72wcLP https://t.co/mHppH6qYdY
David Liew drdavidliew ( View Tweet)
Pirfenidone in RA-ILD, TRAIL-1 study. Long-awaited. Early termination due to COVID led to under-powering. Slowed decline in FVC, especially in UIP pattern. Seemed to have less adverse events than we see with nintedanib. Abstr#L10 #ACR21 @RheumNow https://t.co/sYRDhG3u4y
Richard Conway RichardPAConway ( View Tweet)
Adipokines in RA
⚡️Highest Quartile Adiponectin associated w/ ⬆️ all-cause mortality HR 1.46 ⬆️ CV mortality HR 1.85
⚡️Highest Quartile Leptine ⬆️ 25% all-cause mortality
#ACR21 #Abst1645 @RheumNow
https://t.co/O1NAbfMvif https://t.co/VVdgZHP1j5
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
How do RA pts go with ICI cancer therapy?
@VUMCRheum audit reflects overall prev experience:
- approx 50% flare (?some reflect DMARD W/H)
- flares overwhelmingly managable
- few (1/19 here) cease ICI due to RA flare
RA pts deserve best cancer Rx too!!
#ACR21 ABST1523 @RheumNow
David Liew drdavidliew ( View Tweet)
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)
