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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)
Interesting nuance from @philseo re tocilizumab in GCA. For new onset disease, it may be appropriate to use every other week tocilizumab @RheumNow #RNL2024 https://t.co/moCvpQSkq0
Richard Conway RichardPAConway ( View Tweet)
Do you need to pulse steroids in GCA?
ACR 2022 abstract#0459 data says oral only may be sufficient
Oral vs IV MP - p=0.621
Still favor IV in severe cases
@philseo #RNL2024 @RheumNow
Eric Dein ericdeinmd ( View Tweet)
Amaurosis fugax is not the only vision symptoms to assess in patients with #GCA. Blue vision, double vision (if patients have to look at you in a side gaze prevent double vision) may also be present - Dr. P Seo @rheumnow #RNL2024 https://t.co/AhQnOJF7fa
TheDaoIndex KDAO2011 ( View Tweet)
#RNL2024 @RheumNow
@philseo: I now give Tociliizumab for nearly all patients with GCA
GiACTA shows we weren't doing well enough with steroid monotherapy
GiACTA shows dosing frequency does not make a big difference in new diagnosis, but makes a difference in relapsing disease https://t.co/JBgUQtZSAr
Eric Dein ericdeinmd ( View Tweet)
When thinking of GCA there are only 2 questions you need to ask. Dr. @philseo reminds us to
1. Establish if new or recurrent disease
2. Assess for presence of visual symptoms
#RNL2024 @RheumNow https://t.co/MGML3EafPu
Dr. Rachel Tate uptoTate ( View Tweet)
How I do it, treatment of CGA with Dr. @philseo, who thoughtfully paused so everyone could take a picture of this slide knowing full well it was already at our fingertips! Such a gentleman!
#RNL2024 @RheumNow https://t.co/8kqacqkRM6
Dr. Rachel Tate uptoTate ( View Tweet)
Dr. Phillip Seo contemplates if Taylor and Travis had vasculitis, surely the dose for each would not be the same. Wish you were here @rheum_cat to weigh in on this. #RNL2024 @rheumnow https://t.co/1ynctgIknx
TheDaoIndex KDAO2011 ( View Tweet)