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ACR20 - Day 4.1, 4.2 & 4.3
Check out our many podcasts from the ACR 2020 meeting - listen in for faculty reports and overviews. You can also find the RheumNow podcast on Apple Podcast, Apple Car Play, Android Auto or where ever you prefer to listen.
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ACR20 - Day 3.3 & 3.4 Podcasts
Check out our many podcasts from the ACR 2020 meeting - listen in for faculty reports and overviews. You can also find the RheumNow podcast on Apple Podcast, Apple Car Play, Android Auto or where ever you prefer to listen.
Listen here:
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HCQ not associated with ⬆ incidence of cardiac dse in this cohort of RA pts.
We should continue using it. Benefits >>>risks.
@RheumNow #ACR20 abs1999 https://t.co/zYpbX0CsR1
sheila RHEUMarampa ( View Tweet)
NEW ACR2020 Draft Guidelines for the Pharmacologic Treatment of RA
All the guidelines in 2 tables!
1. MTX 1st, oral > SC
2. Minimize GC!
3. TTT TTT TTT
4. Biologic/tsDMARD > Triple Tx
5. Taper MTX 1st
Close to my practice; suspect will be controversial!
#ACR20 #ACRambassador https://t.co/iFSlq1H65V
Mike Putman EBRheum ( View Tweet)
Abst#1717 confirms that early start of csDMARDs as 1st line tx & keeping ts/bDMARD as 2nd line tx (or more) is associated w/ a favorable outcome at 10 yrs in the ESPOIR cohort (a French multi-center cohort that followed patients w/ early RA). #ACR20 @RheumNow https://t.co/bzZiShCF97
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
@SSNaushon MTX remains backbone of therapy given low cost, safety profile, and long experience with it. Majority of pts do well on MTX and do not require TNFi @Rheumnow.
Eric Dein ejdein1 ( View Tweet)
Patient-physician discordance seen in ~30% #rheumatoidarthritis patients starting #DMARDs
- ↑Patient-reported pain & functional impairment assoc. w/ discordance
- Patient-centric treatment discussions needed to reduce discordance
Abs#1978 #ACR20 @RheumNow
https://t.co/CdlHrBOdy0
Mrinalini Dey DrMiniDey ( View Tweet)
Very strong push by #ACR20 to recc MTX in most RA patient scenarios including RA ILD, RA nodules, NAFLD in new RA guidance document @rheumnow
k dao KDAO2011 ( View Tweet)
You have a patient with RA on 25 mg MTX SQ, tolerating well without side effects. They have moderate disease activity. Your next step: @Rheumnow. #ACR20
Eric Dein ejdein1 ( View Tweet)
New #ACR RA guidelines is cost conscious:
1. DMARD naive: Preferred MTX over LEF>HCQ/SSZ and preferred MTX over biologic/tsDMARD
2. DMARD naive low DAS: HCQ or SSZ preferred >MTX>LEF
3. T2T goal LDA/remission
@rheumnow (thread)
k dao KDAO2011 ( View Tweet)
Switching or adding a DMARD in pts w/ moderate-high dz RA activity & hx of previous serious infection w/in the past 12 mos as opposed to starting/increasing GCs is conditionally recommended per draft recs of new ACR RA treatment guidelines. #ACR20 @rheumnow @CCalabreseDO
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Draft #ACR20 Rx Recs for RA: MTX is conditionally recommended with NORMAL LFTs and no advanced fibrosis. Role of HCQ for NALFD has been suggested at ACR, but not enough for mod-high disease activity @RheumNow. https://t.co/QFF3BK1NF0
Eric Dein ejdein1 ( View Tweet)
Draft #ACR20 Rx Recs for RA: on max tolerated MTX - add bio or tsDMARD conditional recommendation over triple therapy (MTX, HCQ, SSZ). @RheumNow. https://t.co/s6fKEW8czc
Eric Dein ejdein1 ( View Tweet)
Draft #ACR20 Rx Recs for RA: Use MTX, starting oral but remember MTX tricks to maximize success. Folic acid, split dosing, SubQ all keys per Dr. O'Dell to maximize @RheumNow. https://t.co/8K9BjotZha
Eric Dein ejdein1 ( View Tweet)
I am glad now that chloroquine is not available (permanent back order) in Canada as results of high retinal toxicity w chloroquine was sobering & changed my practice. I won’t use it long term @RheumNow #ACR20 @CRASCRRheum abstr#1825 https://t.co/1RQi41uV1B https://t.co/lc9za22Zw1
Janet Pope Janetbirdope ( View Tweet)
A large observat study showed no difference in risk of major CV events in RA pts that were newly started on either MTX or HCQ. A greater stroke risk but lower risk of MI & hospitalized HF was seen in MTX initiators. #Abst1993 #ACR20 @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Using a panel of urinary prtns, data from this study show transferrin, AGP1, ceruloplasmin, MCP1 & sVCAM1 are sig. ⬆in active LN pts.
More studies req'd for confirmation.
Utility in monitoring renal response to tx?
@RheumNow #ACR20 abs1796 https://t.co/3Zicpz3uDd
sheila RHEUMarampa ( View Tweet)
We need to work together with our patients to ensure medication adherence during this pandemic.
1⃣30% of 734 pts on DMARDs changed their med use during COVID
2⃣Med change without physician guidance
3⃣Changes resulted in ⬆️steroid use
@RheumNow #ACR20 Abs#L05 https://t.co/n18zqed4wC
Robert B Chao, MD doctorRBC ( View Tweet)
Accdg to this study, no association was found between IFN levels and cognitive function in SLE pts (even after considering factors like SLE dse duration)
Interesting! @RheumNow #ACR20 abs1788 @ZahiTouma https://t.co/F4j8H1CWJ9
sheila RHEUMarampa ( View Tweet)
Since MTX doesn’t work in cardiac prevention in non inflammatory pop’n (CIRT trial) should we use MTX in knee OA with inflammation? RCT n=344 w primary knee OA w swelling & pain. Rx MTX v glucosamine POSITIVE results #ACR20 abstr#1648 @RheumNow @CRASCRRheum #ACRbest https://t.co/7VptCPxKU8
Janet Pope Janetbirdope ( View Tweet)
