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Abs 0463 #ACR21 @RheumNow
Park & colleagues compared treatment persistence across abatacept, TNFi, and JAKi in dual seropositive RA patients using Medicare database
- Users of abatacept were more persistent to index time of 12 months and showed longer time to discontinuation https://t.co/0huE7zZjLq
Akhil Sood MD AkhilSoodMD ( View Tweet)
Pre clinical RA: don't miss the feet 🦶🏼! Among 577 patients
with clinically suspect arthralgia undergoing MRI:
-23% intermetatarsal bursitis > ACPA + 56% vs. 19%
-higher risk or RA HR 3.3.
Would we find the same results w/ US?
#OP0468 @RheumNow #ACR2021 https://t.co/VkzUu93qGq https://t.co/GGw7UgdPVR
Aurelie Najm AurelieRheumo ( View Tweet)
Accdg to this study by Dr. B VanDijk et al, intermetatarsal bursitis (IMB) was seen in 23% of clin suspect arthralgia(CSA) pts; predicted clinical arthritis in ACPA+; ⬆ frequent w/ synovitis & tenosynovitis
Addtl tool for early RA dx?
@RheumNow #ACR21 abs0468 #ACRBest https://t.co/bcUuy8bHLJ
sheila RHEUMarampa ( View Tweet)
#ACR21 Abst#0455 ARIAA Study: Abatacept for subclinical arthritis
⭐️ ACPA + arthralgia + MRI inflammation 🔥
⭐️ ⬇️ MRI inflam (primary) and ⬇️ progression to arthritis (secondary)
▶️ Many patients likely early RA, would still rec starting MTX 1st
https://t.co/4aREvqlpUI @Rheumnow https://t.co/vqRgsd75Il
Links:
Eric Dein ericdeinmd ( View Tweet)
#ACR21 Abst#0293:
Lung involvement in 67 sero+ RA pts assoc w/:
⭐︎ SSc-specific ab
➡️ RP155, Th/To, fibrillarin, NOR90 in ILD group
➡️ Ku, Pm/Scl100, CENP-A/B in non-ILD group
⭐︎ older age, ⚦ sex, heavy 🚬
⭐︎ ↑ WBC, CRP, RF
#ACRBest @Rheumnow
https://t.co/Yo4jRKqvfV https://t.co/l5gbKoZBkm
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
ARIAA study of abatacept in pre-RA. Abatacept ⬇️MRI inflammation and reduces progression to RA. Of course it does. Like all these studies, really not sure what this is telling us. Abstr#0455 #ACR21 @RheumNow https://t.co/yNVVZFBWDq
Richard Conway RichardPAConway ( View Tweet)
Prevention study using Abatacept in 100 patients with arthralgia is superior (61%) to placebo (31%) in improving subclinical inflammation in RA at-risk patients (ACPA+, MRI+, Arthralgia+) at 6 months. No new safety issue emerged @RheumNow #ACR21 Abst#0455 https://t.co/DoRItcHfBE
Dr. Antoni Chan synovialjoints ( View Tweet)
Can we stop RA developing? Not previously.
Double-blind RCT:
- arthralgias+ACPA+MRI changes
- but no clinical synovitis
- abatacept for 6m
didn't progress to arthritis: 92% v 65%
improvement in MRI: 61% v 31%
+ benefit to 18m not shown
"provocative"!
#ACR21 ABST0455 @RheumNow https://t.co/TGxCBhk4r9
David Liew drdavidliew ( View Tweet)
#ACR21 Abst#0155
⭐︎ Tenosynovitis on MRI hand/foot in ACPA(-) undifferentiated oligo-arthritis pts is predictive of RA
➡️NPV 93%, Se 85%
⭐︎ BM edema not prognostic of RA development
Do you already use MRI to help detect early RA?
@Rheumnow
https://t.co/mpageAYeT2
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
ARRIA Study: Abatacept vs PBO in pre-clincial RA (N98) pts x 6 mos. Showed ABA prevented arthritis (8 vs 35%), improved MRI inflamm (61 v 31%), fewer D/C (14 vs 43%) - all signif. Further FUV 12 mos off therapy still significant at 18mos #ACR21 Abstract 0455 https://t.co/ZxFUj6KfLT
Dr. John Cush RheumNow ( View Tweet)
#ClinicalPearl What lasts longer/⬆️retention in sero+ RA: Abatacept or TNFi or JAKi? #ACR21 abst#0463 @RheumNow Adjusting for confounding incl line of Rx / past bio Rx, #abatacept wins. But data not stratified for bio naive or exposed. Not sure if that would alter results https://t.co/1dEQncwPQF
Janet Pope Janetbirdope ( View Tweet)
What increases risk of RA-assoc #bronchiectasis, separate from #RA-ILD?
Results from @BrighamResearch find seropositivity (esp high +ve RF/CCP), older age, disease duration, & low BMI incr. risk of isolated bronchiectasis in RA.
#ACR21 Abs#0288 @RheumNow
https://t.co/jvvRucqTjL https://t.co/aFCfxrbUdV
Mrinalini Dey DrMiniDey ( View Tweet)
@BethIWallace et al. on fibromyalgianess and GC in #rheumatoidarthritis pts.
Accdg to their study, pts w/⬆ levels of fibromyalgianess at BL had higher odds of GC persistence on ffup.
Something to consider when evaluating need for GC adjustment.
@RheumNow #ACR21 abs0120 https://t.co/MTWEXGHJ2n
sheila RHEUMarampa ( View Tweet)
#ACR21 Abst#0290:
Ever wonder about other predictors of mortality in pts w/ RA-Lung Disease besides ILD (OR 2.3) or older age?
⭐︎ ↑ mortality associated w/ pleural effusions (OR 3.3)
AND, notably...
⭐︎MTX use was protective (OR 0.4)!!!
@RheumNow
https://t.co/KKRkQVY2pf https://t.co/JsU2Rqzi6R
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
This study looked into the prevalence of subclinical atherosclerosis in #rheumatoidarthritis pts w/n 5 yrs of dx using carotid US.
📌vs. controls, RA pts had ⬆ CPs, cIMT
❗Screen RA pts for CV risk early on in their diagnosis
@RheumNow #ACR21 abs0271 https://t.co/btU6IcM3xb
sheila RHEUMarampa ( View Tweet)
#ACR21 Abst#0293
RA patients with lung disease have increased rates of SSc-specific autoantibodies compared to RA w/o lung disease.
▶️ Suggests we may need to investigate further into overlap phenotype in RA-ILD
@Rheumnow https://t.co/04FFuBUKmA https://t.co/A83kaie2gr
Links:
Eric Dein ericdeinmd ( View Tweet)
#Flu vaccine coverage remains low in patients with #rheumatoidarthritis.
Results from @earlyarthritis Abs#0141
https://t.co/DoZl5xyq2Q
How can we increase vaccine uptake in our patients?
@RheumNow https://t.co/nldA63EcVW
Mrinalini Dey DrMiniDey ( View Tweet)
Dr O'Brien on co-existent AAV and RA. Not something I'm used to seeing, but maybe we need to think about it more? 25 cases with RA+AAV, 52 with RA + ANCA but no AAV, not sure what the denominator is here though. Abstr#0428 #ACR21 @RheumNow @profgayecunnane https://t.co/fN3BRpc7UJ
Richard Conway RichardPAConway ( View Tweet)
🔥 Ready for the next level of imaging? The radio-labelled tracer binding to integrin αvβ3 99mTc-maraciclatide is able to detect hypervascularization in RA joints and correlates w/ PDUS findings
⭐️ Sens 78%
⭐️ See 91%
Fancy, yet more invasive than US! #Abst0174 @RheumNow #ACR21 https://t.co/eCOxjJsERh
Aurelie Najm AurelieRheumo ( View Tweet)
Dr Adachi presents ⬆️BMD gain with denosumab than risedronate in RA. Non-significant reduction in fractures (very small numbers) Interesting, but need to see fracture benefit in larger study to justify dmab as first line Abstr#0445 #ACR21 @RheumNow https://t.co/GgaS9JZGzb
Richard Conway RichardPAConway ( View Tweet)
