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When MAS is suspected. Soluble IL2 receptor alpha and CXCL9 may be useful (however t cell lymphomas and viral infections like hepatitis may also have them)
#ACR25 @RheumNow
Key takeaways below https://t.co/wJv1dvwU88
Bella Mehta bella_mehta ( View Tweet)
Soluble IL2 receptors help assess macrophages behavior. Ferritin also asses the same in Macrophage activation syndrome.
ADA2 is the newer biomarker for hemophagocytic syndromes.
#ACR25 @RheumNow
Interferon gamma also a newer important target in MAS https://t.co/7sWwninBTM
Bella Mehta bella_mehta ( View Tweet)
Simultaneous measurements if S100, Ferritin and IL-18 increase diagnostic utility of these biomarkers in Stills disease.
@RheumNow #Acr25 https://t.co/3wmijNcpVY
Bella Mehta bella_mehta ( View Tweet)
Low percentage of glycosylated Ferritin was more specific for Stills disease but not used frequently in clinical practice.
@RheumNow #ACR25 https://t.co/wTK1eIcSKX
Bella Mehta bella_mehta ( View Tweet)
Biomarkers in Stills disease and MAS. #ACR25 @RheumNow
IL 6 may not be helpful compared to CRP, and IL 1 beta is difficult to measure
IL-18 seems to be the best one. https://t.co/u3oBTd4eaP
Bella Mehta bella_mehta ( View Tweet)
What do we know about IL-18
Normal levels less than 500
Non specific 500 to 15000
Stills (quiet) 2000 to 10000
Mas/glares 20000 and more
@RheumNow #ACR25 https://t.co/ZAltAD5Q8V
Links:
Bella Mehta bella_mehta ( View Tweet)
#ACR25 SMILE RCT of Incomplete #SLE (ANA+ but not meeting SLICC) showed HCQ didn’t slow down SLE progression. But multiplex arrays showed reduction in autoantibodies with HCQ that were distinct from abs assoc. w progression. Would biomarker endpoints be the answer? @RheumNow https://t.co/XcvacgObVo
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Short chain fatty acids (SCFA) and the relevant microbiome have been linked to RA development and severity.
Study of monozygotic twins, where only one has RA, two diff cohorts:
lower SCFA
lower SCFA microbiome
Biomarkers, or even therapeutic target?
#ACR25 ABST0442 @RheumNow https://t.co/HW1YfkfOG3
David Liew drdavidliew ( View Tweet)
Need better lymphoma biomarkers in Sjögren’s?
APRIL joins BAFF as a promising candidate—high APRIL levels linked to ↑ B-cell activation, disease activity & future lymphoma.
Easily measurable, potentially targetable.
@RheumNow #ACR25 Abstract #1683
Jiha Lee JihaRheum ( View Tweet)
What can we use to better predict MACE in RA patients?
ESPOIR cohort showed value of two cardiac biomarkers:
- hs-cTnT
- soluble ST2
Combined, predicted MACE even after adjusting for disease activity/traditional CV RF. We need something like this!
#ACR25 ABST1334 @RheumNow https://t.co/EUNDuuMaYD
David Liew drdavidliew ( View Tweet)
Loarce et al. Poor performance of CXR and PFT in diagnosing RA-ILD (compared to HRCT). Message is, if you think they have RA-ILD, you need to do CT. @RheumNow #ACR25 Abstr#1335 https://t.co/eeSTf72mvM
Richard Conway RichardPAConway ( View Tweet)
Who with #SSc-ILD will progress?
progression is non linear - can stabilize and worsen
Search for Predictive biomarker
For clinical care & enriching RCTs
Maybe #KL6 🤷♀️
Maybe IP-10, MIG
No strong #biomarker
Depends on what is used
#ACR25 @RheumNow @ACRheum
Abst#0882 #0883 https://t.co/lyTRUEY9SI
Links:
Janet Pope Janetbirdope ( View Tweet)
Abstrat 1414 Compared to #PsO, early #PsA showed:
🔹 ↑ Dactylitis (66%), Enthesitis (78%), CRP/ESR
🔹 Longer morning stiffness & ↑TJC/SJC
🔹 MRI/US: frequent tenosynovitis & bone changes
🔹 Predictive model combining these features showed Sens 89%, Spec 84%
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Analysis from FVSG identified 36pts with anti-rituximab antibodies
In AAV, lookout for this in pts who are MPO+ & w/higher CD19 at 6 mos. Worse relapse free survival in both AAV & CRYO!
@TerrierBen can you share the prevalence of these abs?
#ACR25 @RheumNow #ACRBest abstr#1604 https://t.co/Nyx6JxbvUk
Links:
Mike Putman EBRheum ( View Tweet)
A combined biomarker assay may predict which AAV patients will not respond to RTX therapy
A next step towards precision / personalized rheumatology?
@RheumNow #ACR25 Abst 1602 https://t.co/gcrZUNV0b9
Links:
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Avouac et al. Lipid changes after JAKi initiation. 85 patients. Increases at 6 months. Largely appeared driven by HDL increase, and correlated CRP decrease. Appeared transient with return to baseline with time. @RheumNow #ACR25 Abstr#1333 https://t.co/CQ6u3ck1Ch
Richard Conway RichardPAConway ( View Tweet)
In pooled PsA trials (n=1222), deucravacitinib reduced disease activity–linked proteomic scores in both sexes by Week 16. Proteomic profiling identified 133 unique proteins in males and 177 in females vs sex-matched healthy controls. Females showed greater enrichment in https://t.co/TTAWUtOLP0
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Sex based differences in PsA proteomics
Analyse from POETYK PSA 1 & 2 deucravacitinib RCT
Large overlap but female pts specificities, Upregulation of:
-JAK STAT pathway
-Cytokine interaction
Linked with higher disease activity in female groups
Yes Correlation, but not https://t.co/VwiVOkxpoB
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
#0850 Single-cell RNA-seq of RA synovium uncovers a new biomarker & therapeutic target: PHIF
Made by Tph cells, drives macrophage activation and mirrors disease severity.
Big step forward in understanding RA immunopathogenesis. @RheumNow #ACR25 https://t.co/KtyxU0Lqly
Mrinalini Dey DrMiniDey ( View Tweet)
#0851
Urinary Tenascin C predicts kidney function loss in lupus nephritis
170 AMP-LN patients: Tenascin C (from renal myofibroblasts) was the top predictor of eGFR decline (HR 4.6)
Proteomic 11-marker risk score (AUC 0.91) outperformed proteinuria for prognosis #ACR25 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
