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Ab#0458 #ACR24
10 year outcomes of 176 patients with seroneg RA
32 pts (18%) had change in dx - SpA (11), seropos RA (6), OA (5), crystal (3), CTD (3), Ifn-related/paraneopl/RS3PE, sarcoid (1)
40 (23%) had drug-free remission
30 (17%) started b/tsDMARD
@RheumNow
Eric Dein ericdeinmd ( View Tweet)
Gender differences in axSpA extend to dse activity assessment tools.
PREDICT-SpA:
🔶️BASDAI score performed better in women.
🔶️ ASDAS-CRP homogenous performance on both genders.
Consider BASDAI for assessing dse activity in women?
@RheumNow #ACR24 abs571
@rheumarhyme https://t.co/rKJXn2EPXa
sheila RHEUMarampa ( View Tweet)
A study from the EuroSpA collaboration validates new BASDAI cut-offs for disease activity in axial spondyloarthritis based in ASDAS: <1.4 for remission, <2.8 for low activity, and >5.9 for very high activity. This research enhances our understanding of disease states and their… https://t.co/OkPiTwSHz6 https://t.co/NjIDeme9dm
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
A 6-year study of the link between alcohol consumption and spinal radiographic progression in axial spondyloarthritis (axSpA). Results indicate that alcohol may worsen spinal damage, particularly in males and those with radiographic axSpA. Future research should explore… https://t.co/IIvTyq7kBe
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Using #MachineLearning for predicting flares in axSpA @DiegoBenavent et al, data from METEOR-SpA registry showed the ff predictors of flares thru the reduced logistic regression model:
🔅lower ASDAS
🔅enthesitis
🔅prior flares
🔅longer treatment duration
@RheumNow #ACR24 abs559 https://t.co/wyIo9gnKVJ
sheila RHEUMarampa ( View Tweet)
Characteristics of difficult-to-treat AS accdg to a retrospective study by @DaoudAnsaam @mmagrey1 et al
⬆️ BMI
+ comorbidities: HTN, CKD, depression
+ EAMs: IBD, Pso, iridocyclitis
+ HLA-B27
Interesting real world data.
@RheumNow #ACR24 abs573 https://t.co/GlE4tFpsSz
sheila RHEUMarampa ( View Tweet)
Data from the study by Dr. Aguilar et al showed that high dose NSAID use was not assoc'd with incident HTN in their cohort of early axSpA patients.
Shows important role of NSAIDs in #axSpA but still should be used judiciously
@RheumNow #ACR24 abs540
@rheum_cat @rheumarhyme https://t.co/LK5yFZynu4
sheila RHEUMarampa ( View Tweet)
Switching vs cycling - which is better? In PsA & axSpA, a real-world analysis shows that switching to IL-17Ai after TNFi discontinuation may lead to similar or better outcomes compared to cycling to another TNFi. Data from the CorEvitas PsA/SpA Registry. Abstr#0585.… https://t.co/AJP4NBjmzr
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
The risk of discontinuing first line biologics was twice higher in non-radiographic female patients compared to males. Abstr#0572 @RheumNow #ACR24 https://t.co/1tQUhsbqUu
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Data from the French DESIR cohort reveals no significant link between high-dose NSAID use and incident hypertension in patients with axial spondyloarthritis. Two thirds were high dose NSAID users at baseline. Incident hypertension occurred in 11% individuals during follow-up.… https://t.co/EAICDwzxNT
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#0585 🔬PsA/axSpA: TNFi Cycling v IL-17Ai Switch
➡️470 pts: Switchers to IL-17Ai had similar/better outcomes v TNFi cyclers @ 6 mo
➡️PsA: Switchers had improved arthritis/psoriasis(-5.0, p=0.02)
➡️axSpA: Switchers had improved fatigue(-9.4, p=0.01)
#ACR24 @RheumNow
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
In the SPACE cohort, patients with chronic back pain suspected of axial spondyloarthritis often receive a diagnosis within 35 months from symptom onset. Key determinants for early diagnosis include HLA-B27 positivity and sacroiliitis on imaging. Early diagnosis can be a game… https://t.co/RrcrtRoMfL
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Is biologic response different in men vs women with axSpA?
A Meta-analysis of 11 studies including 11,199 axSpA pts evaluated sex-related response to bDMARDs
-Male pts more likely to achieve BASDAI 50 and ASDAS low disease activity responses compared to females.
#Abst0599… https://t.co/FopBLS4bF6 https://t.co/PpoZB9HwZN
Links:
Adela Castro AdelaCastro222 ( View Tweet)
The METEOR study reveals distinct clinical features in spondyloarthritis (SpA) patients with vs. without IBD.
Key features of those with IBD:
- Lower male prevalence
- Higher uveitis rates
- Lower psoriasis rates
- More structural damage in SI joints
Mirroring gut… https://t.co/EyBZQ91DDn
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Implementing an automated inflammatory back pain screening tool in community rheumatology practices significantly enhances the identification of axial spondyloarthritis. With 14.3% of positive screenings leading to diagnosis.
Another innovation that may help with the rapid… https://t.co/qSwryK22uj
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
🤨To cycle or not to cycle TNFi. Abst#0585 studied pts with PsA and axSpA with primary TNFi failure:
-Switching to IL17Ai may benefit phGA for arthritis and psoriasis in PsA pts and fatigue in axSpA pts. @AlexisOgdie
#ACR24 @RheumNow https://t.co/Jc0cdmrVhI
Adela Castro AdelaCastro222 ( View Tweet)
A study in difficult-to-treat (D2T) ankylosing spondylitis (AS) reveals distinct characteristics in patients, including: - Higher BMI - Increased comorbidities - Presence of EAMs - HLA-B27 positivity is linked to higher odds of being D2T, highlighting potential genetic… https://t.co/XcShdxSwhm
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Data from the EISER study show that IBD was significantly more prevalent in pts with r-axSpA than nr-axSpA.
Makes sense in a way since longer dse duration may play a role.
🔶️THM - screen SpA pts for IBD; ask for GI symptoms
@RheumNow #ACR24 abs554 https://t.co/Q6jeDUFa8Z
sheila RHEUMarampa ( View Tweet)
TNFi cycling vs. switching to IL-17Ai?
Dr @AlexisOgdie et al from CorEvitas registry:
PsA & axSpA cohort - switchers (TNFi to IL17i) had greater improvements in cDAPSA & BASDAI vs. cyclers (2nd TNF)
Not stat significant but offers alternative Tx options
@RheumNow #ACR24 abs585 https://t.co/8m347BRM75
sheila RHEUMarampa ( View Tweet)
Amazing review @NamrataRheum on the important role the rheumatologist can play to improve the care of our older patients!
Don’t forget the 5Ms!
🧠Mind (cog/mood)
💊Medication (PIM)
🏃♀️Mobility
👉Multi-complexity
💪🏻Matters most (pt priority)
@RheumNow #ACR24 #gerirheum https://t.co/0Iv4TdS8AX
Links:
Patricia Harkins DrTrishHarkins ( View Tweet)
