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“At 2 years, 50% of patient with +RF/+CCP Ab will develop RA, at 5 years, 70%” – Dr. Gabalawy on can we predict who will get RA, is there a point of no return, can we prevent the progression #RNL2024 @rheumnow https://t.co/G8Rxd3CAoi
Links:
TheDaoIndex KDAO2011 ( View Tweet)
Seropositive RA is a spectrum to disease
Hani El Gabalawy @RheumNow #RNL2024
Genetic and environmental factors affecting autoimmunity and leading to disease
Clinical suspect arthralgias usually finds "imminent RA", may be too late at that stage for prevention https://t.co/mGclCr3cth
Links:
Eric Dein ericdeinmd ( View Tweet)
Dr. Hani Gabalawy shared his pre-clinical stages of seropositive RA
--Break in the immune tolerance > pathogenic autoimmunity > RA
Unknowns: timeline, can we arrest pre-clinical stages, etc?
#RNL2024 @RheumNow https://t.co/8cMNGKM4rk
Dr. Rachel Tate uptoTate ( View Tweet)
Using diet to shape the microbiome and to improve outcomes in inflammatory arthritis and response to medication. An anti-inflammatory and Mediterranean diet can help improve outcomes in RA, Monica Guma #RNL2024 @RheumNow https://t.co/x64Tbseuvz
Dr. Antoni Chan synovialjoints ( View Tweet)
"The gut microbiome may affect how patients respond to their therapies" - Dr. Guma another reason why diet is important #RNL2024 @rheumnow https://t.co/7qI72HWRg0
TheDaoIndex KDAO2011 ( View Tweet)
“Even a cookie changes the gut microbiota!” – Dr. Guma showing dynamic microbiota changes to the food we eat and even to the medications we take. #RNL2024 @rheumnow https://t.co/5d6Ld39BzG
TheDaoIndex KDAO2011 ( View Tweet)
Monica Guma at #RNL2024 @RheumNow
How does Mediterranean diet help inflammation?
Maintains healthy microbiota
Enhancing production of anti-inflammatory metabolites
Maintains intestinal barrier integrity https://t.co/CyzTGBJzhm
Links:
Eric Dein ericdeinmd ( View Tweet)
You are what you eat!
So how does the Mediterranean diet affect the gut?
*maintaining/shaping healthy gut microbiota
*enhancing anti-inflammatory metabolite production
*maintaining intestinal barrier integrity
Dr. M. Guma #RNL2024 @RheumNow https://t.co/O9by7CahRW
Links:
Dr. Rachel Tate uptoTate ( View Tweet)
How does the Mediterranean diet affect inflammation? Dr. Guma noted the diet helps to:
1. maintain healthy microbiota
2. enhance production of anti-inflammatory metabolites
3. maintain intestinal barrier integrity.
#RNL2024 @rheumnow https://t.co/d3ByStvXyR
TheDaoIndex KDAO2011 ( View Tweet)
Dr. M Guma noted @ACRheum 2022 Guidelines on RA recommend the #MediterraneanDiet; studies have shown this diet reduces CV risk, RA disease activity #RNL2024 @RheumNow https://t.co/AdKWgME4nD
TheDaoIndex KDAO2011 ( View Tweet)
#RNL2024 @RheumNow
2022 ACR Guideline for Integrative Interventions for RA
- Conditionally recommend Mediterranean diet
- Conditionally recommend Against other diets or dietary supplements
*Low or very low to moderate evidence due to absence of good studies
🍇🫒 https://t.co/PkZ9ovQ1ON
Links:
Eric Dein ericdeinmd ( View Tweet)
ICYMI: We have an ACR guideline for diet!
Luckily, you're likely already recommending the Mediterranean diet (conditionally recommended.) https://t.co/7W1ZIpqo47
Dr. Monica Guma #RNL2024 @RheumNow
Dr. Rachel Tate uptoTate ( View Tweet)
ICYMI There are 2022 Guidelines for exercise rehab and diet for patients with #RheumatoidArthritis
found here https://t.co/PWjPHGqqeM
#RNL2024 @RheumNow
TheDaoIndex KDAO2011 ( View Tweet)
#Cardiorheumatology is an emerging, important field; contact Dr. Weber if interested in learning more. #RNL2024 @Rheumnow https://t.co/WhMlC7AtHU
TheDaoIndex KDAO2011 ( View Tweet)
#RNL2024
@RheumNow
ASCVD Risk Calculators underestimate risk in patients of RA
Inflammatory disease was added as a "risk enhancer" in 2019 update
"A low ASCVD and/or absence of symptoms may be not be reassuring" https://t.co/XjTuzvvO4v
Links:
Eric Dein ericdeinmd ( View Tweet)
Why is improved plaque identification important?
1. Most stress tests are normal!
2. Most events occur in pts with normal function studies
3. Plaque burden predicts risk, better than stenosis
Dr. B. Weber #RNL2024 @RheumNow https://t.co/Qs19qIYj5v
Dr. Rachel Tate uptoTate ( View Tweet)
ICYMI: new guidelines published in 2019 for CV prevention. It's important to assess CV risk in our patients because inflammatory diseases is now included as a risk factor (helps when deciding on starting pts on JAKi)- Dr. B Weber #RNL2024 @RheumNow https://t.co/nBQjs49avu https://t.co/apyDjaxudi
Links:
TheDaoIndex KDAO2011 ( View Tweet)
Primary ASCVD Prevention Guidelines for your reference from Dr. B. Weber. #RNL2024 @RheumNow https://t.co/erxIgeeLNU
Dr. Rachel Tate uptoTate ( View Tweet)
Dr. B. Weber's review of the 2019 ASCVD risk factors which now includes inflammatory diseases (RA, HIV, PsO).
She believes this will help us to better understand and grow our knowledge around patient risk. @RheumNow #RNL2024 https://t.co/9bV7VfExNf
Dr. Rachel Tate uptoTate ( View Tweet)
Nuclear imaging assesses cardiac function, anatomy & microvascular dysfunction (MD). MD is underrecognized but can be measured by coronary flow reserve. MD is associated with worse longterm outcomes in systemic inflammatory disease – Dr. Weber #RNL2024 @rheumnow https://t.co/Bv22UKi6mM
Links:
TheDaoIndex KDAO2011 ( View Tweet)