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Outcomes Switching to Monotherapy: SEAM-RA Trial

Eric Dein, MD Nov 07, 2020

Combination therapy with biologic and conventional DMARDs can be highly effective at inducing remission in patients with RA. Once controlled, patients are often interested in stopping combination drug therapy due to concerns related to medication burdens, side effect profiles, or safety.

Article

ACR20 - Opening Day Podcast

Jack Cush, MD Nov 07, 2020

Another great way to get highlights from the ACR 2020 meeting - listen in to faculty reports and overviews.

Click here to listen

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ACR Best Abstracts - Day 1

Jack Cush, MD Nov 06, 2020

The RheumNow faculty reporters have been glued to their monitors all day, viewing video, reading and listening to abstract presentations and I charged them to earmark those presentations were the “Best” they saw today. Below is the list of most often noted #ACRbest abstracts from Day 1.

Editors Pick for #ACR20—Leflunomide–hydroxychloroquine combination therapy in patients with primary Sjögren's syndrome (RepurpSS-I): a placebo-controlled, double-blinded, randomised clinical trial https://t.co/cunDxVl5XG https://t.co/OGItXCuWDI

DEFINE_ME

HCQ might decrease risk for NAFLD! Restrospective study of 5600 pts noted patients on HCQ (despite having more metabolic syndrome, HTN, DM) had 24% less incidence of NAFLD compared to pts not on HCQ Abstr#0177 #ACR20 @rheumnow https://t.co/ZoK2aC0ZQR

Association of Hydroxychloroquine Use with Development of Non-Alcoholic Fatty L…

Interesting data re HCQ decreasing new PAH in Early SSc #scleroderma Not sure I believe it. Confounding, diff subsets get #hydroxycholoroquine due to inflammatory arthritis etc. Maybe a big pragmatic RCT is warranted as PAH is lethal @RheumNow @CRASCRRheum #ACR20 abstr#925 https://t.co/Al81sMGgxI

https://twitter.com/doctorrbc/status/1325079846679089152

Never forget how far we have come in rheumatology therapeutics, in a very short period of time. Some of the original slides that Tiny Maini and Marc Feldmann used. @r_burmester giving the Phillip Hench Lecture #ACR20 @RheumNow https://t.co/YI32BX2iw8

#HCQ assoc. w/ ↓platelet activity & ↑vascular health in #SLE: - 132 patients, 108 on HCQ - Ex-vivo expts show ↓platelet aggregation & downregulation of platelet functional pathways - HCQ may improve vascular health in SLE Abs#0870 #ACR20 @RheumNow https://t.co/ST9n2HGyhM

Hydroxychloroquine Is Associated with Lower Platelet Activity and Improved Vasc…

Most ignore pharmacists annoying faxes re safety of QT interval with #hydroxycholoroquine likely the right thing to do! @RheumNow #ACR2020 @CRASCRRheum abstr#431. https://t.co/pXBIDOV2MP

Hydroxychloroquine may reduce rate of progression of systemic sclerosis associated pulmonary hypertension when initiated early (<18 months). Prospective, observational study. @RheumNow #ACR2020 Abs#0925 https://t.co/nj0mNAY5Pe

Study of 372 new #hydroxychloroquine users suggests risk of #HCQ #retinopathy at 10yrs is lower compared to previous prevalence-based estimates, although dose >5mg/kg may increase this risk. #RheumTwitter Abs#0540 #ACR20 @RheumNow https://t.co/kOSToCljeq

Risk of Hydroxychloroquine Retinopathy in the Community - ACR Meeting Abstracts

Mayo study found incidence of HCQ retinopathy w/ <5 mg/kg/d 5 years = 0%, at 10 years = 2.5% (historically w/ 6.5 mg/kg/d 5 yr incidence 1%,10 years 2%, 20 years 20%) Based on this study, which dose of HCQ will you prescribe? Abstr#540 #ACR20 @rheumnow

Will we start getting fine-specificity ACPAs to drive treatment of RA? Abst#0743 shows fs-ACPA (anti-fibrinogen B) predict greater response to ABA+MTX vs MTX alone. #ACR20 @RheumNow. Role of RA antibodies will continue to evolve and guide Rx. https://t.co/pY4mm19Jc7

HCQ Not Associated with QTc Length in SLE and RA Patients: Dr. Janet Pope @Janetbirdope #ACR20 https://t.co/zPIaFIiqr5 https://t.co/Wk8YQpIpo7

https://bit.ly/2U3niaQ

Consistent data that antimalarials did NOT decrease hospitalization for viral infections in the pre #COVID19 era in US claims database in SLE &RA pts #0002 @RheumNow @CRASCRRheum #ACR20 #ACR2020 https://t.co/nZp5dOeHXB

ACPA+ and subclinical synovitis does not automatically mean developing to RA. Interesting work by Cleo Rogier et al. Something to consider in pts w/arthralgias & when to start csDMARDs @RheumNow #ACR20 Abstr#481 #ACRbest https://t.co/q3vIITmtq2

Methotrexate and Nonalcoholic Fatty Liver Disease: Dr Eric Dein (@ejdein1) Dr. Eric Dein discusses the findings of abstract #0181 at the #ACR20 annual meeting. https://t.co/TzbRRbw1Kf https://t.co/vK6EahTyQ8

https://bit.ly/32ktuj8

How do you treat ACPA+, subclinical synovitis (US/MRI+)? Abst#0481 reviews 3 cohorts for progression to clinical inflam arthritis. 44-68% did not progress to IA in 1 year, is DMARD over treating? #ACR20 #ACRBest @RheumNow

Who can have sustained DMARD-free remission (SDFR)? Abst#0479 says early DAS response after DMARD initiation in ACPA-negative patients #ACR20 @RheumNow. Who do you try for DMARD-free intervals? https://t.co/EOfPt4YQAu

Perform (annual) skin exams in patients in MTX based on discovery of a new adverse effect signal with use of low dose MTX (median dose 15 mg/wk) with a NNH of 167! Screening 160 RA patients on MTX will identify 1 skin Ca. Amazing #ACR20 Year in Review by @JYazdanyMD. @RheumNow https://t.co/hUCzKSYZnB

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Outcomes Switching to Monotherapy: SEAM-RA Trial

ACR20 - Opening Day Podcast

ACR Best Abstracts - Day 1

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