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Are Emulation Trials a Fantasy?
Are these ‘trials’ helpful, despite the biases that occur with observational data, or do they truly mimic the results of randomized controlled trials (RCTs)?
https://t.co/x6NogGQksW https://t.co/f8o8N55tlJ
Dr. John Cush RheumNow ( View Tweet)
axSpA: Moving the needle in time to diagnosis
The journey to axial spondyloarthritis (axSpA) diagnosis is often prolonged and challenging. Understanding the factors contributing to the delays is important to improve the clinical, psychological, social and economic outcomes.… https://t.co/wnwtj8jj0q https://t.co/Pds2uxVfJV
Dr. John Cush RheumNow ( View Tweet)
Assessment and management of axSpA
Dr. Antoni Chan reports on abstract 0818, Defining BASDAI Cut-offs for Disease Activity States in Axial Spondylarthritis – Results from the EuroSpA Collaboration, and abstract 0819, The Assessment of SpondyloArthritis International Society… https://t.co/ropQJdElyb https://t.co/IVn5u2l7iP
Dr. John Cush RheumNow ( View Tweet)
RheumNow’s expanded coverage of the #ACR24 meeting is sponsored in part by Bristol Myers Squibb and UCB. All content is chosen by RheumNow and its faculty.
Dr. John Cush RheumNow ( View Tweet)
Are we under-monitoring in scleroderma ILD?
Dr. Janet Pope discusses abstract 0678, Patients with Interstitial Lung Disease Due to Systemic Sclerosis or Rheumatoid Arthritis Need Monitoring More Frequently Than Annually, and abstract 0706, Single Center Prospective Cohort of… https://t.co/1y1VXGvqjp https://t.co/4ofh45cYwq
Dr. John Cush RheumNow ( View Tweet)
Hypoxia seems to exacerbate neutrophil activation by ANCA
- enhanced F-Actin polymerization
- enhanced NET formation
Could hypoxia predilection in certain tissues (kidney, lung) lead to the AAV phenotypic disease patterns?
@RheumNow #ACR24 https://t.co/KxaeMvkd2t
Links:
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Prior studies have shown that IFN is increased in non-lesional skin of SLE pts.
In this study, they found a ⬆️ expression of IFN stimulated genes (ISGs) in pts w/ a history of CLE.
No correlation w/ CLASI act & IFN scores but only few pts.
@RheumNow #ACR24 abs2678 https://t.co/cPT6yPkoCb
Links:
sheila RHEUMarampa ( View Tweet)
Prof Petri reports the ff predictors of fracture in SLE:
-older age
-Caucasian race
-female sex
⚠️ Prednisone (but not recent IM triamcinolone or IV methylpred) is a MAJOR risk factor.
When possible, avoid prednisone!
@RheumNow #ACR24 #ACRbest abs2679
@rheumarhyme https://t.co/q2NMRaYsAF
Links:
sheila RHEUMarampa ( View Tweet)
Lacaille et al. Long term harms of previous steroids in RA. CV/infection mortality increase 7% every year/use. Takes 3.5 and 10 years to return to normal after 1 and 2 years use. Never returns to normal if >2 years use @RheumNow #ACR24 Abstr#2673 #ACRbest https://t.co/qcp5mCHmeB https://t.co/keXw5Qg2ld
Links:
Richard Conway RichardPAConway ( View Tweet)
All-caps abstract text throw-down by Michelle Petri re:fractures in SLE 😆
I keep saying this; our obsesssion with vitamin d is not commensurate w/reality
It's. The. Prednisone.
#ACR24 @RheumNow Abstr#2679 #ACRBest https://t.co/13luByNvYT
Links:
Mike Putman EBRheum ( View Tweet)
What are the predictors of fracture in #SLE?
🦴Prednisone! Even at low doses ≤5mg
🦴Stroke
🦴Caucasian race
🦴Female
🦴Low BMD
Try to avoid steroid use. If they are needed, IM triamcinolone or IVMP preferable to oral GC.
Ab2679 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
Does CVD mortality risk change after stopping GC in RA?
➡️28078 incident GC users
➡️Incr mortality risk from CVD &infections persists post-cessation
➡️Risk never returns to pre-GC level after prolonged use
⏩Use GC at lowest dose for shortest time possible
Ab2673 #ACR24 @Rheumnow https://t.co/dtLU8obLke
Links:
Mrinalini Dey DrMiniDey ( View Tweet)
Increased risk of mortality related to negative effects of GC use persists long after stopping and never return to pre-GC levels. #GCStewardship
#ACR24 @RheumNow ABST#2673 https://t.co/5AwHDmvQGf
Jiha Lee JihaRheum ( View Tweet)
Ab2674 #ACR24
➡️Most pts starting 1st-line TNFi, who didn't achieve treatment response at 3M, also didn't achieve response from months 3-12
➡️1/4 pts achieving LDA/remission at 3M were no longer in LDA/remission at 12M
@RheumNow https://t.co/pFOo86tJTx
Mrinalini Dey DrMiniDey ( View Tweet)
Data from the RISE registry show that 9.3% of SLE pts had thrombocytopenia and a smaller percentage with mod-severe TP (2.7%). Severe TP was much rare.
Large data, but well represented grp?
@RheumNow #ACR24 abs2680 https://t.co/Y1Lo9lJGtO
Links:
sheila RHEUMarampa ( View Tweet)
An early favorable response to TNFi initiation indicates better long-term success in RA. Assess early and adjust treatment accordingly.
#ACR24 @RheumNow ABST#2674 https://t.co/YTThYiiLpZ
Jiha Lee JihaRheum ( View Tweet)
#ACR24 BEST Abstracts from Day 1
The RheumNow faculty have parked at the plenaries, trafficked the posters and have been finding the best the meeting offers on the first day.
https://t.co/FHu616Jpyq https://t.co/oKuRcGRRAZ
Dr. John Cush RheumNow ( View Tweet)
Would you trust #AI to carry out & read your #USS?
2 systems, ARTHUR & DIANA, were comparable to that of a rheumatologist specialising in MSK US at joint & patient levels
Might this be the future of assessment in rheumatology care?
AbL20 #ACR24 @RheumNow https://t.co/XtnlYafzp4
Mrinalini Dey DrMiniDey ( View Tweet)
Nailfold video capillaroscopy (NVC) allows the definite distinction between primary and secondary #Raynaud's phenomenon and can identify early changes such as few giant capillaries &/or microhemorrages
promoting early diagnosis
@RheumNow #ACR24 @rheumarhyme https://t.co/Yl37w6BEZR
sheila RHEUMarampa ( View Tweet)
Another + #SLE #RCT - large N
#Dapirolizumab = Peg CD40L + SoC
Vs
#Placebo + SoC
Rapid improvemt
steroid sparing
So what to use in Pts if +Ph3
👇
TYK2 Deucravacitinib
JAKi Upadacitinib
Dapirolizumab
CAR 🚗 Rx
Anifrolimumab
Benlysta
ETC!
#ACRBest L16 @RheumNow #ACR24 https://t.co/wTFucF7BYO
Janet Pope Janetbirdope ( View Tweet)