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The ACR 2021 meeting has concluded. Dr. Jack Cush recounts a few more great abstracts from this past week’s virtual meeting.
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Identifying patients that will develop RA in situations of seropositivity without overt clinical arthritis or identifying patients with undifferentiated oligo/polyarthritis that will develop RA remains a challenge in the field of rheumatology.
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The REDO trial presented data in abstract 1443 in an oral presentation challenging how low we can go with rituximab for rheumatoid arthritis. Their study randomized 118 patients with rheumatoid arthritis to 1000 mg, 500 mg, and "ultra-low" dose 200 mg.
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Early cardiovascular disease assessment and management is critical at diagnosis in patients with Rheumatoid Arthritis (RA).
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Evidence suggests that RA patients are at increased risk for cognitive impairment. This is likely mediated by certain factors, including chronic inflammation and accelerated atherosclerosis. In the clinical setting, it is important to identify RA patients at increased risk for cognitive impairment.
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Should we start considering therapeutic drug monitoring when prescribing TNFi for treatment of our rheumatologic conditions?
Dr. John Cush
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Lipidomic Differences in PsA and RA: Dr. Pedro Castillo ( @_Castillo_Pedro) discusses abstract #0946 presented at the #ACR21 annual meeting.
https://t.co/M8O1OdvFAk https://t.co/4QMgXPhLzn
Dr. John Cush
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Can "Ultra-low" dose Rituximab work for RA?
At day 3 of #ACR21, the REDO trial presented data in abs1443 in an oral presentation challenging how low we can go with rituximab for rheumatoid arthritis.
Dr. Eric Dein ( @ejdein1) shares highlights.
https://t.co/jaTjBPRKVe https://t.co/7Q9nxlUt7R
Dr. John Cush
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RA: Cardiovascular Risk Stratification and Potential Predictors of Risk
Dr. El Ramahi ( @MeralElRamahiMD ) shares important takeaways from abstracts presented at #ACR21.
https://t.co/69E7aA0Wag https://t.co/6nR5TLeyga
Dr. John Cush
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Cognitive Impairment in Patients with Rheumatoid Arthritis
Dr. Akhil Sood ( @AkhilSoodMD) discusses abstracts presented at #ACR21.
https://t.co/zz8auqZjIW https://t.co/RSHjyonBrj
Dr. John Cush
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Can we Use Frax Score in RA Patients? Dr. Eric Dein ( @ejdein1) reviews abstract #0563 presented at the #ACR21 annual meeting.
https://t.co/UcvTWhlcvW https://t.co/8AdHa2enlz
Akhil Sood MD
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Abst 1515
Williams & colleagues studied role of CD4+ and CD8+ PD-1+ T cells in patients with early RA
- CD4+ and CD8+ T PD-1+ T cells were dominant cell types in synovial tissue
- 6 months after treatment, gene expression of CD4+ PD-1+ T cells decreased
#ACR21 @RheumNow https://t.co/TWLym8oHuK
David Liew
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Put those two RF together (essentially nailing down RA pts at risk of cancer):
age >65 or ever smoked, all tofa vs TNFi: HR 1.55 (1.05-2.30)
age >65 or ever smoked, tofa 5 bid vs TNFi: HR 1.44 (0.93-2.24)
neither RF, all tofa vs TNFi: HR 1.16 (0.53-2.55)
#ACR21 @RheumNow https://t.co/Uvr4wBhFVF
Eric Dein
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#ACR21 Ab#1941: ORAL Surveillance VTE risk
▶️Tofa 10 BID risk > 5 BID > TNFi for VTE, DVT, PE
▶️Age, male, obesity, HTN, h/o VTE, oral contraception/HRT, steroids, antidepressants were risk factors
@RheumNow
https://t.co/JOKNyYVZfX https://t.co/mTkgkwPIT6
Richard Conway
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Hospitalisation for heart failure ⬆️ in inflammatory diseases. RA>PsA>AS>PsO . HRs 1.1-1.6 compared to general population. Abstr#1925 #ACR21 @RheumNow https://t.co/kKlGQM5Tcg
Eric Dein
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#ACR21 Ab#1939: Tofa CV Outcome (STAR-RA)
▶️Pooled data does not show ⬆️ risk of CVD
▶️Trend in pts w prior CVD -HR 1.27 (0.95-1.7), cannot r/o CVD risk in pts w risk factors
Less clear than oral surveillance data, but concerns in those w risks
https://t.co/JOKNyYVZfX @Rheumnow https://t.co/GGYJfxcqhc
Janet Pope
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Why is there more CHF in #RheumatoidArthritis ? Also dose response between highest inflammation RA the PsA then axSpA then PsO. ?Cytokine profile varying with disease and maybe CRP. Who knows. Abst#1925 #ACR21 @RheumNow https://t.co/JIH3qwkLpx
Robert B Chao, MD
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Should we be measuring drug levels in pts taking infliximab?
⭐️Drug monitoring vs. standard dosing showed 73% sustained control vs. 55% (RA, PsA, SpA, UC, Crohn's, PsO)
#ACR21
Abs#1946
#ACRBest @RheumNow
https://t.co/sWMen50ljP https://t.co/F4Wpqis3id
Janet Pope
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Anti-MAA Ab is not ‘baa’ humbug. In prevalent #RheumatoidArthritis, + MAA Ab was predictive of developing #RA #ILD. ? Novel biomarker. Needs validation but nice convincing data @RheumNow #ACR21 #ACRBest abst#1916 https://t.co/wuTPzSIsey
Aurelie Najm
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Another study linking long term GC and CV risk in RA!
Medicare data >65yo 130000+ pts
1-year incidence CV ⬆️ as follows:
📍Dose ≤5mg 1.4%
📍Dose 5-10mg 1.7%
📍Dose >10mg 1.9%
Not replicated in younger pts (Optum data)
#ACR21 #Abst1915 @RheumNow https://t.co/DLXdfvfiBW
