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COX2 inhibitors associated with inhibition of radiographic spinal progression in AxSpA pts compared to non-selective NSAIDs.
⬇️radiographic spinal progression over 2 yrs
⬇️mSASSS progression
@RheumNow #ACR20 Abs#2030 https://t.co/p1CeNBm3ma
Robert B Chao, MD doctorRBC ( View Tweet)
The FAST trial had 33% of pts with CVD and pts w/class III/IV CHF were not allowed in this study (vs. CARES trial where all subjects had baseline CVD); I am still cautious prescribing febuxostat to pts who have severe CVD until we have more data. @RheumNow https://t.co/fJ9bLcXpR2
k dao KDAO2011 ( View Tweet)
IN GOUT: CARES study said febuxostat increases CV risk; Todays FAST study says No incr CV risk w/ FEB. In your Gout pt w/ CV hx, would you use febuxostat? #ACR2020
Dr. John Cush RheumNow ( View Tweet)
Following the results of the FAST trial, would you have any concerns about prescribing febuxostat if clinically indicated?
#ACR20 @RheumNow
David Liew drdavidliew ( View Tweet)
@RheumNow #ACR20 Abs L08 Prospective 4 year PROBE trial of Febuxostat vs allopurinol long term CV safety: febuxostat was not associated w/increased risk of death compared w/allopurinol. 222 (7·2%) pts died in the febuxostat group compared to 263 (8·6%) in the allopurinol group
Olga Petryna DrPetryna ( View Tweet)
FAST trial: allopurinol vs febuxostat on safety
(for gout pts on allopurinol, with ≥1 CV RF, TTT dosing)
febuxostat non-inferior for CV events
Well, that's a relief.
gout flare similar, good follow-up, colchicine did not influence
out in Lancet today?
#ACR20 ABSTL08 @RheumNow https://t.co/5LeXV5mgu9
David Liew drdavidliew ( View Tweet)
Results of the FAST trial presented at #ACR20
- Safety study required by the EMA
- Febuxostat non-inferior to allopurinol for any outcomes
- Long-term use of febuxostat is not associated with an increased risk of death
Published in @TheLancet today https://t.co/EvJGPpDCR8
Links:
NatRevRheumatol NatRevRheumatol ( View Tweet)
Dr MacDonald presents Febuxostat versus Allopurinol Streamlined Trial. 6128 patients. HR 0·89 [95% CI 0·75-1·06] for cardiovascular events in febuxostat vs allopurinol. Mortality 7.2% vs 8.6%. Reassuring re cardiovascular safety of febuxostat @rheumnow #ACR20 Abstr#L08 #ACRbest
Richard Conway RichardPAConway ( View Tweet)
FAST trial (Plenary) showed opposite of CAREs study. Febuxostat vs PBO in 6128 Gout pts, showed little dropout (~6%) in a 4 year study. Febuxostat (mean 81mg) had similar, flare rates, MACE/cardiac endpoints and CV death vs allopurinol #ACR20 Abstr#L08 https://t.co/FkdDtPB4Oi https://t.co/J9KonQHpT2
Dr. John Cush RheumNow ( View Tweet)
Upadacitinib vs. Adalimumab vs. PBO in PsA Phase 3 RCT ⬇️MSK symptoms, PsO, function, pain, fatigue, rads progression in UPA *⃣UPA15 non-inferior to ADA for ACR20, UPA30 superior *⃣Similar VTE in all arms @RheumNow #ACR20 Abs#2026 https://t.co/OHzIjXKqAu
Robert B Chao, MD doctorRBC ( View Tweet)
Rituximab in AAV: how to dose?
Should we be giving:
- 'haem dosing': 375mg/m2 x4 doses
- 'RA dosing': 1000mg x2 doses
Systematic review says: no difference
Reassuring given the variation in practice in real life!
#ACR20 ABST2048 @RheumNow https://t.co/Jf4Ue6HRRL
David Liew drdavidliew ( View Tweet)
Anakinra in #Stills disease - Double blind, placebo controlled RCT in Stills disease total 12pts, 6 placebo, 6 Rx grp. All pts reached ACR70 at week 2 without fever and sustained it at 12 weeks. 5/6 reached ACR90 @RheumNow
#ACR20 ABS#1633 #ACRbest https://t.co/9E4vm7WzhP
Bella Mehta bella_mehta ( View Tweet)
Wonder if you can predict which pts you can successfully taper off bDMARDs? Abst#1538 from Denmark showed that a neg IgM-RF (OR 0.26) & low Doppler serum score for 24 jts predicted successful discontinuation of bDMARDs at 2yr f/u in RA pts w/ DAS28-CRP<2.6. #ACR20 @RheumNow https://t.co/CbJTguxaoa
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
I am glad now that chloroquine is not available (permanent back order) in Canada as results of high retinal toxicity w chloroquine was sobering & changed my practice. I won’t use it long term @RheumNow #ACR20 @CRASCRRheum abstr#1825 https://t.co/1RQi41uV1B https://t.co/lc9za22Zw1
Janet Pope Janetbirdope ( View Tweet)
We need to work together with our patients to ensure medication adherence during this pandemic.
1⃣30% of 734 pts on DMARDs changed their med use during COVID
2⃣Med change without physician guidance
3⃣Changes resulted in ⬆️steroid use
@RheumNow #ACR20 Abs#L05 https://t.co/n18zqed4wC
Robert B Chao, MD doctorRBC ( View Tweet)
Retrosp study in France compared MRIs of 96 pts w/ SpA (65% w/ IBP) vs 104 w/o (25% w/ IBP):
- 65% of pts w/ SpA had bone marrow edema (BME) mainly in the iliac quad of intermed middle segment
- 20% w/o SpA had BME mainly in antero-middle quad. #Abst1535 #ACR2020 @RheumNow https://t.co/1ptGGUbUS4
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
How often do you perform NFC in suspected SSc patients? @RheumNow #ACR20
sheila RHEUMarampa ( View Tweet)
Pleiotropic effect of IL6, interesting points to note:
— it can cause pain
— it can cause fatigue (IL6 impacts hepcidin w/ subsequent development of iron deficiency)
— IL6 levels increase in those w/ poor sleep
#ACR20 @RheumNow @CCalabreseDO
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Older patients with polypharmacy are at ⬆ risk for drug-drug reactions and adverse effects. @RheumNow #ACR20 https://t.co/uKsYO9B8PZ
sheila RHEUMarampa ( View Tweet)
Dr. Subedi: "we need to stop blaming just the age" in geriatric patients for adherence. Busy, middle aged patients more likely than geriatrics to have adherence issues. 3S040. Pharmaco Pearls for Older Rheum Pt. #ACR20 @RheumNow https://t.co/3UAkjRNT3u
Eric Dein ejdein1 ( View Tweet)
