In a world where telemedicine and virtual care are not going away, is there value in patients assessing their own tender and swollen joints?
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Januse kinase (JAK) inhibitors are targeted synthetic disease modifying anti-rheumatic drugs (tsDMARDs) that have risen in popularity as earlier treatment options for rheumatoid arthritis.
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The first full day of Abstracts and Presentations from ACR Convergence, was full of highly engaging sessions, quality posters and unique presentations. To hear more about the best of the best, I would encourage you to look at our Day 1 Recap Video and Day 1 ACR Best Abstracts. Here are a few of my favorites from the first day.
Eric Dein
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#ACR21 Abs#1210: Frequency of anterior atlanto-axial sublux in RA
⭐️Anterior atlanto-axial subluxation (aAAS) = 3+ mm, frequency = 25%
⭐️Radicular pain 20%, surgery 6%
▶️Longer disease duration, ⬆️ frequency of extra-articular manifestations
https://t.co/BfjCTlRJbt @Rheumnow https://t.co/xd9h5e9cDH
Aurelie Najm
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#clinicalpearls Cervical involvement in RA: is it underestimated? Cohort of 240pts: anterior atlantoaxial subluxation (aAAS) found in n=25 10.4 % patients, 1/3 with no neck pain! Joint restriction OR: 5.8 hx arthroplasty OR:3.6
#Abst1211 #ACR21 @RheumNow
https://t.co/KRkDP4ETMu https://t.co/soKTMPiMwy
#RA pts on #baricitinib less likely to discontinue treatment & more likely to achieve remission than pts receiving biologic /other tsDMARD.
👉🏼Results from RA-BE-REAL observational study
👉🏼Bari(2 or 4mg) vs biologic/other tsDMARD
Abs#1223 #ACR21 @RheumNow
https://t.co/WRN1OCX9Bq https://t.co/UCFF6hAY7G
Eric Dein
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#ACR21 Abs#1224. ⬇️ CD39 expression on B cell predicts occurrence of anti-drug Ab in RA on RTX
⭐️13/23 pts on RTX became ADAb+. No diff in concomitant MTX usage
⭐️Baseline CD73 similar, but lower CD39 predictive of ADAb
https://t.co/QzbAmXtTmZ @Rheumnow https://t.co/CLtEev69YD
Eric Dein
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#ACR21 Abs#1225: B/L Extracell Matrix Biomarkers predict ABA response in MTX-naive, +ACPA early RA
⭐️ECM biomarkers predict SDAI remission or DAS28 w ABA+MTX vs PBO+MTX.
⭐️⬆️CTX1 biomarker predicts efficacy endpts for ABA+MTX
https://t.co/7wHQefb5D4 @Rheumnow
Wk 12 disease activity predicts wk 24/26 remission/low disease activity with #upadacitinib 15mg in MTX-naïve or inadequate responders to MTX and/or TNFi pts.
≥50% improvement in SJC/TJC at Wk 12 was assoc with wk 24/26 remission/low disease activity.
Abs#1237 #ACR21 @RheumNow https://t.co/PAaCe5MAcu
Aurelie Najm
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Ultrasound in CSA patients:
Retro US cohort 110pts
28.2% w/ 💥Power Doppler synovitis. 36.8% at 6mo evolved to RA among which 100% PD+ vs 25% PD-
PD + predicts evolution to clinical RA (OR 13.1; CI 1.07-161.04)
Easier and less invasive than MRI!
#Abstr1525 #ACR21 @RheumNow https://t.co/MkhWTvnv3L
Eric Dein
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#ACR21 Abs#0819. RheumTAP real-world cohort of pts tapering Rx in remission on RA
▶️ Pts tapering 7.6x ⬆️ likely to flare in f/u
Great convo soon on @Rheumnow re: tapering studies. @davidliew asks how many more times do we need to see drug w/d fail?
https://t.co/BiZSM7yp7o https://t.co/iDXGVpFZzB
Akhil Sood MD
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Abst 0789
Baker & colleagues examined adipokine levels in association with disease activity in RA patients
- Patients with high levels of adipokines less likely to achieve low disease activity & remission
- These patients more likely to escalate to b/tsDMARDs
#ACR21 @RheumNow https://t.co/1xlO4W9q9v
Akhil Sood MD
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Another exciting day at #ACR21 and covering for @RheumNow
Also presented my poster (Abstr 0587) DMARD Use in Medicare Patients with #RheumatoidArthritis and Risk of Long-Term Opioid Use
- DMARD users showed lower odds of long term opioid use compared to non-DMARD users https://t.co/2XZgYY8ORg
David Liew
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We know we're all not as great at treat-to-target in RA as we should be.
If we want to get fit, we join a group class.
If we want to study, we join a study group.
Why not the same with TTT, to motivate us to our best?
Virtual learning collaboratives 👏
#ACR21 ABST0815 @RheumNow https://t.co/siVOyKjPNx
MRI Imaging in RA and SpA: Dr. Sheila Reyes (@RHEUMarampa )
Dr. Sheila Reyes discusses abstracts #0468 and #0469, presented at the #ACR21 annual meeting.
https://t.co/KUoO88dEhQ https://t.co/10R4jC5p0y
Ethnic disparities in pts with RA & CVD - paucity of evidence in published lit
Need to improve study inclusion, diversity to improve quality of care
#ACR21 https://t.co/sWKcHugU9W
David Liew
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In pts w/o RF, liver bx prev suggestd if lifetime cumulative MTX dose was 1-1.5g, then 3.5-4g.
All pts in centre offered Fibroscan
liver stifness associations:
- age, BMI
- not cumulative MTX dose
maybe survival bias, but what we're doing now is fine!
#ACR21 ABST0786 @RheumNow https://t.co/I6IhS3jhmC
Meral K. El Ramahi, MD
Tweet
Does concomitant SJS affect tx effectiveness in RA?
Abst#0839 suggest yes!
➡️RA+SjS have an inferior response to TNFi than RA patients w/o SjS
BUT, RA/SJS pts w/ longer RA dz duration & ↑ DAS28 + HAQ-scores.
What's your clinical experience with this?
#ACR21 @Rheumnow https://t.co/TIc3raMOSJ
Meral K. El Ramahi, MD
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Abst#0572: In US veterans w/ RA followed for 17 yrs, several cytokines+chemokines
⭐️Associated w/ ↑ risk of incident MACE independent of typical CVD RF & RA activity
&
⭐️Predicted MACE even if in LDA/remission
WOW! We need to do better @ CVD risk strat!
#ACRBest @RheumNow https://t.co/J74rRa9EQE
