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The RheumNow faculty reporters have been scouring and reporting on the best abstracts from the ACR. Here is a sampling of their choice abstract presentations reported during ACR 2020 Day 2 (#ACRbest).
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Dr. Cush reviews the news, and kicks off ACR21 learning and how to take in the annual meeting.
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The American Society of Clinical Oncology, Inc (ASCO) has updated its guidelines and recommendations for the management of immune-related adverse events (irAEs) in patients treated with immune checkpoint inhibitor (ICPi) therapy. Below are select statements from this guideline.
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New research to be presented this week at ACR Convergence, the American College of Rheumatology’s annual meeting, shows a relationship between genotype, bone marrow failure and survival in patients with the rare autoinflammatory disease VEXAS syndrome, which was only identified in 2020.
Md Yuzaiful Md Yusof
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#ACR21 #Abstr1908 Potential prognostic biomarker for lymphoma in #sjogren. ISG15 (IFN-I) expression was consistently ⬆️in pts with lymphoma vs none, both in blood and salivary gland biopsy. Work needed re: relation to other markers, ethnicity @RheumNow https://t.co/8VYYEXpXSw https://t.co/ZIkpx5kUfu
Didem Saygin, MD
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Dr Ami Shah - Scleroderma & Cancer:
🛑 ⬆️ risk of ca around the time of dx in SSc patients with RNA-pol-III (especially first 5 years after dx), anti-Th/To protective?
🛑Her approach for ca screening in newly diagnosed with SSc pts and red flags as below
#ACR21 #ACRambassador https://t.co/2VcWn2UInm
Veena Katikineni
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Dr. Fiorentino on cancer risk stratification and screening in myositis. Come chat at noon in the Myositis Community Hub to learn more!
#ACR21 #ACRAmbassador https://t.co/I0iQuPAuOl
David Liew
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How do RA pts go with ICI cancer therapy?
@VUMCRheum audit reflects overall prev experience:
- approx 50% flare (?some reflect DMARD W/H)
- flares overwhelmingly managable
- few (1/19 here) cease ICI due to RA flare
RA pts deserve best cancer Rx too!!
#ACR21 ABST1523 @RheumNow
Richard Conway
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This case is from the hypereosinophilic syndrome talk. This was NOT EGPA! It was cancer. Be careful! #ACR21 @RheumNow https://t.co/UhdpeHBfOE
David Liew
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Are there people looking at steroid-sparing therapy as irAE treatment or prevention?
@CCalabreseDO: are there ever
#ACR21 irAE Study Group @RheumNow
(also @NAbdelwahabMD @ReidMDMPH on stage) https://t.co/CLmNaLB68O
Md Yuzaiful Md Yusof
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Either we need to review the Yearly PAP cervical screening in SLE women or work hard to improve patient awareness. Suspect the latter as time between tests was over 4 years late 😱 and 2.7% developed cancer #ACR21 #Abstr0133 @RheumNow https://t.co/wm01MfoFjf https://t.co/blD8WafZsE
Meral K. El Ramahi, MD
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Knowledge Bowl at #ACR21
⭐️The first lung fibrosis described in Sjogren's with lung biopsy showing benign polyclonal lymphocytes and plasma cells with a risk for malignant transformation.
➡️Lymphocytic Interstitial Pneumonia
@RheumNow
Janet Pope
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What to do if pt on a TNFi develops cancer? Can you safely restart TNFi later? Depends on cancer, timing - how long ago was cancer, Rx and patient preference. Data diff from RABBIT registry vs British bio registry @RheumNow #ACR21 #ACRBest 7S413 Have a look https://t.co/q9SFKlFJzg
Akhil Sood MD
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Very interesting talks by Dr. Kim and Dr. Hyrich on DMARDs and Cancer risks
#ACR21 @RheumNow https://t.co/Dl5WPo7mmj
David Liew
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This feels like an excellent starting point for Tuesday's ORAL Surveillance malignancy discussion.
RWE Cohort: HR 1.01 (0.83-1.22)
RCT-dup Cohort: HR 1.19 (0.86-1.64)
ORAL Surveillance: HR 1.48 (1.04-2.09)
Interesting day 4 ahead!
great talk @SeoyoungCKim #ACR21 7S413 @RheumNow https://t.co/YSau21goMr
Olga Petryna
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Abst0569 #acr21 @RheumNow mortality in SpA:⬆️ overall mortality in AS (RR 1.64, 95% CI: 1.49-1.80,) but not PsA (RR: 1.12, 95% CI: 0.96-1.30). CV, resp & infection specific mortality significantly higher for PsA Cancer related mortality in PsA not higher than the gen pop
TheDaoIndex
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Retrospective study of cancer pts Rx w/ ICI and autoimmune Ab (ANA, RF, CCP, SSA/SSB, ANCA)
👉152 pts
👉59% had irAE
👉preICI Ab+⬆️odds of irAE (OR 17.5 95% CI 1.76-174, p=0.015)
👉strong assc b/t +RF and +CCP for ICD-arthritis
#ACR21 Abst#0440 @Rheumnow https://t.co/kUv5ddSAnY
Jeffrey Sparks MD MMSc
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Large case-control study (n=8028) to identify baseline predictors of rheum irAEs after immune checkpoint inhibitor initiation for cancer.
Type of cancer (melanoma, GU), combination ICI, pre-existing autoimmune disease, and recent GC use each had higher odds of rheum irAE #ACR21 https://t.co/rHI6VQ37QB
Dr. John Cush
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Health insurance data from Korea analyzed 17,854 SLE pts & saw incr risk hematologic & solid cancers; solid (126.9/10K PY;SIR 1.8), heme (11.2/10KPYs; SIR 1.7). Most common in SLE: breast, reproductive & thyroid then liver & colon cancers https://t.co/dRs7SUwUAY
Dr. John Cush
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FDA put a box warnings on breast implant packaging to include info that 1)Breast implants are not lifetime devices; 2) complication risk increases over time; 3) risk of anaplastic large cell lymphoma, 4) may be assoc w/ systemic Sxs https://t.co/VnpJg45PZY
