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Dr. Gensler gave a fantastic talk on SpA mimics
☝️Not all IBP is axSpA - interpret in the appropriate context + imaging
WOF other mimics
🔸 Sacral insufficiency fractures
🔸 Infections
🔸DISH
#ACR25 @RheumNow https://t.co/7TIqyp5rYe
Links:
sheila RHEUMarampa ( View Tweet)
In a Brazilian cohort (n=791), axSpA diagnosis delay dropped from 41.7 yrs (1960s) to 1.9 yrs (2020s). Female representation rose to 50%. Non-radiographic axSpA now 16.7%. MRI and updated criteria driving earlier, more equitable recognition. Abstract#1407 @RheumNow #ACR25 https://t.co/8hIpX0a1Sa
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
RheumNow’s expanded coverage of the #ACR25 annual meeting is sponsored by Bristol Myers Squibb, Novartis, and UCB. All coverage content is independently selected by RheumNow & its faculty.
Dr. John Cush RheumNow ( View Tweet)
Who talks to their neighbour?
+SSA / Ro talk differently to nearby cells in #SjD #salivary #glands vs NEG Ro SjD
Ro52 acts differently than Ro60
?implications for Rx response? 🤷♀️
#ACR25 @RheumNow @ACRheum #Sjogren’s
Abst#1684
#ACRBest!
Elegant work from Sara McCoy https://t.co/UWUKAxi0UW
Links:
Janet Pope Janetbirdope ( View Tweet)
How many patients do you need to treat to prevent one RA conversion in at-risk individuals?
APPIPRA and ALTO Interception studies, long term data
Number Necessary to Treat to prevent 1 RA conversion across time:
1yr = 4
2yrs = 7
3, 4, 5 yrs = 9
6 yrs = 11
#ACR25 #ABSTRACT1678 https://t.co/GBzUJG8jVk
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
DYK?
A bipartite ilium is a common SIJ variant.
More common among women.
SpA mimics involving biomechanical stress: BME & sclerosis
🔸OCI - assoc w/ multiparity, obesity
🔸Degenerative dse
#ACR25 @RheumNow https://t.co/IoZepAJKJ6
Links:
sheila RHEUMarampa ( View Tweet)
So who with inflamm arthralgias might benefit from abatacept, in terms of delaying RA onset?
ALTO study (APIPPRA continuation)
1y abatacept then follow
If autoAb x5 (RF, ACPA IgG, IgA, anti-CarP, AAPA): sustained delay of RA
If not: benefit only on Rx
#ACR25 ABST1678 @RheumNow https://t.co/3Pc5ZLzVf6
Links:
David Liew drdavidliew ( View Tweet)
#ACR25 Abstr#1401 Sjogren’s #SjD is definitely not a benign disease! Real world study using US database showed high disease burden within 12 mths of diagnosis (i.e. healthcare resource use). GC use was high (~50%). Better therapy is needed to improve outcomes @RheumNow https://t.co/MI3vQ5LByr
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
TNFi induction first year in RA leads to:
- less D2T RA at 5y
- more sustained remission from 10y onward
- less DMARD utilization
- less healthcare utilization
in these real-world matched cohorts
given biosimilar prices, this might be worth considering
#ACR25 ABST1677 @RheumNow https://t.co/uL9nHtLkXZ
Links:
David Liew drdavidliew ( View Tweet)
#ACRBest @RheumNow https://t.co/K8kmlzIjxt
Aurelie Najm AurelieRheumo ( View Tweet)
Early TNFi treatment leads to
-Less D2T at 5 yrs
-More sustained remission at 10yrs
-Less bDMARD escalation at 5yrs
-More DMARD free remission at 5yrs and 10 yrs
-20% reduction annual healths costs
-11 mo delay in ttmt escalation
Safety data were not presented
#ACR25 https://t.co/jPMGUGPtqP
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
SELECT-COMPARE RA UPA vs. ADA
What do we learn from 7 years data? Not much
Patients who did well on the first drug, keep doing well
Patients who required switching for primary failure don't do as well, w/ 26% pts reaching DAS remission in UPA + MTX vs. 16% in ADA + MTX gp
No https://t.co/JLUTRZuZOm
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Primary CNS vasculitis: what else causes vessel wall enhancement on dedicated brain MRI?
From Dr. Hajj-Ali https://t.co/v5ZtyezX3x
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
At the Global Rheum Summit, patients called for care that values people, not just disease.
✅ Respect lived experience
✅ Enable shared decisions
✅ Support education & coordination of care decisions.
@RheumNow #ACR25
Jiha Lee JihaRheum ( View Tweet)
~1 in 6 pts with #sarcoidosis May have #cardiac involvemt
1/3 respond to #MTX + #steroids
Followed by repeat #PET
Failures get
👇
#infliximab >#adalimumab
👇
#JAKi
Better survival >yrs ago
R heart involved ⬆️risk of MTX nonresponse
#ACR25 @RheumNow @ACRheum abst#1664 #ACRbest https://t.co/kYt9JRNSVH
Links:
Janet Pope Janetbirdope ( View Tweet)
In case you missed it in @ACR_Journals: HCQ for 1y does not prevent RA development in people with CCP3 >2x ULN, either:
- during 1y of treatment
- in 2y follow-up
https://t.co/gtzNiSmutb
but StopRA will give us plenty of insights - data is never wasted
#ACR25 ABST1674 @RheumNow https://t.co/DDZib5VGtX
Links:
David Liew drdavidliew ( View Tweet)
SELECT-COMPARE (upadacitinib vs adallimumab in mod-severe RA, no CV enrichment) 7y data:
safety profiles very similar, except for:
- zoster
- CK rise
- lymphopenia
- hepatic disorder
In the general RA population, no new JAKi safety signals
#ACR25 ABST1676 @RheumNow https://t.co/BA2JxONGfa
David Liew drdavidliew ( View Tweet)
#ACR25 Please find our Day 1 Recap of the conference where we discussed our favourite abstracts and learning points 😃 @Janetbirdope @AurelieRheumo @RheumNow https://t.co/X125tjyqi5
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Abstract 1421: PsA and 'Brain Fog'
Pts w/ #PsA who did not achieve Minimal Disease Activity (MDA) had higher odds of subjective cognitive decline vs those with MDA
🔹 Fatigue, and to a lesser extent depression/anxiety, ↓ this associated risk
@RheumNow #ACR25 https://t.co/RohwKJZDzp
Links:
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
In the IMPACT trial (Abs 0855), certolizumab met its primary endpoint: <20% had an adverse pregnancy outcome (APO) among females w/ APS & prior APO.
✅ 94% live births, all survived to discharge
📈 Median GA: 37 wks (no APO) vs 31 wks (APO)
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
