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ACR 2024 - Day 3 Report
Highlights from Day 3 at ACR24 included the plenary session presentation on Nipocalimab (previously reviewed), but the big highlight was the Lupus Nephritis guideline recommendations.
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JAKs and Other Drugs in PMR
This has been an interesting ACR meeting in terms of PMR updates. I would argue that we are still far too wedded to glucocorticoids only in the management of PMR. Yes, some patients will do fine with just glucocorticoids but we persist far too long with a glucocorticoid only strategy in others who clearly need an alternative as glucocorticoid adverse events multiply.
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#Scleroderma #molecular #signatures in #skin predict long term outcomes
👇worst with inflammatory signature
This may have clinical and trial applicability
Nice work!
Abst0711 #ACR24 @RheumNow @ACRheum https://t.co/3CFxu6bACu
Janet Pope Janetbirdope ( View Tweet)
#PAH in #SSc still has a poor #prognosis
đź‘Ž
Esp #ILD with PAH - a double whammy
But also
group 1 PAH
And
Some are unclassifiable ▶️also bad px
Need
Earlier detection
More interventions
?prevention
Abst#0678 #ACR24 @RheumNow @ACRheum @sclerodermaUM https://t.co/AEQsTC1pzQ
Links:
Janet Pope Janetbirdope ( View Tweet)
#Positive #RCT of #Nipocalimab a FcRn receptor inhibitor in #Sjogrens #Disease
đź‘ŹPhase 2 +RCT
ESSSDAI and ESPRI both improved
🤷‍♀️what it means to lower #antibodoes #Ro #La
Excited for Phase 3 results
#ACRBest #ACR24 @RheumNow @ACRheum abst#2527 https://t.co/NeeYT7VR16
Links:
Janet Pope Janetbirdope ( View Tweet)
#MDA5 #dermatomyositis assoc #ILD
May do better w
#tofacitinib vs #CNI in 515 pts
Too bad they didn’t do a pragmatic RCT as we do t know the reasons for prescribing each #Rx
But impressive survival w #tofa
#ACR24 @ACRheum @RheumNow abst1736 https://t.co/HLJknSYcNJ
Janet Pope Janetbirdope ( View Tweet)
Autoantibody tests are everywhere, but how do we make sense of them? With the proper algorithms, can we go beyond interpretation to predicting autoimmunity before it develops?
Check out my article: Taking the AI out of AutoImmunity
https://t.co/d3ZNYWQaaQ
@RheumNow #ACR24
Akhil Sood MD AkhilSoodMD ( View Tweet)
Risk stratification of GCA pts: who might lose vision?
Cranial MRI with vessel wall enhancement used to calculate additive score... # of vessels affected
Higher scores a/w ocular GCA > non-ocular GCA > no GCA and decreased w/ tx
@RheumNow #ACRbest #ACR24 https://t.co/knDVrl84Qs
Links:
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Conversation with @RheumKay on his #ACR24 biosimilar talk for @RheumNow
https://t.co/LzAIGIG4wu https://t.co/CqSYLpJYAh
Eric Dein ericdeinmd ( View Tweet)
@drceowen @TheLancetRheum @RheumNow Efficacy in newly diagnosed & established PMR is not necessarily interchangeable
different treatment paradigm
?different immunologically
Many other diseases have different Rx for induction vs maintenance, early dx vs established.
Having said that: doesn't look great for MTX. https://t.co/89lByaYdYq
David Liew drdavidliew ( View Tweet)
Lot said about #ACR24 ABST1697:
MTX in newly diagnosed PMR, neg RCT
Many have said no hope for MTX in PMR now
Agree doesn't bode well
However, MTX may still have role in established PMR
@drceowen & I have made that call a priori @TheLancetRheum https://t.co/ywCJc0zHzC
@RheumNow https://t.co/JUXk2tDNyR
Links:
David Liew drdavidliew ( View Tweet)
#Artificial #Intelligence can detect #osteoporosis
On #CXR
To detect #thoracic #vertebral #fractures
> 100000 #chest #radiographs - test and validation cohorts found + results on ROC
Helpful -sometimes vertebral changes are
Not read on CXRs
#ACR24 @RheumNow @ACRheum #2116 https://t.co/NxEaH0AKJv
Links:
Janet Pope Janetbirdope ( View Tweet)
#Publication #bias to Nth degree.
>1/3 of registered #postmeno #osteoporosis trials are NOT #published
👇search of trials
673 published
Vs
489 not published 890000 pts
MOSTLY when performed in the USA
No accountability for NOT publishing
#ACRbest #ACR24 @RheumNow #2122 https://t.co/UyMMbHhvvV
Janet Pope Janetbirdope ( View Tweet)
If your pt with #rheumatoid #arthritis is
#exhausted - there is a reason
#Meta-analysis of 70000 RA Pts
#Insomnia is ⬆️4X vs gen population
Due to
▶️#pain
▶️#inflammation
▶️#depression
🤷‍♀️
#ACR24 @RheumNow @ACRheum abst#0480
Janet Pope Janetbirdope ( View Tweet)
It is NO LONGER a ACCEPTABLE
To NOT consider
#MMF or #Cyclo + another proven #Rx
Added to
#HCQ and #tapering /limiting #glucocorticoids
RCTs in #lupus #nephritis support this
? Is which to add
#belimumab
#CNI #volclosporin
#obinutuzimab
#ACR #ACRbest @RheumNow @ACRheum https://t.co/a7WMFfCyXl
Janet Pope Janetbirdope ( View Tweet)
RheumNow’s expanded coverage of #ACR24 is sponsored in part by Bristol Myers Squibb and UCB. All content is chosen by RheumNow & its faculty
Dr. John Cush RheumNow ( View Tweet)
Paraoxonase-1: Possible Biomarker for Progression to RA
Dr. Jonathan Kay discusses abstract 0464, Increases in Paraoxonase-1 Activity over Time Associates with Reduced Risk of Incident Inflammatory Arthritis in an Anti-Citrullinated Protein Antibody-Positive Population,… https://t.co/yhcCrrvjxH https://t.co/caf5dUvrOQ
Dr. John Cush RheumNow ( View Tweet)
JAK-pot! How fast do DMARDs work?
Dr. Mike Putman interviews Dr. Kim Lauper about abstract 0501, How Fast Do JAK-inhibitors, TNF-inhibitors, Abatacept and IL-6 Inhibitors Act in Rheumatoid Arthritis? An International Collaboration of Registers of Rheumatoid Arthritis Patients… https://t.co/GO9EwyrVpV https://t.co/lELE5SJW5i
Dr. John Cush RheumNow ( View Tweet)
PREDICT-SpA: Evaluating the influence of gender on disease assessment tools
Dr. Sheila Reyes reports on abstract 0571, Gender-specific Performance of Disease Activity Assessment Tools in Axial Spondyloarthritis: Ancillary Analysis of the PREDICT-SpA Study, presented at #ACR24.… https://t.co/EGlCap6pEw
Dr. John Cush RheumNow ( View Tweet)
@DrLisaCS distills the challenges of MCTD 👇
🔵Clinical phenotyping key to improve patient outcomes
@jhrheumatology @RheumNow #acr24
https://t.co/APfXPwxvfE
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)