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Rituximab Efficacy in MAINRITSAN Long-Term Studies
The original randomized controlled, prospective MAINRITSAN study of 115 patients (87 with granulomatosis with polyangiitis, 23 with microscopic polyangiitis, and 5 with renal-limited ANCA-associated vasculitis [AAV]) demonstrated superiority of rituximab (RTX) over azathioprine (AZA) for maintenance of remission at 22 months in ANCA-associated vasculitis patients after CYC remission induction.
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Maintenance issues in GPA. Clear messages. 1. RTX is best 2. Fixed 6-monthly RTX best for 1st 2 years. 3. Don't stop RTX at 2 years! @anisha_dua @RheumNow #RNL2024 https://t.co/jS3jWm0CcS
Richard Conway RichardPAConway ( View Tweet)
The answer to "always" is "always" no, correct? PEXIVAS low dose is a great baseline plan, but always adjust in light of the individual patient both upfront and especially if things aren't working out @anisha_dua @RheumNow #RNL2024 https://t.co/RPnpAdB1eG
Richard Conway RichardPAConway ( View Tweet)
Rapid GC taper in ANCA vasculitis
#RNL2024 @RheumNow
@anisha_dua
PEXIVAS - reduced GC is safe, decreased ifns
Retrospective real world - 234 pts. Reduced dose GC+RTX increased death/ESKD HR 2.42. No difference in infections https://t.co/SWIUSyVbWb
Eric Dein ericdeinmd ( View Tweet)
Great talk @anisha_dua re:AAV, solid updates on mgmt decisions
Looking forward to debating this study with @lastwalsh w/@MatsJunek moderating... @TerrierBen any updates on when your RWD study will be published?
@RheumNow https://t.co/ywVaOIp2WJ
Mike Putman EBRheum ( View Tweet)
Contrasing ACR/VF and EULAR GPA guidelines from @anisha_dua @RheumNow #RNL2024 https://t.co/RLJx9fJHGk
Richard Conway RichardPAConway ( View Tweet)
"Real world studies: When people stop being polite and start getting real." Dr @anisha_dua #RNL2024
Comparing Walsh to Nagle in terms of primary outcomes, regimens, pt populations, and plasma exchange.
@RheumNow https://t.co/io8OGnWxdS
Dr. Rachel Tate uptoTate ( View Tweet)
Is there data for PLEX in GPA?
@anisha_dua #RNL2024 @RheumNow
PEXIVAS negative study
But subgroups show decreased dialysis...
But, no improvement in mortality and increased infection risk https://t.co/K9VbcNNsge
Eric Dein ericdeinmd ( View Tweet)
#RNL2024 @RheumNow
@anisha_dua
Throwing the kitchen sink in severe GPA
CYC + RTX combo - sick population (median GFR 9, 47% on HD, 52% DAH, all received PLEX too)
- 85% survival, 69% not ESKD, low rates of relapse (13% at 36 mos)
But, prolonged B cell depletion, aggressive Rx https://t.co/9AZFMQ3o9P
Eric Dein ericdeinmd ( View Tweet)
@anisha_dua reviews differences between EULAR vs ACR Vasculitis guidelines #RNL2024 @RheumNow https://t.co/1aIbnX5KBI
TheDaoIndex KDAO2011 ( View Tweet)
@anisha_dua reviews GPA management in 2024. Here are your ACR/VF 2021 and EULAR 2022 guideline updates. Review these regimen options for your patients. #RNL2024 @RheumNow https://t.co/SvQoe0YKKV
Dr. Rachel Tate uptoTate ( View Tweet)
Clinical Pearl!
@DrCassySims currently treats with ASA 81mg po daily during vasculitis pregnancies at 12 weeks for preeclampsia ppx.
She notes there is some data/use of 162mg po daily in Europe which may change the way we practice in the future.
#RNL2024 @RheumNow
Dr. Rachel Tate uptoTate ( View Tweet)
Pregnancy in vasculitis checklist:
- goals and timeline
- disease activity in 12 mos
- is there end organ damage?
- Review Rx
- h/o clots/miscarriages, APLS?
- Check Ro/La
- Role for ASA?
- Refer to MFM
Catherine Sims #RNL2024 @RheumNow
Eric Dein ericdeinmd ( View Tweet)
How do vasculitis pts do during pregnancy?
Variable due to different diagnoses of flares
Gatto 2012: TA 3% flare, GPA 45% flare
Fredi 2015: 35% flare
Nguyen 2021: LVV 25% flare, 36% SVV
-Catherine Sims
#RNL2024 @RheumNow
Eric Dein ericdeinmd ( View Tweet)
You can still attend RheumNow Live!
Below is a preview of one of our "STEP" talks - by Mike Putman, MD, who brings his vast knowledge to the forefront, shedding light on Myths & Mistakes on ANCA-Associated Vasculitis.
https://t.co/LzcVytLDij
Register: https://t.co/NWXKNhQzc5 https://t.co/ogAfTtH5Nk
Dr. John Cush RheumNow ( View Tweet)
IL-17 pathway as a target in giant cell arteritis - full read review of pathogenic role of IL-17 and Th17 cells, in #GCA; backed up by the phase II proof-of-principle TiTAIN study showing potential efficacy of secukinumab in GCA pts https://t.co/MThzw2joGO https://t.co/PmrJjf9C3a
Dr. John Cush RheumNow ( View Tweet)
QD Clinic - GCA & Steroid Weaning
Weaning steroids in chronic GCA patient
https://t.co/HtrzP43Ivr https://t.co/xZZlNmeqP1
Dr. John Cush RheumNow ( View Tweet)
Excited to be talking at https://t.co/hposbnLVdD!!
As usual, @RheumNow screen-grabbed me at an opportune moment 🤣😆
Highly recommend the conference; register live/online at the link above! https://t.co/XewJXRASi8
Mike Putman EBRheum ( View Tweet)
Experience the Future of Rheumatology at RheumNow Live 2024, just two weeks away!
Don't miss out – secure your spot today for an unforgettable journey into the latest advancements and insights.
https://t.co/ny6R6QBq0j https://t.co/slHPPOQIDi
Links:
Dr. John Cush RheumNow ( View Tweet)
Experience the Future of Rheumatology at RheumNow Live 2024, just two weeks away!
Don't miss out – secure your spot today for an unforgettable journey into the latest advancements and insights.
https://t.co/bbnb97MOHO https://t.co/QXO34ZmP2i
Links:
Dr. John Cush RheumNow ( View Tweet)
