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Plotting Future ACR Convergence Meetings (11.24.2023)
In this week's podcast, Dr. Jack Cush reviews the ACR Convergence 2023 meeting and proposes how to best learn at your next large medical meeting.
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Reconsidering Steroids
There is not a single one of us in rheumatology who hasn’t prescribed steroids, but we really need to reconsider how much and how often we use them.
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TNFi and RA-ILD – The Pendulum Swings Again
TNF inhibitors revolutionised the treatment of rheumatoid arthritis. While highly effective for the joint manifestations of the disease, a note of caution was sounded regarding the potential for worsening of ILD with these agents. Within this framework, a study by England et al presented at ACR23 was highly relevant.
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IgG4 disease- the WInS withdrawal study results
IgG4-related disease describes a group of fibroinflammatory diseases whose features may include autoimmune pancreatitis, swelling of or within an organ system, salivary gland disease, swollen lymph nodes, skin manifestations, and symptoms consistent with allergies or asthma. While remission induction treatment with glucocorticoids has proven effective, the high relapse tendency is an ongoing challenge for clinicians.
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Long term F/U of early RA, T2T RCTs (n 1616) finds excess mortality > 10yrs for BeST (SMR 1.32) & IMPROVED (SMR 1.33) RCTs; highest in ACPA+ smokers (SMR 2.80 & 2.14); Cancer main cause. SMR incr 34% & 13% for ea 1 pt incr in DAS https://t.co/2DdHMGIlOk https://t.co/7bnCOzB8vd
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Infections During Treatment of GPA with Rituximab
Dr. Richard Conway (Dublin, Ireland) discusses abstract 1584 presented at the 2023 ACR Convergence meeting in San Diego, CA.
https://t.co/eKi3KExEnk https://t.co/b9G9w5e9tc
Dr. John Cush RheumNow ( View Tweet)
Watch and Weigh In: Upadacitinib for Pain: Is That Real?
Dr. David Liew reports on abstract 0429 at the 2023 ACR Convergence meeting in San Diego, CA.
https://t.co/AbD9UpXQfY https://t.co/iRgUnNInuD
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Computer Vision: Is It Ready for RA Assessment?
Dr. David Liew reports on abstract 0402 and 1293 at the 2023 ACR Convergence meeting in San Diego, CA.
https://t.co/4rQDjFXjH2 https://t.co/8FM40kh3bw
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Hemophagocytic Lymphohistiocytosis in Still's Disease
Dr. Bella Mehta discusses abstract 1143 presented at the 2023 ACR Convergence meeting in San Diego, CA.
https://t.co/bFeGK6MTcc https://t.co/cxJg6rQ7gm
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Watch: Deep Neural Networks and Radiographic Progression in AxSpA
Dr. Antoni Chan discusses abstracts 1389 and 1398 presented at the 2023 ACR Convergence in San Diego, CA.
https://t.co/F9hpNvmvVc https://t.co/xR0uW1CkUw
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The impact of SGLT2-inhibitor on SLE outcomes
SLE is associated with increased risk of cardiovascular events due to both traditional and disease-specific risk factors.
https://t.co/BjjerQhsrR https://t.co/vpzSaAIOjU
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Are Rheumatologists doing Enough for Cervical Cancer?
Should rheums be counseling patients on cervical cancer prevention and screening? The data from Abstract #1479 at #ACR23 suggests this should be an important conversation with our lupus patients.
https://t.co/FKaLSiBHV6 https://t.co/zR46JU5mlR
Dr. John Cush RheumNow ( View Tweet)
Combined 4 tofacitinib RCTs (4404 pts) found baseline probable major depression or anxiety disorder in 44.5%, 39.8%, 45.4%, 39.1% on TOFA 5 BID, TOFA 10 BID, adalimumab, & placebo. Effective RA Rx w/ Tofa or ADA lead to improved depression and anxiety https://t.co/y6UoFXANo7 https://t.co/aV5uV9qWbz
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#PsA Metanalysis of 54 RCTs (22621 pts; 49% male). Males had less severe Dz than females (TJC, HAQ, global, pain) but higher PASI & CRP. Males had higher ACR20 resp to inhib of IL-17 (OR 1.7), IL-23 (1·46), 12/23 (2·67), TNF (1·55) but no diff w/ JAK/Tyk2 https://t.co/fOl9zpCv1G https://t.co/JXAj5sG1bf
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Substudy of the ADVOCATE trial looked at 214 ANCA assoc vasculitis pts treated with #RTX; avacopan Rx showed improved recovery of renal function, faster reduction in albuminuria and lower glucocorticoid toxicity compared to a prednisone taper. https://t.co/ujynO9oAj0 https://t.co/JWBrKzGux1
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MSK disorders affects >1.63 billion worldwide. Global Burden of Diseases study estimates that by 2050, 1.06 billion will have "other" MSK Dz (excluding RA, OA, LBP, gout, neck pain) - up from 494 million in 2020. https://t.co/cCf8biqjx1 https://t.co/Xv9qlvQl90
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International study of 600 lupus pts - photosensitivity seen in 65% & was associated other lupus skin Dz (OR = 3.8). Fatigue was the most frequently reported systemic manifestation (82%). https://t.co/kjuvRZnB13 https://t.co/UTMNgiXbZZ
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Can We Prevent RA? Results from the APIPPRA Trial
Dr. Jonathan Kay talks with Dr. Andrew Cope about abstract 0835 at the 2023 ACR Convergence meeting in San Diego, CA
https://t.co/d4nXIQbvEC https://t.co/n9kvz8Z8tY
Dr. John Cush RheumNow ( View Tweet)
Long term F/U of early RA, T2T RCTs (n 1616) finds excess mortality > 10yrs for BeST (SMR 1.32) & IMPROVED (SMR 1.33) RCTs; highest in ACPA+ smokers (SMR 2.80 & 2.14); Cancer main cause. SMR incr 34% & 13% for ea 1 pt incr in DAS https://t.co/mXrCnzfe4W https://t.co/wWxfI1kMbm
Dr. John Cush RheumNow ( View Tweet)
Simulated Trials to Counter ORAL Survelliance
Dr. Jack Cush and Dr. Janet Pope at the 2023 ACR Convergence meeting in San Diego, CA.
https://t.co/XF8zlISqKC https://t.co/yXn7KADIdo
Dr. John Cush RheumNow ( View Tweet)