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ICYMI: Methotrexate: shall we split up?

d Aurelie Najm, MD, PhD

Methotrexate is widely used in rheumatic diseases yet poses common tolerance issues, especially for the oral form; and bioavailability is known to be limited for doses over 15mg. In the SMART study, Prasad et al. present the first RCT comparing either single dose (25 mg) or split-dose (10 mg morning, 15 mg evening, same day) once weekly MTX for 24 weeks.

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ICYMI: ACR Plenaries: Changing the Practice of Rheumatology

d Kathryn H. Dao, M.D.

Over the years of navigating the annual meeting, I found the sessions with the most impact to my practice were the Plenary Sessions. During these sessions, the latest research is presented, new ideas are floated, and old myths debunked. Here are the top ACR2023 Plenary abstracts I found impactful for my practice.

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ICYMI: Maintain Vigilance for CV Risk Postpartum in Autoimmune Diseases

d Bella Mehta, MBBS, MS

Pregnant women with autoimmune rheumatic diseases (ARDs) and antiphospholipid syndrome (APS) face significantly increased risks of cardiovascular events (CVEs). This increased risk is often attributed to ARDs, its medications or comorbidities associated with it.

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EULAR 2023 Recommendations on Fatigue

d Jack Cush, MD

Fatigue is highly prevalent in inflammatory rheumatic and musculoskeletal diseases (I-RMDs) patients, is often unaddressed and yet it has significant effects on patient quality of life. A EULAR task force set out to develop recommendations for the management of fatigue in people with I-RMDs.

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ICYMI: Here at Last: Treatment Options for VEXAS

d Michael Putman, MD, MSCI

We have known about the VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome for nearly 3 years, but there has been relatively little to say about how to treat it. To date there have been over twice as many publications about VEXAS (263 publications) as there have been patients described with respect to treatment strategies (116 patients). One of the late breaking abstracts may finally have rectified this imbalance.

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PsA undergoing lumbar degenerative disease (LDD) surgery have 2 fold higher risk of VTE. National Inpatient study 471,283 LDD surgeries showed PsA had higher overall morbidity (9 % v 7 %), VTE (1.4 % v 0.7 %), unfavorable D/C(21% v. 17 %). https://t.co/C0eimmwEmm https://t.co/58PoJOJEeY

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RA pts more likely to get autoimmune thyroid Dz (AITD), but after dx, AITD risk signif. drops (HR 0.81), suggesting RA Rx lowers AITD risk; greater drop in biologic Rx RA (HR 0.54).Swiss registry compared 13,731 new-onset RA pts to 63,201 matched controls https://t.co/n0n2EfUyqR https://t.co/yMMHvYRsyY

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Cannabis Use in Rheumatic Diseases Dr. Janet Pope discusses several abstracts presented at the 2023 ACR Convergence meeting in San Diego, CA. https://t.co/C2vbbERoHZ https://t.co/XeiS0cJjuy

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INVIGORATE-1 Study: IV Secukinumab for Treatment of Active axSpA Dr. Atul Deodhar reports on abstract 2545 at the 2023 ACR Convergence meeting in San Diego, CA. https://t.co/Fhv7dhDTJA https://t.co/Zz0PwFjOD4

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CDC: Chronic Fatigue Syndrome 2021-2022 The current CDC report estimates that 1.3% of adults had myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), based on the most recent population based National Health Interview Survey (NHIS 2021–2022). https://t.co/4LeQ7DJPyI https://t.co/5ITG46d25M

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ICYMI: Cancer and TNF inhibitors Cancer risk minimisation is a high priority for people with rheumatic diseases, as it is for the general population. Tumor necrosis factor inhibitors (TNFi) have a long history of association with cancer risk discussions. https://t.co/rNSTcT5O6L https://t.co/f5lvMTH7ik

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The ARGO Project for Rheumatology Fellows Dr. Sheila Reyes (Philippines) talks with Dr. Lisa Traboco about abstract 2078, presented at the 2023 ACR Convergence meeting in San Diego, CA. https://t.co/RRjc38JpEQ https://t.co/q9rCxbWzNh

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When should we be starting therapy in GCA and PMR? The problem with having therapies that work is that you then have to figure out what to do with them. You cannot hide behind the ambiguity of therapeutic inadequacy. https://t.co/oRWTeH5Q9h https://t.co/BbswdffoKM

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Save the date for RheumNow Live 2024, on January 27-28, in Dallas, TX, or from the comfort of your own space through our virtual platform! Why choose RheumNow Live? Because this isn't just another conference – it's a revolution in medical education! https://t.co/K2YYqjjs8F https://t.co/MinRm9N9rz

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Health disparities in SLE reviewed disparities by Parodis et al. Racial and ethnic influences on manifestations and outcomes reviewed, along with common pitfalls in studies, along w/ proposed framework for research on health disparities in SLE (full read) https://t.co/7GvzttR9HZ https://t.co/wYGiMg4zqK

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Promising Therapies for Sjogren's Dr. Yuz Yusof discusses abstracts 1634 at the 2023 ACR Convergence meeting in San Diego, CA. https://t.co/8iSDMKtKwa https://t.co/QCYTnpYKFN

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ICYMI: SpA Sleuths: The Case of Undiagnosed IBD As rheumatologists, we are medical detectives investigating complex and often elusive autoimmune and inflammatory conditions https://t.co/dE0NLXKDvT https://t.co/DalUXRf3MB

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CBT or Naltrexone in Fibromyalgia https://t.co/9SGRbY97oD https://t.co/wN2cMuqgHa

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Expert consensus(ASAS) prefers SpondyloArthritis(axSpA) as preferred over "ankylosing spondylitis" (historic but no longer appropriate based on MRI research showing this is more than SI disease). AS radiographic axSpA(r-axSpA) can be used interchangeably https://t.co/jvT3lQFaPq https://t.co/WRNrbfjK1S

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Danish study compared 106K adults w/ major osteoporotic fracture (hip, vertebrae, wrist, humerus) vs 1+ mill controls & found Mortality highest 30d following 1st index hip Fx (HR 10.98 women; & HR 16.40 men). Pneumonia most common cause of mortality https://t.co/0D7ynN4f5L https://t.co/qX61cgq1SL

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