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Treating dactylitis and enthesitis: this is a sign of aggressive disease. Dr. @AlexisOgdie will treat with high dose NSAIDS and get patients on biologics quickly. #RNL2024 @rheumnow
TheDaoIndex KDAO2011 ( View Tweet)
Which IL17i to choose? Depends on the domain
Dr. Armstrong: For the skin, the studies show brodalumab, ixekizumab and bimekizumab are superior to secukimumab for #psoriasis
Dr. @AlexisOgdie noted we don't see much differences in these IL17i for the joints.
#RNL2024 @rheumnow
TheDaoIndex KDAO2011 ( View Tweet)
The differences do appear to relate to actual treatment specific differential response. As well as no difference with JAKi, there seems to be no difference in placebo response @lihi_eder @RheumNow #RNL2024 https://t.co/7H4KRvd6WG
Richard Conway RichardPAConway ( View Tweet)
Many advanced treatments appear to work less well in female patients with PsA, but JAKi seem to not demonstrate this phenomenon. Not sure what to do with this data in clinical practice but it is certainly intriguing @lihi_eder @RheumNow #RNL2024 https://t.co/GDrg715ctg
Richard Conway RichardPAConway ( View Tweet)
@AlexisOgdie @_AprilArmstrong @lihi_eder are the amazing “Hot topics in PsA” panelists. #RNL2024 @RheumNow #womenforthewin https://t.co/6V2QyGJM98
Dr. Rachel Tate uptoTate ( View Tweet)
Dr. Lihi Eder discusses the differences between sex and gender.
Sex is a biologically-based construct defining differences between male and female
Gender has socio-cultural aspects of being a man, woman, or other AND has effect on social norms/expectations
BOTH are important to… https://t.co/iceTS0w5LY https://t.co/slSQMwF91J
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Dr. Rachel Tate uptoTate ( View Tweet)
Differences in PsA:
Women tend to have higher pain scores with lower pain thresholds and are more likely to report "diffuse pain" compared to men. Keep this in mind with your assessments.
Remember mimics of sacroiliitis including osteitis condensas ilii. Look at the imaging below… https://t.co/AUjkQwfSuk https://t.co/5iXx5cxm4U
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Dr. Rachel Tate uptoTate ( View Tweet)
BASDAI tends to be higher in women while there is no appreciable difference in ASDAS scoring in men compared to women.
Dr. L. Eder believes this could be due to the pain scoring in both indices.
#RNL2024 @RheumNow @lihi_eder https://t.co/i7XPenrmGG
Dr. Rachel Tate uptoTate ( View Tweet)
Did you know the majority of lecturers at #RNL2024 are women? #StrongWomenLeaders @ACRheum #RNL2024 #WomenChangingLives @rheumnow https://t.co/0TO8XUhhg5
TheDaoIndex KDAO2011 ( View Tweet)
With regard to SpA patient journey:
On average, women are diagnosed 2.3 years later than men.
Additionally, women tend to have more visits to rheumatology to reach diagnosis of PsA, AS, and RA!
Remember your inherent bias along with sex/gender disparities.
Dr. L. Eder… https://t.co/o0Hv3NrXpB https://t.co/vsMN3HkSv6
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Dr. Rachel Tate uptoTate ( View Tweet)
Did you know?
There is very limited reporting of sex-disaggregated RCT results, data necessary from an FDA standpoint. Dr. L. Eder points out the importance of this data from a clinical standpoint.
Let's do better!
#RNL2024 @RheumNow @lihi_eder https://t.co/3FETZZWt0B
Dr. Rachel Tate uptoTate ( View Tweet)
This is the risk. We have to be aware and better at this in order to serve our female patients better @lihi_eder @RheumNow #RNL2024 https://t.co/7JIDtlSGXh
Richard Conway RichardPAConway ( View Tweet)
The panel addresses the question about using combination biologics and combo tsDMARDS + biologic. These combos are being studied. The panel noted combo apremilast +biologic is pretty commonly used appears to be effective and safe. #RNL2024 @rheumnow https://t.co/EeIlhJiDZU
TheDaoIndex KDAO2011 ( View Tweet)
Dr. Eder noted in her metanalysis of treatment efficacy in PsA based on gender – women had poorer response to treatments; the placebo effects are the same between men and women, suggesting a biologic mechanism and rather than a “psychosomatic” effect. #RNL2024 @rheumnow https://t.co/3H2Nfamg70
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TheDaoIndex KDAO2011 ( View Tweet)
My volume of referrals for OCI or degenerative disease (or sometimes completely normal SI joints) read as "sacroiliiitis" really does seem to have been increasing lately @lihi_eder @RheumNow #RNL2024 https://t.co/vksNCaADck
Richard Conway RichardPAConway ( View Tweet)
👉“Eighty percent of drugs withdrawn from the market pose greater risk for women.” – Dr. Eder #RNL2024 @rheumnow #genderDifferences https://t.co/RZrIdvecbY
TheDaoIndex KDAO2011 ( View Tweet)
Welcome to the "FDA-approved" team Bimekizumab. Dr. Armstrong shows MOA of IL17a and IL17f dual inhibition, and the important PASI scores showing 2/3 of pts clear by week 16. @RheumNow #RNL2024 @_AprilArmstrong https://t.co/KiTcVsGzpD
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Dr. Rachel Tate uptoTate ( View Tweet)
Dr. April Armstrong shares a beautiful picture around pathophysiology in PsO/PsA, as demonstrated in a non-joint graphic below. "Consider the domains when choosing biologics." #RNL2024 @RheumNow @_AprilArmstrong https://t.co/2nUAUYZLL3
Dr. Rachel Tate uptoTate ( View Tweet)
The different outcomes and response to treatment in males and females are related to sex differences in pain mechanisms and gender roles. Women report a higher BASDAI level, the ASDAS is equal in both sexes, Lihi Eder #RNL2024 @RheumNow https://t.co/7jjkgmmUg8
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Dr. Antoni Chan synovialjoints ( View Tweet)
Radiographic changes are more common and severe in males with PsA. Over-weighting radiographic changes in your clinical reasoning will lead to missed diagnoses in women @lihi_eder @RheumNow #RNL2024 https://t.co/3OpMt7QaU8
Richard Conway RichardPAConway ( View Tweet)