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ACR20 - Day 2 Report
Saturday was the day 2 with many posters and live sessions at the 2020 Virtual ACR/ARP meeting. Here are a few of my highlights from day two:
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Dr England presents on multimorbidity in RA, PsA, gout, and OA within RISE registry. Highly prevalent in all 4 but most pronounced in gout and RA. Critical to recognise and manage. @rheumnow #ACR20 Abstr#1466 https://t.co/XtwIfJnVXV
Richard Conway RichardPAConway ( View Tweet)
Data from BIOBADASER 3 showed that there was a ⬇ in the incidence of S. pneumonia-related infxns in RA pts on b/tsDMARD after receiving the stepwise combined vax scheme (conj+PS) @RheumNow #ACR20 abs1465 #VaccinesWork https://t.co/KlestmKfaO
sheila RHEUMarampa ( View Tweet)
Are you talking RA patients about vaccination? Abst#1465 shows S pneumonia vaccinations decreases pna by nearly half in <65 yo, as well as effectiveness in elderly. Theme of day: approach ifn and CV risk are best rheum interventions! @Rheumnow #ACR20 https://t.co/ZilXfFWTUM
Eric Dein ejdein1 ( View Tweet)
Coal mining is associated with developing RA, but what is it about it?
It's the silica. The more silica and the longer exposed, the more likely. Hopefully, one day, we'll get be able to prevent this...
@UCSFMedicine @UCSFRheum #ACR20 ABST1462 @RheumNow https://t.co/mlZNpJD9iv
David Liew drdavidliew ( View Tweet)
Diet and risk of RA: there's a link, but how healthily do you need to eat?
Benefit keeps on going up to... let's say healthier than your correspondent. No conference burger tonight😐
(benefit goes up to top 11% in study)
Nurses Health Study @jeffsparks #ACR20 ABST1463 @RheumNow https://t.co/4kEOixMQ8e
David Liew drdavidliew ( View Tweet)
Abst#1462 shows coal mining and non-coal silica exposure with increased risk of RA with OR ~4. Great study, not a surprise that toxin exposures linked to autoimmunity. #ACR20 @RheumNow. https://t.co/OnwVUfoRCU
Eric Dein ejdein1 ( View Tweet)
Dr Trupin presents further data on link between silica exposure and coal mining in particular with development of incident RA. Duration and intensity of exposure both associated with increased risk. @rheumnow #ACR20 Abstr#1462 https://t.co/5SpqElhlZN
Richard Conway RichardPAConway ( View Tweet)
Can hs-troponin and hsCRP predict future major cardiovascular events? Certainly appears so in RA pts (n=636).
To what extent do subclinical dx and inflammation combine to cause future RA CV pain?
PRECISION trial subgroup @ElaineHusniMD @DanielHSolomon #ACR20 ABST1189 @RheumNow https://t.co/ZYTpodatVI
David Liew drdavidliew ( View Tweet)
The lung-joint axis in RA just keeps on getting stronger
Lung ACPA present in early untreated RA/CSA:
crossreact acetylated/carbamylated antigens
differ in effects on cell types (neut activation, fibroblasts, osteoclasts)
Isn't lung ACPA fascinating?
#ACR20 ABST1445 @RheumNow https://t.co/9VKSRYlndT
David Liew drdavidliew ( View Tweet)
Study of 351 SLE patients from Leiden shows that SLE with Neuropsychatric disease do not have a higher mortality than lupus without CNS disease; but do have higher mortality than gen. population #ACR20 Abstr#1264 https://t.co/CmBjfUj1Ur https://t.co/WYZQDaI4yt
Dr. John Cush RheumNow ( View Tweet)
Who will clot in #Lupus? 150 with SLE, clots ^ if PC4d + = market of plt Activation & arterial thrombosis abstr#1510 needs validation in another SLE group. V interesting @RheumNow @CRASCRRheum #ACR20 https://t.co/UBGxaFwhwZ
Janet Pope Janetbirdope ( View Tweet)
ACR/AF JIA guidelines presented @ACR20:
👉Initiate DMARD early over NSAID monotherapy
👉Use SQ MTX> oral MTX > SSZ/LEF
👉add biologic preferred over triple DMARD
👉DON'T use chronic low dose steroids
👉combo biologic+DMARD > biologic monoRx
https://t.co/lwoFSTuV91
@rheumnow https://t.co/wzh2LCS0dN
k dao KDAO2011 ( View Tweet)
History of IBS, more aggressive disease phenotype & active SpA before conception or during pregnancy increased the risk for adverse pregnancy outcome. #ABS1324 #ACR20 @RheumNow https://t.co/NQ6kDMSaJ3 https://t.co/I3sxRmPL6j
Dr. Rachel Tate uptoTate ( View Tweet)
821 SLE pts from Hopkins lupus clinic showed that LAC was best predictor of venous + arterial thromboses. β2glycoproteinI IgA (+) also important! #ACR20 #Abstr#1261 https://t.co/H0hz9Gp5Hy https://t.co/Vpiih4LyuZ
Dr. John Cush RheumNow ( View Tweet)
In our quest to reduce delays to diagnosis in axSpA, this paper in patients with psoriasis, AAU and IBD, the ASAS-modification of the Berlin algorithm was superior to the original algorithm, with enhanced sensitivity @RheumNow #ACR20 Abstr#1303
Dr. Antoni Chan synovialjoints ( View Tweet)
Do you recommend Omega-3 fish oil (2-9 grams per day) to your patients with RA (doubled blinded RCT in 140 pts w/ recent onset of RA showed increased likelihood of achieving remission & less failure of triple therapy in high-dose fish oil group). #ACR20 @RheumNow @LCalabreseDO
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
This study shows that serum anti-PAD4, anti-PAD3/4XR abs are highly specific for RA-ILD and assoc'd w/ better lung function in RA-UIP.
Small patient sample. Potential prognostic biomarker? @RheumNow #ACR20 abs1200 https://t.co/f5VFjJhVXF
sheila RHEUMarampa ( View Tweet)
Dr Lee reports on risk of melanoma and NMSC risk in RA in cohort study using propensity score matching. No difference in risk between MTX and HCQ overall. Increase BCC in MTX (HR 1.32) but less SCC (HR 0.77) @rheumnow #ACR20 Abstr#1001 https://t.co/LDWgfGK9LS
Richard Conway RichardPAConway ( View Tweet)
Nintedanib in rheum ILD (RA/SSc/CTD)
I appreciate the volumes might not seem like much, but:
- in first 1y Rx 20% more are spared a FVC decline>10%
- biggest diff in UIP-like pattern
With the right patient selection, nintedanib does have its place!
#ACR20 ABST1048/1049 @RheumNow https://t.co/jGZdR84bBU
David Liew drdavidliew ( View Tweet)
