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Ten-Year Analysis of Low-Dose Glucocorticoids in early RA
Abstract #1998 by C. Roubille et al from Montpellier, France is a 10-year prospective analysis that looked at the risk of severe outcomes related to very low-dose glucocorticoid in early rheumatoid arthritis from the ESPOIR cohort.
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Rheumatology Round-Up with Drs. Kavanaugh & Cush
The Annual Review of Best ACR 2020 abstracts featuring Drs. Cush and Kavanaugh filmed on the last day of Virtual ACR 2020 Nov. 9, 2020. Watch now!
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Watch Dr. Janet Pope review abstracts #1198 and #1473 on lifestyle and risk of RA, lupus presented at the #ACR20 annual meeting.
https://t.co/SAffgj4i5l https://t.co/VCpMbN3zmg
Links:
Dr. John Cush RheumNow ( View Tweet)
Tofa for RA by the grp of Dr. Atul Deodhar:
>Tofa(56%) vs. pbo(29.4%)-significant improvement in ASAS20 at wk 16
>Primary & secondary endpts met
>No new safety signals reported
@Rheumnow #ACR20 https://t.co/G9U5cCQU7K
sheila RHEUMarampa ( View Tweet)
Dr. Jonathan Kay leads an international panel of rheumatologists to elicit their opinions on key abstracts at #ACR20. Panelists: @drdavidliew, @ejdein1, @MeralElRamahiMD, @RichardPAConway, @RHEUMarampa, and @jeffsparks
https://t.co/btZKgwvoSn https://t.co/Okdvx9HuNc
Links:
Dr. John Cush RheumNow ( View Tweet)
What would you use in multidrug failure RA pt from last tweet +RF nodules & keratitis failed 2 TNFi & 2 JAKi @RheumNow #ACR20 @CRASCRRheum
Janet Pope Janetbirdope ( View Tweet)
Low-dose steroids in RA: what's the harm, right?
(You probably know where I'm going with this)
ESPOIR 10y data: total events, and severe infections worse with dose and time
(cumulative 8.4g ≡ 5mg/d)
No doubt some residual confounding, but real risk!
#ACR20 ABST1998 @RheumNow https://t.co/BAQmOR1ped
David Liew drdavidliew ( View Tweet)
What would you use next? sero+ RA new keratitis requiring prednisone and now also 20 SJC. New rheumatoid nodules. Pt has been on triple csDMARDs + Leflunomide, then 2 JAKi and 2 TNFi also with MTX each time. All Rx works for 6 months then relapse. @RheumNow @CRASCRRheum https://t.co/9cTS1tNE42
Janet Pope Janetbirdope ( View Tweet)
Dr Lillegraven presents a randomized open-label phase 4, non-Inferiority trial of TNFi tapering in RA patients in sustained remission. 63% of tapered patients flared over 12 months vs 5% of maintained. Good response to reintroduction of TNFi @rheumnow #ACR20 Abstr#2010 https://t.co/Ki7PTsetbH
Richard Conway RichardPAConway ( View Tweet)
Abst#2000. PRIME team Medicare database study pts with new RA started on MTX higher VTE risk than HCQ (HR 2.3). Unable to assess disease activity because claims database, but would imagine MTX grp more severe, driving increased VTE risk @RheumNow #ACR20 https://t.co/Z14xFTVXTp
Eric Dein ejdein1 ( View Tweet)
2020 #ACR20 RA guidelines were against steroid usage in RA. ESPOIR French cohort: 10 years of very low dose GC show increase events (death/CVD/fracture/severe ifn) even on low doses. HR increases every year. Cum GC dose-effect esp ifn, CVD. @RheumNow #ACRBest https://t.co/7b7chCPRxm
Eric Dein ejdein1 ( View Tweet)
Another great late-breaking asbtract: #HerpesZoster in patients w/ #rheumatoidarthritis taking #upadacitinib #JAKinhibitor
-HZ events more common in patients taking 30mg vs 15mg
-HZ more common in UPA vs those taking ADA+MTX & MTX
Abs#2002 #ACR20 @RheumNow
https://t.co/tQ03wBueW5
Mrinalini Dey DrMiniDey ( View Tweet)
Late breaking: in older #rheumatoidarthritis patients, those taking MTX have 2x risk of #VTE compared to those on HCQ. Important to consider #thromboembolic risk factors when starting new RA treatment.
Abs#2000 #ACR20 @RheumNow
https://t.co/lt8xDT4Ne8
Mrinalini Dey DrMiniDey ( View Tweet)
Which DMARD would you use in an RA pt Rx naive pt with mod dz activity and who has RA lung dz?
#acr20 @RheumNow
k dao KDAO2011 ( View Tweet)
Which JAKi will you use after MTX failure? #acr20 @rheumnow
k dao KDAO2011 ( View Tweet)
Which biologic will you use after MTX and TNF failure for RA pts? #acr20 @rheumnow
k dao KDAO2011 ( View Tweet)
Large cohort of older RA pts newly rx w/HCQ or MTX:
👉~2-fold ⬆ risk of VTE – both PE and DVT- among patients newly treated with MTX vs. HCQ.
@RheumNow #ACR20 abs#2000 @DanielHSolomon https://t.co/ZnDuMhTMYF
sheila RHEUMarampa ( View Tweet)
HCQ not associated with ⬆ incidence of cardiac dse in this cohort of RA pts.
We should continue using it. Benefits >>>risks.
@RheumNow #ACR20 abs1999 https://t.co/zYpbX0CsR1
sheila RHEUMarampa ( View Tweet)
NEW ACR2020 Draft Guidelines for the Pharmacologic Treatment of RA
All the guidelines in 2 tables!
1. MTX 1st, oral > SC
2. Minimize GC!
3. TTT TTT TTT
4. Biologic/tsDMARD > Triple Tx
5. Taper MTX 1st
Close to my practice; suspect will be controversial!
#ACR20 #ACRambassador https://t.co/iFSlq1H65V
Mike Putman EBRheum ( View Tweet)
Rheum Now shares Day 3 highlights from #ACR20.
https://t.co/xNv1fG97ib https://t.co/Psa8bRqlVh
Links:
Dr. John Cush RheumNow ( View Tweet)
