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Here at Last: Treatment Options for VEXAS
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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Are Rheumatologists doing Enough for Cervical Cancer?
Should rheumatologists be counseling patients on cervical cancer prevention and screening?
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#ACR23 – Day 1 Report
The day began with a bang with the Year in Review that featured the sage insights of Drs. Philip Seo and Tomas Mustelin about the scientific and clinical rheumatology highlights from the past year.
https://t.co/a79M2boHRH https://t.co/5P18ybazGK
Dr. John Cush RheumNow ( View Tweet)
Taylor et al. Novel blood assay for sero+ and sero- RA. Differentiates well from other diseases. May be very valuable for sero- RA diagnosis = sensitivity 83.7%, +LR 21.46, and -LR 0.17. Needs validation. Abstr#2586 #ACR23 @RheumNow https://t.co/jw41F8YohE https://t.co/kXi3km0b07
Richard Conway ( View Tweet)
Last abstract of #ACR23 was #ACRBest
Plasma cfDNA signatures (synovial mapped) to identify RA vs OA, other inflamm arthritis
Great performance, even with seroneg RA
A blood test to:
diagnose
?phenotype
?identify best b/tsDMARD
Could be massive
Peter Taylor ABST2586 @RheumNow https://t.co/tJX2jXV0Oe
David Liew drdavidliew ( View Tweet)
#ACRbest Yrin Preview @ACRheum
J Bathon
Take home
Symptomatic #Rx of ACPA+ people WITH #DMARD is too late to alter risk of #RA when drug is d/c
AI to read joint erosions on X-ray May be ‘too little too late’
#Steroids in #RA increase #MACE even after d/c
#ACR23 @RheumNow
Janet Pope ( View Tweet)
Identifying GCA diagnosis and disease activity through proteomics from plasma:
diagnosis looks good
disease activity looks harder
(Much like a lot of things in GCA, really)
Exciting work @MayoClinic @MdWarrington @jsung0906 #ACR23 ABST2601 @RheumNow https://t.co/SwxN58LieB
David Liew drdavidliew ( View Tweet)
#ACR23 Yr in Preview
J Bathon
Shared decision making w tradeoffs showed sex differences for concerns & preferences in #RA present
dependent on how you ask the questions
Unmet needs (I think 🤔)
biomarkers of flare for #inflammatory #arthritis
Rx select’n/retention
@RheumNow
Janet Pope ( View Tweet)
Is MSOT the New Ultrasound?
Dr. Aurelie Najm reports on oral abstract 0750 presented at #ACR23
https://t.co/okbGHTR0i3 https://t.co/9zkHPiFl74
Dr. John Cush RheumNow ( View Tweet)
Watch: Assessment and Treatment of Cardiovascular Risks in Rheumatoid Arthritis
Dr. Antoni Chan discusses abstract 0387 and abstract 0391 presented at #ACR23
https://t.co/avnarOGZui https://t.co/4CeAumv31b
Dr. John Cush RheumNow ( View Tweet)
Greigert et al. IL17 in GCA. Increases vascular inflammation. Synergistic effect on myofibroblasts with IFN-γ - increases IL-1B, IL-6, GM-CSF, CCL20 (recruits T cells), CCL2 (recruits monocytes), VEGF (neoangiogenic). Abstr#2599 #ACR23 @RheumNow https://t.co/p4GumZStAZ https://t.co/zZv0TF4fmn
Richard Conway ( View Tweet)
Telitacicept a recombinant fusion protein targeting, neutralizing BLyS and APRIL, phase 3 study in RA MTX-IR at 24 wk, ACR20 (60% vs 27% PBO), ACR50 (21% vs 6% PBO), reduced DAS28-ESR, no radiographic progression, Wang L Abst#L20 #ACR23 #ACRBest @RheumNow https://t.co/nuvizqQZsR https://t.co/PRtlea3AqU
Dr. Antoni Chan ( View Tweet)
#ACR23 Abstr#2587 Can we agree on how to measure frailty in #SLE? A cohort study: moderate agreement at best among SLICC-FI, SPPB, FRAIL=>2 & PROMIS PF=<40. SLICC-FI was robust predictor of all outcomes except for cognitive impairment. FRAIL & PROMIS not far behind @RheumNow https://t.co/qWjM4crPvg
Md Yuzaiful Md Yusof ( View Tweet)
A randomised clinical trial show improvements in clinical outcomes CDAI, VAS for both the ITIS diet and the Med diet. Baseline differences in the microbiome between responders and non-responders were seen. Sala Climent M, Abst#2124 #ACR23 @RheumNow https://t.co/tiyNcV7cmD https://t.co/EEP4zrwjXs
Dr. Antoni Chan ( View Tweet)
Abstract 2583 at #ACR23
👉Possible predictive model of at risk of RA patients with ACPA positivity based on baseline levels of peripheral blood lymphocyte sub-populations:
⭐️High % of B cell and low % of NK cells increase the probability of developing arthritis in ACPA + pts… https://t.co/3KEOI4eul0 https://t.co/irX6InWMbl
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Large French study on infection risk of PsA biologics
12k pts over 6 years
When compared to Humira, only Enbrel and Stelara had lower infection risk
Concurrent steroid use associated with increased infection 1.85HR
@RheumNow #ACR23 Abs#2566 https://t.co/Os1esuodfl
Robert B Chao, MD ( View Tweet)
Saliclick: minor salivary gland biopsy was a safe and rapid procedure for the diagnosis in Sjögren’s Syndrome without observed numbness occurring, focal lymphocytic sialadenitis in 20%, with a focus score >1 for 62%. Hugle T, Abst#2190 #ACR23 @RheumNow https://t.co/VYKdQw2YlC https://t.co/dWLWj2AdkI
Dr. Antoni Chan ( View Tweet)
Trajectory of FVC in Systemic sclerosis associated ILD in open label SENSCIS study
Decline in FVC over 52 weeks decreased by 57% on nintedanib
But am I also just seeing a study FVC decline even with nintedanib?
@RheumNow #ACR23 Abs#2594 https://t.co/3h4mhm0ceU
Robert B Chao, MD ( View Tweet)
A model for prediction of progression to RA
Factors asso w/ progression
-ACPAs
-High % B cells
-Low % NK cells
Only in ACPA+ individuals
Low ACPA titers, High % NK cells and Low B cells = 76% non progressors
@RheumNow #ACR23 ABST2583 https://t.co/vNIwyrOJtJ
Aurelie Najm ( View Tweet)