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How often do you ask about #fatigue, #depression & #anxiety in pts with RMDs?
Study of >1000 pts found anxiety symptoms in 1/3 pts and significant association between fatigue & anxiety and depression
Highlights importance of regular review of MH symptoms
Ab2657 #ACR24 @RheumNow https://t.co/0zMOMybrCI
Mrinalini Dey DrMiniDey ( View Tweet)
A#2652
NEWTON study 🇫🇷 Retrosp cohort
51% relapse. Median @8.7 mos, dose 9mg pred
Rf: limb art involv- HR 1.9
Pred taper speed not risk for relapse
Most relapse -> incr GCs
Toci 1/3 at dx, 50% stopped
-61% d/c due to remission, 39% SEs
-1/3 relapse after d/c
@RheumNow #ACR24 https://t.co/NP0wieDmvo
Eric Dein ericdeinmd ( View Tweet)
Peyrac et al. 211 GCA. Relapse in 52% at median 261 days (so 1st year). 83% on GCs at relapse, median dose 6.5mg pred. 36% relapse post-toc discontinuation, at median 133 days. 64% no relapse when toc stopped, at median 511 days @RheumNow #ACR24 Abstr#2652 https://t.co/NqtdDNGGoc https://t.co/mXD8x7O6Ww
Links:
Richard Conway RichardPAConway ( View Tweet)
What is the effect of cs/bDMARDs on weight in #PsA?
⬇️Weight loss seen with:
IL17i
IL23i
csDMARDs
⬆️Weight gain seen with:
TNFi
IL12/23i
Important to consider #comorbidity & #BMI in management decisions in PsA
Ab2639 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
A New ACR
Dr. Jack Cush highlights a few notable changes to the ACR meeting format this year, and offers pointers on the best way to stay informed and abreast of reporting from the #ACR24 Convergence meeting in Washington, DC.
https://t.co/YmI6s1TanV https://t.co/hsByGEBtnz
Links:
Dr. John Cush RheumNow ( View Tweet)
A#2648
PET for GCA
Delayed imaging at 180 min improve dx performance for pts on GCs
Optimal PET w/in 3 days of GC, most patients unable to do w/in that window
Delay has sensitivity 92% even on prednisone - may be good tool for pts unable to get early PET/CT
#ACR24 @RheumNow https://t.co/kxpNfRqkGN
Links:
Eric Dein ericdeinmd ( View Tweet)
Study by Maria Dall'Era et al. compared voclosporin-based triple immunosuppressive therapy with high-dose GC in active lupus nephritis.
- Fewer adverse events in the voclosporin group, despite a higher incidence of specific issues like decreased GFR and hypertension.
- 25%… https://t.co/ToRu2rdErC https://t.co/uUXzNNuLDb
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
@YooJinKimYJK @andreafava et al: 20% of pts in their #lupus cohort had recurrent pericarditis.
Majority had 1 recurrence (51%)
Independent predictors of recurrence:
Younger age
Prednisone tx
Active dse
Time from initial episode
🔅regular ffup is 🔑
@RheumNow #ACR24 abs2372 https://t.co/UELwE31X0u
sheila RHEUMarampa ( View Tweet)
➡️More DMARD-exposed pts w late-onset RA reduce long-term GC use than DMARD-unexposed
➡️Persistent GC use is common
➡️In DMARD-exposed, GC use may be related to limited access to high-cost drugs
➡️In DMARD-unexposed, comorbidity burden may limit DMARD use
Ab2606 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
How do you manage DMARDs when giving the recombinant #zoster #vaccine (#RZV)?
➡️75 pts with ARDs
💉2-week #MTX discontinuation after each dose of RZV
⏩Significant boost in immune response without difference in flare rates
Ab2612 #ACR24 @RheumNow https://t.co/o4iqj3e1Be
Mrinalini Dey DrMiniDey ( View Tweet)
A#2649
Relapsing Polychondritis
Latent Class Analysis to define clinical phenotypes of heterogeneous dx
Type 1- ear, nose, subglottic stenosis
2- tracheo/bronchomalacia
3- absence tracheomalacia
Decision tree to classify pts in subgroups
#ACR24 @RheumNow https://t.co/xpZedPVl7f
Links:
Eric Dein ericdeinmd ( View Tweet)
Loiseau et al. 4700 pSS, 47000 comparators. pSS associated with increased risk of every CV/VTE outcome. Did not have that in my priors! @RheumNow #ACR24 Abstr#2631 https://t.co/QKemUhbcG8 https://t.co/twpjdS2L63
Links:
Richard Conway RichardPAConway ( View Tweet)
A#2650
MRI can show extent of vessel wall inflamm to guide severity of GCA
Brain & orbital MRI performed
Assessed 7 arteries bilaterally -> CAMRIS-GCA MRI score (0-10)
33 GCA (17 ocular), 41 not GCA
CAMRIS-GCA ass w/ ocular GCA, higher severity. Improved w Rx
@RheumNow #ACR24 https://t.co/19XCuZJXqF
Links:
Eric Dein ericdeinmd ( View Tweet)
Among axSpA patients enrolled in the BE MOBILE 1&2, those who received Bimekizumab achieved ASAS40 response earlier vs PBO
Improvements in spinal pain and physical function were significantly reported as early as wk 1 in those who received BKZ vs PBO
@RheumNow #ACR24 abs2363 https://t.co/JmcQdURTY4
Links:
sheila RHEUMarampa ( View Tweet)
A re-evaluation of lupus arthritis. Old dogma is RA is erosive and SLE non-erosive. With better imaging, lupus arthritis can be erosive. Vivianne Malstrom. @RheumNow #ACR24 https://t.co/JEqVPLGNfu
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Did you know?
#Lupus arthritis have clinical and US classifications.
On MRI, findings will show:
- periarticular hyperplastic tissue
- capsular swelling
- edematous tenosynovitis
@RheumNow #ACR24 @rheumarhyme @theactiverheum https://t.co/EoKh2Q3V9Z
Links:
sheila RHEUMarampa ( View Tweet)
McInnes et al. 24 week phase 2 ARGO trial. Sonelokimab, IL-17A- and IL-17F-inhibiting nanobody, in PsA. ACR50 responses shown in picture. Good efficacy across domains, but this is phase 2, will await the phase 3. @RheumNow #ACR24 Abstr#2582 https://t.co/FQflZMPes0 https://t.co/DATqo37yib
Links:
Richard Conway RichardPAConway ( View Tweet)
A#2582 McInnes
Sonelokimab - IL17A,F nanobody
Prior P2 in PsO, HS
ARGO: P2 W24 RCT
Significant improv in ACR response
High PASI90/100 data
Up to 60% achieved MDA by W24
Improved PsAID domains (PRO)
Safety no IBD, MACE, depr. 2% oral candida
IZAR-1,2 - P3 ongoing
#ACR24 @RheumNow https://t.co/O4fEhTC8jK
Links:
Eric Dein ericdeinmd ( View Tweet)
SEC demonstrated high retention rates after 5 years in pts with PsA and r-axSpA in this real-world study.
Reasons for stopping SEC:
lack of efficacy
pt decision
lost to ffup
AEs
Reassuring data on SECs position in the treatment of PsA/AS.
@Rheumnow #ACR24 abs2344 https://t.co/zECEsheQIi
sheila RHEUMarampa ( View Tweet)
Merrill et al. SLEek LTE. ABBV-599 (Elsubrutinib and Upadacitinib Combination) and Upadacitinib monotherapy in SLE. 104 week data. SRI-4 85.4%, 82.1%, and 61.3% in the ABBV-599 HD, UPA 30 mg, and PBO to ABBV-599 HD group @RheumNow #ACR24 Abstr#2577 https://t.co/wc6Mb13U4O https://t.co/Xu1pMhAUrG
Links:
Richard Conway RichardPAConway ( View Tweet)