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Stopping therapy in GCA
They say the easiest bit about GCA, like PMR, is the first week after you start steroids. Those fond memories belie the challenge of ongoing treatment in GCA. In a steroid-only world, there is only misery. Steroid-sparing therapies have changed this completely.
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McDermott et al. Target trial emulation of different b/tsDMARDs in RA-ILD. RTX as SOC. No significant differences seen in hospitalisation or death. Trends to abatacept and JAKi looking better... @RheumNow #ACR25 Abstr#2662 #ACRBest https://t.co/ghHEKztvgz
Richard Conway RichardPAConway ( View Tweet)
Biologic choice in PsA: consider factoring in obesity ⚖️
Abstract 2691: In a longitudinal cohort study, obesity associated with ↓ odds of achieving minimal disease activity (MDA) among pts on TNFi, but not with other DMARDs
@RheumNow #ACR25 https://t.co/p4KaH6HKYj
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
#2661 In >5000 veterans with RA-ILD, 8 distinct FVC trajectories were identified. >1/2showed a progressive decline (≥0.7%/yr). These progressive patterns predicted higher mortality & respiratory hospitalisations, underscoring major disease heterogeneity. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
Abstract 2690: Food as a Medicine
Mediterranean vs low-calorie DASH vs control diet in PsA (multicenter RCT):
🔹 All 3 groups showed significant weight loss & DAPSA by wk 24
🔹 Weight loss not diet type may be the driver of clinical improvement
@RheumNow #ACR25 https://t.co/rBS3HR1HXl
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Sooner May Still Be Too Late: Kidney Biopsies in SLE
#ACR25 kicked off with Plenary Session by Michelle Petri (Abstract 0772: Redefining When to Biopsy the Kidney in Patients with SLE. As part of a collaboration with the Accelerating Medicines Partnership, Petri and colleagues https://t.co/bU09vpcDew
Dr. John Cush RheumNow ( View Tweet)
In a 5-year EHR-based cohort, PsO patients initiating IL-17i had significantly lower incidence of PsA/IA vs IL-23i, IL-12/23i, or TNFi. IL-17i reduced time with PsA/IA by 45% vs IL-23i, 61% vs IL-12/23i, and 74% vs TNFi. Further research need investigate if IL-17i may delay https://t.co/0PTbXZpLbu
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Abstract 2697: Compared to MMF, tacrolimus showed
- similar SRR by week 96 (58.5% vs. 69.2%, OR 0.62; 95% CI 0.29-1.29)
- similar time to renal AE/deaths (HR 0.70; 95% CI 0.37-1.35)
- serious AEs less frequent (12.3% vs. 30.8%)
@RheumNow #ACR25 https://t.co/o3LtgOp7St
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
In PsA patients, GLP-1 RA therapy led to significant weight loss and improvements in CRP, pain, lipids, and blood pressure. PsA outcomes improved proportionally with weight loss. Regression analyses revealed that each 1% reduction in body weight was associated with significant https://t.co/Pph1PjfOve
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#2681 Tackling the “lipid paradox” in RA: inflammation-adjusted TC & LDL (using hsCRP correction) improved ASCVD risk prediction and flagged more high-risk patients than standard lipids. A smarter way to guide statin use in RA. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
What exercise best for steroid-induced osteoporosis? Does it have to be weight bearing?
Turns out anything helps - get out there and don’t let perfect be the enemy of good!
Laura Coates in the #ACR25 meeting review @RheumNow https://t.co/VGH2rz3dzb
David Liew drdavidliew ( View Tweet)
Does diet matter in PsA?
Randomized study comparing advice, DASH low calorie, Mediterranean diet
Seems that weight loss corresponds better with benefit than diet. BMI reduction remains focus in PsA
Laura Coates #ACR25 meeting review @RheumNow https://t.co/CqR25sJdDc
David Liew drdavidliew ( View Tweet)
Trends in Translational Abstracts content this year by Tomas Mustelin in the
“Abstracts that Will shape research in the near Future” Year in Preview session
@RheumNow #ACR25 https://t.co/i5CA8cxHeQ
Aurelie Najm AurelieRheumo ( View Tweet)
#ACR25 Clinical Preview by Prof Coates to be applied tomorrow!
Early Tx
Abstr#1677 First-line TNFi for 12-mth vs step-up = better outcomes at 5-Yr
Abstr#2662 Target emulation trial = No differences in hospitalization, death/transplant RTX vs TNFi, ABA, JAK, IL-6i @RheumNow https://t.co/yostJyc5T9
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Year in Preview
SLE: 52% subtherapeutic on weight based HCQ dosing
Precision prescribing needed, more so for CKD
@RheumNow #ACR25 Abstract 1722 https://t.co/8WqorQ1xJx
Jiha Lee JihaRheum ( View Tweet)
Click on the link to see my take on implantable vagal nerve stimulation RCT in RA 🎥👇🏼
https://t.co/CZrFKouSqp
@RheumNow #ACR25 #ABSTRACT1675
Aurelie Najm AurelieRheumo ( View Tweet)
The DIPSA study: can diet improve PsA?
Finally a RCT, and the general message is Loose weight, regardless of the diet!
3 arms:
-Mediterranean diet 31pts
-Low-calorie Dietary Approaches (DASH-LC) 30pts
-Standard of care 31pts
Primary outcome change in DAPSA wk 12
DASH-LC https://t.co/XH9Xdn0g96
Aurelie Najm AurelieRheumo ( View Tweet)
Fukui et al. CorEvitas study. 12076 RA patients. Propensity score matching. Kidney dysfunction (eGFR<60) reduced chance of CDAI remission (HR 0.71) or remission/LDA (HR 0.88) @RheumNow #ACR25 Abstr#2640 https://t.co/uvTjOQlGD7
Richard Conway RichardPAConway ( View Tweet)
Dr. LRoss presents the SCTC SSc Heart Involvement classification criteria
♥️Criteria score >/= 11pts
🔸SN 77.8%; SP 95.9%
🔸OR 82.6
Huge endeavor towards standardization of SHI to help improve patient outcomes in the future 👏👏
#ACR25 @RheumNow https://t.co/QrgYlksjZB
Links:
sheila RHEUMarampa ( View Tweet)
Sjögren’s: two Phase 3 RCTs (NEPTUNUS-1 [QM], -2 [Q3M]) test Ianalumab (BAFF/BAFF-R) vs placebo.
ΔESSDAI at 48wk: Ianalumab QM > PBO, statistically significant
But ΔESSDAI ≈ 0.5–1 pt (vs PBO) below MCII (≥ 3)
Promising biology, modest clinical gain
#ACR25 @RheumNow LB24 https://t.co/8y580ch9iJ
Jiha Lee JihaRheum ( View Tweet)
