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Although general agreement that dz activity monitoring is important, implementation of AS/axSpA guideline recommendations is lacking. Guideline uptake & implementation should be considered in future updates of axSpA/AS tx recs. #ACR23 Abs #1385 https://t.co/RsyDppe3aR @rheumnow https://t.co/xxZ9pa77h9
Dr. Rachel Tate ( View Tweet)
Defining accuracy of Administrative Codes for Autoinflammatory Syndromes is important to lay groundwork!
AOSD, SJIA, BD, FMF, CAPS and SAPHO-CNO ICD codes validated as Autoinflammatory syndromes (AIS)- PPV low
@RheumNow #ACR23 #abst1129 https://t.co/XqIrUmUCVc
Bella Mehta bella_mehta ( View Tweet)
Never forget the physical toll that RA has taken on our patients.
RA pts in BC🇨🇦, dx 1996-2008 (n=13367)
Fraility score 5y post-dx:
twice as likely to be frail vs matched controls
I would love to see those dx 2008-2018
Have biologics moved the needle?
#ACR23 ABST1275 @RheumNow https://t.co/gMXo5Pp1qA
David Liew drdavidliew ( View Tweet)
Upcoming Plenary II session
Ab#1584 on Bactrim for GPA pts on RTX
Should you use this for prophylaxis after weaning the prednisone?
#ACR23 @RheumNow
Eric Dein ( View Tweet)
#ACR23 Abstr#0509 Is sero-ve #Sjogren sero-ve? A study showed promising diagnostic model comprises clinical & novel autoantibodies (DTD2) using whole peptidome array (AUC:74%) to avoid need for lips biopsy in ANA-ve. Need further validation & wider access to this test @RheumNow https://t.co/FmE8AJdMVe
Md Yuzaiful Md Yusof ( View Tweet)
In this updated pooled safety analysis from clinical trials of PsO, PsA & axSpA pts given SEC 150 &/or 300mg SC (ADeodhar et al)
⬆️freq AEs: nasopharyngitis & URTI
Low EAIRs/100pt yrs for IBD, malignancies & MACE
No new safety signals
Reassuring data.
#ACR23 ABST1436 @RheumNow https://t.co/guF0gC4hQM
sheila ( View Tweet)
In their cohort, Dr. Jorge reports that SLE pts who used SGLT2i had⬇️risk of MACE(HR 0.69 [95% CI 0.48-0.99]) & renal progression(HR 0.71 [95% CI 0.51-0.98]) vs DPP4 use
Risk of MACE also⬇️in LN subgrp
🧐💊A potential role of SGLT2i for SLE/LN?
#ACR23 ABST1579 @RheumNow #ACRbest https://t.co/Dod8DqRvLo
sheila ( View Tweet)
#ACR23 @RheumNow
SGLT2 inhibitors help CV & renal outcomes, but SLE pts excluded @AprilJorgeMD
ComparedSGLT2 to DPP4 inhibs, real world observation emulation study in SLE pts with T2DM
Lower incidence of MACE & renal progression
Subgroup w LN - risk reduction 10.2 MACE/100 py https://t.co/JpJ0yWNQBe
Eric Dein ( View Tweet)
Excellent start to Plenary II
Should we borrow SGLT2i and DPP4i use from endocrine?
SLE pts who initiated SGLT2 or DPP4: lower risk of MACE and renal progression
@RheumNow #ACR23 Abs#1579 https://t.co/RsaWuetyft
Robert B Chao, MD ( View Tweet)
RA peripheral blood mononuclear cells display IFN-gamma signature
Driven by 2 cell subsets: T cells & macrophages
IFNg driven transcription factors
Increased only in ACPA+ RA
Differential biology could inform ACPA stratified therapy
ABST1271 @RheumNow #ACR23 https://t.co/EN2noKGupK
Aurelie Najm ( View Tweet)
Glucocorticoids-free zone in SLE?
For over 70 years, glucocorticoids, (GC) have been a part of standard therapy in SLE. They are classically used to not only induce remission or treat an acute flare, but also as maintenance therapy. #ACR23
https://t.co/sfRhNj6OpZ https://t.co/k6VoG5lKO7
Dr. John Cush RheumNow ( View Tweet)
To remind us. Glory be! GLORIA a #RCT in elderly active #RA: MTX+10 mg daily #prednisolone which was better than MTX alone. But more infections and no comparison of inexpensive Rx such as adding #HCQ. Still debated as to benefit vs risk of this strategy @RheumNow #ACR23 @ACRheum https://t.co/slOmESbIOW
Janet Pope ( View Tweet)
Rather unsurprising finding at this point, but valuable nonetheless
Per usual, joint efficacy for bimekizumab (IL17i) ~similar to TNF
New twist; similar loss in efficacy over time. Nice to have another IL17i; not sure this is a "blockbuster"
@RheumNow #ACR23 Abstr1437 https://t.co/4sVfSz7ZnK
Mike Putman EBRheum ( View Tweet)
In axSpA, the mean and median progression were 0.54 and 0.38 points in mSASSS per year respectively, lower than what has been reported in similar cohorts, LBP before diagnosis was a strong predictor of progression, Granados R Abst#1389 #ACR23 @RheumNow https://t.co/fvkOzhUG97 https://t.co/k18HxWswbs
Dr. Antoni Chan ( View Tweet)
Great Debate on the use of biologics in treatment of Giant Cell Arteritis and Polymyalgia Rheumatica!
Let's begin with Dr. Robert Spiera on why we should NOT use IL-6i
No evidence of disease modifying
Lose biomarker activity
Cost
@RheumNow #ACR23 #ACRbest https://t.co/XCT02wYb2s
Robert B Chao, MD ( View Tweet)
Interesting abstract re:dx trajectories, I have a counter-intuitive take
I expect pts w/high dx activity to respond BETTER than pts w/LDA at diagnosis
More autoimmunity + less fibro = higher chance to respond to DMARD?
Anyone else feel that way?
@RheumNow #ACR23 Abstr1426 https://t.co/D6GU7tMcY6
Mike Putman EBRheum ( View Tweet)
How does Dr. Robert Spiera manage GCA?
1) Tx with steroids alone, taper by 6 months
2) Do not chase ESR/CRP
3) Pay attention to steroid complications
4) Low threshold to use IL-6i
Similar plan for PMR
Taper steroids by month 4
@RheumNow #ACR23 https://t.co/KSwyfjobFY
Robert B Chao, MD ( View Tweet)
Here is the popular answer@to the #ACR23 debate of up front bDMARD in GCA and PMR Yes vs No. the audience has no consensus. Access is Impt, experience and criteria of who to use it in. @ACRheum @RheumNow https://t.co/7pxF4w926m
Janet Pope ( View Tweet)
Debaters and moderators acknowledge IL6i may not be the only steroid sparing agents that would work for #GCA. Abatacept, secukinumab, JAKi are being evaluated #greatdebate @rheumnow #ACR23
TheDaoIndex KDAO2011 ( View Tweet)
@philseo on why we SHOULD use IL-6i in GCA and PMR
1) Infection risk similar to TNFi
2) Too many (63%) pts remain on steroids at 1-2 yrs
3) May accelerate remission
4) Steroids are Bad, even at low doses
@RheumNow #ACR23 https://t.co/muPPcAc6LC
Robert B Chao, MD ( View Tweet)