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ACR23 – Day 1 Report

d Jack Cush, MD

ACR 2023 is back in San Diego for its annual convergence of thousands of rheumatologists to partake, discover and learn from thousands of abstracts and hundreds of sessions and presentations. It was a big return for the Poster Hall with rows and rows of research, friends, fellows and poster tours.  Below are a few of my favorite presentations from the posters, Plenary and oral sessions on day one.

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Sex bias in RA: time to stop blaming hormones?

d Aurelie Najm, MD, PhD

Whether it’s RA, SLE or Sjogren’s, the increased prevalence of females affected by auto-immune diseases is well established, yet not fully understood. Often, I have heard that sexual hormones are responsible for every aspect of it. Two abstracts presented this year question this paradigm.

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ACR Best

#ACR BEST Abstracts from San Diego – Day 1

d Jack Cush, MD

The RheumNow faculty reporters have been scouring the meeting for what they believe to be the best presentations from the first day at ACR 2023 in San Diego.  From hundreds of online presentations, the poster floor and the plenary podium, here are some of the best abstracts from Sunday Nov. 12th. You can spot these on Twitter by looking for the (#ACRbest) hashtag.

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RheumNow’s expanded coverage of the #ACR23 annual meeting is sponsored in part by Novartis. All content is chosen by RheumNow & its faculty.

Dr. John Cush RheumNow ( View Tweet)

#ACR23 Abs #0844 posterior element inflammation & facet joint ankylosis on MRI uncommon in r-axSpA patients. However, when FJ inflammation is present (vs w/o) the likelihood of developing facet joint ankylosis after 1 year is over 3 x higher. https://t.co/1Kln1pNH3p @rheumnow https://t.co/BatNTFfTG2
Dr. Rachel Tate  ( View Tweet)
Validation is needed, but SPARTAN + add'l stakeholders developed the first draft SPARTAN recommendations for referral of adults with chronic back pain to a rheumatologist for evaluation of axSpA! Check out #ACR23 Abs #0841 https://t.co/ISv2lgHyka @rheumnow https://t.co/Qvy8LlzOw0
Dr. Rachel Tate  ( View Tweet)
When to use #belimumab and when to use #voclosporin? Dr. Dall'Era does the following: Belimumab: GFR<45, low proteinuria, extrarenal dz, pt factors Voclosporin: GFR>45 w/o sig chronicity, high level proteinuria (3+g/), pt preference for oral #ACR23 #MeetExpert @rheumnow https://t.co/0SXRBtChfk
TheDaoIndex KDAO2011 ( View Tweet)
"Get rid of partial response. Why would you want to see an oncologist who say I can get risk part of your cancer? Wouldn't you want to get rid of the whole cancer!" - Dr. M Petri on how we should view lupus nephritis #ACR23 @rheumnow #MeetExpert

TheDaoIndex KDAO2011 ( View Tweet)

Proof of concept for cCAR BCMA CD19 - safely eliminated all autoabs, reset B cell/humoral immune system, & delivered long-term, med-free remission in 1 dose in LN and SLE. More studies needed! #ACR Abs 1493 @rheumnow https://t.co/sT68cN3TKe

Dr. Rachel Tate  ( View Tweet)

ACR#23 Abs #1023: IgG4-RD males > likely (vs females) to have multi-organ & serological activity w/ ^ immunoglobulin concentrations. Interestingly, lower lipase levels observed in males are consistent with greater degrees of pancreatic damage. https://t.co/4hUGmzTQqX @rheumnow https://t.co/kcy5dL62Pn
Dr. Rachel Tate  ( View Tweet)
UTSW Dallas study: Health literacy may be essential limiting factor for families w/ children w/ SLE. Other critical barriers to patient care include food security and living costs such as transportation, housing, and utilities. #ACR23 Abs #1029 https://t.co/jtnIgLZQfC @rheumnow https://t.co/A1zr8quSdd
Dr. Rachel Tate  ( View Tweet)
RheumNow Live registration is open! Join us this January! https://t.co/x3ilRUi1hX https://t.co/7fBLaYwIiT

Links:

Dr. John Cush RheumNow ( View Tweet)
LV mass higher in pts with SLE nephritis.Nested case-control study 48 SLE pts +/- LN. LV mass higher w/LN (66.9 g/m2) vs pts w/o LN (54.8 g/m2, p=0.035). Higher LV mass may increase risk for CV events as CHF, arrhythmias and CV mortality. @RheumNow #ACR23 abst#1447

TheDaoIndex KDAO2011 ( View Tweet)

Real World SLE Rx patterns from the SPOCS cohort. 70+% IFN high, 81% on antimalarials, 21% biologics, and 55% IS, 65% GCs. High IFN pts had more IS and steroid use. 45+% still on GCs at 12 months despite avail of new therapeutics @RheumNow #ACR23 abst#0592

TheDaoIndex KDAO2011 ( View Tweet)

Assessment of MAP kinase pathway gene expression prior to tx may aid in identification of polyarticular course JIA patients that could exhibit poor response to tofacitinib. It may be helpful in personalized tx algorithm! #ACR23 Abs #0830 https://t.co/Z8pykbG7x5 @rheumnow https://t.co/ANZr8aVrVB
Dr. Rachel Tate  ( View Tweet)
STOP-JIA study data from Abs #0831 suggest improved effectiveness with early combination tx vs step up and biologic first tx at the 2-3 yr timeframe for pJIA pts. More data needed to optimize outcomes/tx for these children. https://t.co/vWL5J4FPbo #ACR23 @rheumnow https://t.co/5iJpwglhPu
Dr. Rachel Tate  ( View Tweet)
Vasc Events in Danish Cohort: 3178 SLE pts matched to 60K controls. MI in SLE 2.9% vs 1.4%, cerebrovascular dz 7% vs 2.7%, & PVD 5.5% vs 1.4%. IRR ranged 1.7-7.6. Female SLE pts had 3-5X risk for CVE, Male pts 6-8X risk. @RheumNow #ACR23 abst#1442 https://t.co/PapDiJ0shJ
TheDaoIndex KDAO2011 ( View Tweet)
Obintuzumab in Lupus Nephritis Researchers found that treatment with obinutuzumab was superior to placebo for preserving kidney function and preventing flares in patients with lupus nephritis. https://t.co/Sbh6k6XKjz https://t.co/aDbLUh7WtM

Links:

Dr. John Cush RheumNow ( View Tweet)
Patient perspective: PP09 at #ACR23 "Mindfulness helps me experience less suffering over pain" in patient with PsA + fibromyalgia. ⭐️Consider recommending mindfulness training such as mindfulness based stress reduction @RheumNow https://t.co/DHwduvTPZL
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
ABS0122 at #ACR23 ⭐️Risk of acute MI, stroke & death signif ⬆️ among RA/SLE pts w/ depress, anxiety, &/or PTSD vs w/o both RA/SLE ➡️U.S. pts: 3825 RA, 1862 SLE --> 1790 w/ above mental health dz, no prior CVD ➡️HR 1.28 after adjusting for🚬, obesity, & comorbidities @RheumNow https://t.co/sXMFtaKmYB
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)

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