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Sex bias in RA: time to stop blaming hormones?
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 Abstracts from San Diego – Day 1
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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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
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)
ABS0155 @ #ACR23
Economic impact of switching from SQ MTX (Rasuvo) from oral MTX in U.S. RA pts?'
➡️ Rasuvo associated with significantly higher all cause total expenditure $4704 predominantly due to higher costs associated tin all cause pharmacy utilization $4,223!
@Rheumnow https://t.co/ry8XxjvHRg
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
ABS0164 @ #ACR23
Is a virtual MSK test consistent & comparable to in-person assessments w/ regard to dz activity in f/u of RA pts?
YES!
Some variability in # of swollen joints but approach shown below had good reliability & acceptable lvl of agreement
@RheumNow #ACRBEST https://t.co/yxpPb2Br4n
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
TM01 @ #ACR23: Daunting Case of Diarrhea
65 yo F w/ sero+RA + 2ndary SjS p/w 4 wks diarrhea
-CT a/p: thickening of cecum, ascending colon
-Colonoscopy path: ischemia
-R colectomy: enterocoelic lymphocytic phlebitis, no underlying vasculitis. Dx: IgG4-RD, serum IgG4⬆️
@RheumNow https://t.co/jQ57U5EjPo
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
TM02 @ #ACR23:
19yo F w/ SLE p/w 1w DOE
PMHx: SLE (malar, LN, AIHA, ITP) on HCQ x 10yrs
Dx?
HCQ-induced CM (curvilinear bodies, vacuolar degen)
⭐️RF for HCQ-induced cardio-toxicity:
- older age, F
- HCQ > 10 yrs, ⬆️ daily dose
- hx of cardiac dz
- renal insuffic
@RheumNow https://t.co/GgzB2Chgra
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
TM03 @ #ACR23
40 yo healthy F p/w swelling, red papule, hyperpigmentation, firmness, & tightness on R semi-body
Dx? Unilateral generalized morphea (UGM)
No guidelines for tx of morphea or UGM
This case report showed success w/ IVMP + PO Pred & MTX & TCZ for maint
@RheumNow https://t.co/iOVqhwmCVz
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Come and visit poster 1410 in the poster hall today. I will be sharing our work using the ASAS @Official_ASAS referral guidelines for earlier diagnosis of Axial Spondyloarthritis, Chan A et al Abst#1410 #ACR23 @RheumNow https://t.co/jB3FHPSBqs
Dr. Antoni Chan ( View Tweet)
CAR-T cell Rx show promise for drug-free remission in refractory #SLE without affecting vaccination response despite depleting CD19+ plasmablasts https://t.co/WXa4ADfcF6 abst#0606 @RheumNow #ACR23 https://t.co/ga4DCcbMhD
TheDaoIndex KDAO2011 ( View Tweet)
Argentinian #SLE Registry data eval Ro Ab & outcomes of 1500+ SLE pts. 40% had +Ro Ab. Pts w/+Ro Ab had⬇️complements, other+autoAb, Sjogren's, Raynaud's, interstitial pneumonitis, pericarditis & tended to be on steroids or MTX @RheumNow #ACR23 abst#0561
TheDaoIndex KDAO2011 ( View Tweet)
Promising! #Cenerimod is a selective S1P1 Receptor modulator has potential in SLE through modulating lymphocyte trafficking, inflammation, and autoantigen transport. Phase 2 showed reduced T/B lymphocytes, autoAb levels, and secretions of IFN-a. #abstr0584 @rheumNow #ACR23
TheDaoIndex KDAO2011 ( View Tweet)
RheumNow’s expanded coverage of the #ACR23 annual meeting is sponsored in part by Bristol Myers Squibb and UCB. All content is chosen by RheumNow & its faculty.
Dr. John Cush RheumNow ( View Tweet)
Great work by @Yuz6Yusof
ANA positive and diagnosis , prediction tool to rule out/ in autoimmune pathology.
1-High interferon score.
2-FH autoimmune disease.
3- More criteria.
?Monogenic error of immune system , ?genome assessment .
@RheumNow , Daily recap
Nouf Al hemmadi ( View Tweet)
I vote for the ❤️
Several abstracts evaluated cardiovascular event prevalence and screening tools using ECHO, carotid ultrasound as current CV risk calculators are inadequate when assessing SLE CV risk. See my blog - just published @RheumNow
https://t.co/XLc0YHtJ0B https://t.co/oF0fXBRM6O
TheDaoIndex KDAO2011 ( View Tweet)
1-Can we prevent RA ? Vagotomy?
2-CV events in auto immune rheumatic disease pregnancies.
3-CVS vasculitis , challenges and role of Brain biopsy
And others……..
https://t.co/BX8bDSX1M3
@RheumNow , daily recap
#ACR23
Nouf Al hemmadi ( View Tweet)
Sunday recap @RheumNow
Very interesting abstracts:
https://t.co/BX8bDSX1M3
1- Fecal calprotectin in SpA population.
2-SLE; high or low steroids? Rapid or slow taper?
3-Molecular biomarkers for PAH in SLE.
4-Repeating imaging in ? Chronic back pain?
And others …….
Nouf Al hemmadi ( View Tweet)
#ACR23 Abstr#0784 Beyond renal response, let’s also focus on kidney function and Steroid-sparing effect. Post-hoc analysis of Phase 2 RCT showed Obinutuzumab preserved eGFR by 4ml/min/1.73m2/year with greater number of pts achieving <7.5mg/d of prednisolone bs PBO @RheumNowNews https://t.co/2hW74UF1ta
Md Yuzaiful Md Yusof ( View Tweet)