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Gene signature predicts RA trajectory during pregnancy:
Blood RNAseq *before* pregnancy
🚺 improve during preg: Strong Neutrophil signature
🚺 experience dis worsening:
Strong B cell signature
Needs replication but could have major implications!
@RheumNow #ACR23 ABST2481 https://t.co/gOHwEvOOM6
Aurelie Najm ( View Tweet)
#ACR23 Abstr# 2487 How to reduce PBO response in #SLE trials? Try adding low dose GC as co-primary endpoint. Interim analysis of Phase 2 RCT: SRI-4 + sustained GC dose to ≤5mg/d or ≤BL from Wk16 to 28 was met more in Ianalumab (BAFF-R-i) vs PBO (44% vs 9%) @RheumNow https://t.co/JEnMWKilR6
Md Yuzaiful Md Yusof ( View Tweet)
TM85 #ACR23 @RheumNow
IPF s/p lung transplant p/w diffuse bone pain
Exam: no synovitis, +crackles. Labs: ALP 203
CT chest: stable mycetoma
Xray: periosteal reaction
Dx: vericonazole periosititis
Positive Mucorales PCR, fluoride level 19 (ref <4)
Bone pain improved stopping voric https://t.co/Gt8mOAssvh
Eric Dein ( View Tweet)
Anti-fibrotics in RA-ILD
Retro analysis of 74 pts
AEs frequent 55% and discontinuation in 46% (more than in initial RCTs)
No diff between AF
FCV trajectory mildly improved
ABST2479 @RheumNow @Juge_P_A @PhilippeDieude #ACR23 https://t.co/GqsHxkIFgD
Aurelie Najm ( View Tweet)
Rashes in Rheumatology at #ACR23
Which disease entity are these palms pathognomonic for?
@RheumNow https://t.co/NmT1LTzWmm
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Therapeutic Ladder for Discoid Lupus:
1. Strict🌞protection, smoking avoidance
2. Antimalarials
3. Topicals/intralesional corticosteroids, topical CNI
4. Oral steroids, retinoids, MTX, MMF
5. Thalidomide, lenalidomide
6. IVIG, JAKi, Belimumab... BUT also Anifrolumab!… https://t.co/xSw0s12Uvk https://t.co/stIJ944d9A
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
#ACR23 Abstr# 2485 Belimumab therapy in RCT was associated with increased risk of psychiatric events inc suicidality vs PBO. When compared with standard immunosuppressant, real-world data using emulated trial design showed no increased risk @RheumNow https://t.co/Vqhc5yRsSA
Md Yuzaiful Md Yusof ( View Tweet)
A new innovative way of teaching MS ultrasound to students using teledidactic teaching with portable ultrasound devices resulted in a significant increase in knowledge comparable to the conventional course, Schäfer SV, Abst#2079 #ACR23 @RheumNow https://t.co/re0gErx5ke https://t.co/yPbS9Rj0az
Dr. Antoni Chan ( View Tweet)
Late breaking at #ACR23:
extension of this study for dazodalibep (anti-CD40L) for Sjogren’s symptoms
Another six months with a crossover - & sustained symptomatic benefit after cessation. Fascinating, addresses a desperate clinical need, bring on the phase 3!
ABSTL10 @RheumNow https://t.co/zUfnGEZefj https://t.co/S3lLwhwl85
David Liew drdavidliew ( View Tweet)
Complements & HCQ? (Prof Petri et al)
Significant ⬆️ in C3 (p=0.022) & C4 (p=0.003) levels with HCQ whole blood levels >50 ng/mL
Increasing blood levels of HCQ significantly assocd w/⬆️prob of achieving normal C4
Improving C3,C4; addtl benefit of HCQ?
#ACR23 ABST2327 @RheumNow https://t.co/5ucpXq9ngb
sheila ( View Tweet)
#ACR23 Abstr#2335 A step towards equal access to therapy for ANA+ people with arthritis. A cohort study showed: ANA+ (#SLE, #sjogren, MCTD, UCTD) & arthritis were homogenous related to clinical features, PROs & gene expression score. Offer rationale for basket trial @RheumNow https://t.co/7HTMxE7mSP
Md Yuzaiful Md Yusof ( View Tweet)
HCQ discontinuation in SLE? Why?!
In this retro cohort of 42 pts
Reasons:
Retinal toxicity (57%)
Self-discontinuation (17%)
Factors strongly assoc'd w/ flares 1 yr after discontinuation - mean C3 and +dsDNA at index visit.
#ACR23 ABST2343 @RheumNow https://t.co/BCO9N4gSkX
sheila ( View Tweet)
Im usually super shy on camera but my hair looks great in this video with my friend @RHEUMarampa as we talk about how our reviewer went from a personal project to a fellow study resource. #ACR23 #ACRambassador @RheumNow @cerego https://t.co/KHDni7epFK
Lisa 🐳🗺🧭 rheumarhyme ( View Tweet)
Pain experience in #OA may have different contributing factors
Its a while joint disease!
What are the future targets in #OA being tested? @RheumNow #ACR23 @Tuhina_Neogi https://t.co/lI06pJrdYR
Bella Mehta bella_mehta ( View Tweet)
GCs on MACE in RA in VA
A#2430 #ACR23 @RheumNow
Not just ongoing steroid usage, also prior usage 1 year ago
5 mg use for 30 days one year ago - increases MACE events by 3%
5 mg use for 90 days one year ago - increases MACE events by 9%
Eric Dein ( View Tweet)
Wallace et al. Dose, duration, recency dependent relationship between GC and MACE. Even 5mg/day, 30 day use, and use 1 year prior associated with risk. 5mg, 7.5mg, 10mg pred for 90 days - 13%, 19%, 27% MACE increase Abstr#2430 #ACR23 #ACRbest @RheumNow https://t.co/50B5nGqxu9 https://t.co/lNrUbZOm0o
Richard Conway ( View Tweet)
Even low doses of steroids associated with major adverse cardiovascular events!
Large VA database - >18k RA pts
Dose as low as 5mg/day prednisone for 30 days, 1 year prior to event, associated with increased MACE
@RheumNow #ACR23 Abs#2430 https://t.co/JjeoBi7YTD
Robert B Chao, MD ( View Tweet)
Mok et al. Romosozumab superior to denosumab in high risk GIO. Superior in improving spine BMD. Not fracture. Fracture is what matters. Abstr#2429 #ACR23 @RheumNow https://t.co/5ModHOGsED
Richard Conway ( View Tweet)
A#2429 #ACR23 @RheumNow
ROMO v DEN - 12 mo RCT 70 GIOP pts at high-risk
Mean prednisolone dose 6.6 mg
H/o fragility fx in 1/2 pts
12 mo: Increase in spine BMD- ROMO (+7) and DEN (+2)
Hip and Femoral neck improved both (1.6% both), not signif diff bw grps
AEs: incr injxn site rxn https://t.co/VueuZIjFfM
Eric Dein ( View Tweet)
Physical therapy and lifestyle counseling the main pillars of #OA management are underutilized!
Mainstay remains weight loss and exercise! @RheumNow #ACR23
Rrf memorial lecture @Tuhina_Neogi https://t.co/yXqWIEccq4
Bella Mehta bella_mehta ( View Tweet)