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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)
Still uncomfortable with IL-6i in GCA or PMR especially given the pt population and potential AE? Be on the look out for NEW biologics! Mavrilimumab Secukinumab and MORE! @RheumNow #ACR23 https://t.co/gdcDIcvffa
Robert B Chao, MD  ( View Tweet)
More vitamin D during pregnancy is better, right? Hopkins Lupus cohort, vit D levels & adverse pregnancy outcomes Actually, there's a sweet spot (too high just as unfavourable as too low) Maybe popping vit D pills isn't always limitless @jhrheumatology #ACR23 ABST1364 @RheumNow https://t.co/TVPCqP3dq9
David Liew drdavidliew ( View Tweet)
Patients with autoimmnue diseases have a high maternal and fetal complication rate! Abst 1003 #ACR23 @RheumNow https://t.co/pnvvBUN2JG
Bella Mehta bella_mehta ( View Tweet)
Quick curmudgeonly complaint WHY are we doing 316 week extensions? That's 292 weeks of $$$ data... for what? 1. Insufficient N to assess meaningful safety signals 2. Open label, no comparator It's just a very very expensive observational study @RheumNow #ACR23 Abstr1434 https://t.co/Thj1XjeAn1
Mike Putman EBRheum ( View Tweet)
Have we forgotten our physical rehab roots in RA? RA with severe functional disability 1y of personalised exercise program vs routine care n=215, Leiden broad functional gains as expected Remember: the meds are critical, but can only take you so far. #ACR23 ABST1335 @RheumNow https://t.co/FszhGAv7ln
David Liew drdavidliew ( View Tweet)
A bit of talk about treating pre-RA, but how do patients feel about it? Clinically suspect arthralgia pts, Leeds Influenced by different factors: symptoms personal risk meds experience knowledge perceived effort Acceptable tradeoffs are very personal #ACR23 ABST1258 @RheumNow https://t.co/wZGfdffNji
David Liew drdavidliew ( View Tweet)
Pregnancy Updates That Will Change The Way I Practice Dr. Rachel Tate ( @uptotate) shares two abstracts related to autoimmune patients and pregnancy risks, and her take home practice updates. #ACR23 https://t.co/X85lkKpcea https://t.co/djDujw810T

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Dr. John Cush RheumNow ( View Tweet)
The order of use will affect the safety and effectiveness of drug Rx in #Rheumatoid #arthritis So if #Rituximab is used in later line #Rx - is looks worse@than ex #TNFi used early. Never forget prescribing bias / confounding the results. @RheumNow @ACRheum #ACR23 https://t.co/JJ8BY7n9VM

Janet Pope  ( View Tweet)

The great debate: Dr. Robert Spiera on why advanced therapies should not be used first-line in GCA and PMR 👇 #ACR23 @Rheumnow https://t.co/O7jtpfkoRw
sheila  ( View Tweet)
#Faces of the #ACR23 @RheumNow @ACRheum. Add more! Lots of great talks, posters, panels and hallway conversations. https://t.co/RddUOviJc6
Janet Pope  ( View Tweet)
More nuanced poll for #GreatDebate #ACR23 @RheumNow How should we use biologics for PMR/GCA?

Eric Dein  ( View Tweet)

Nationwide analysis of #AOSD pts with and without #HLH - HLH Much higher in Hispanics Much more in younger pts Abst1143 @rheumnow #ACR23 https://t.co/fluZ4X2HHi
Bella Mehta bella_mehta ( View Tweet)
Dr. Seo noted why he likes to pick fights. He quotes Dr. David Jayne "#GreatDebates are boring if both sides agree!" @rheumnow #ACR23 https://t.co/6VkVg0RMpX
TheDaoIndex KDAO2011 ( View Tweet)
#GCA Rx #bDMARD is established to #steroid spare and reduce relapses. #Tocilizumab #GiACTA Dr Seo said ‘biologics work and steroids are bad!’ ⁦@ACRheum⁩ ⁦@RheumNow⁩ #ACR23 #ACRbest https://t.co/JmSE1KKlf5
Janet Pope  ( View Tweet)
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