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GLP-1 Agonists Show Promise in Slowing Kidney Disease in Lupus Nephritis
A retrospective cohort study presented at #ACR24 explores the benefits of GLP-1Ras in reducing the risk of end-stage renal disease (ESRD) for patients with lupus nephritis. Drawing on data from the TrinetX global research database, the study examines how GLP-1Ras may reduce ESRD progression in a population where 10-20% progress to ESRD within five years, even with immunosuppressive therapies.
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Selective TYK2i zasocitinib, results of Phase 2 DBRCT Dose dependent improvements in various PsA outcomes; NNT~5 for DAS28 remission, NNT~20 for PASDAS Hard to compare to current agents, somewhere between JAKs (woot!) & "apremlist zone" 🫣 #ACR24 @RheumNow Abstr#2584 #ACRbest https://t.co/t0y6C618ll
Mike Putman EBRheum ( View Tweet)
A#2585
PsABIOnd observ cohort study of IL23 (GUS) or IL17i
6 mo interim results of 686 pts
PROs: PsAID-12
High Rx persistence at 6mo -94% on both Rx
Comparable improvement in PsAID-12 - best results skin, discomfort
1/2 with clinically meaningful improvement
#ACR24 @RheumNow https://t.co/TM1jwTRR7C
Links:
Eric Dein ericdeinmd ( View Tweet)
Dr. CStone et al. assessed nailfold dermoscopy in distinguishing DM from SLE
Almost all DM pts had nailfold changes in at least 1 digit vs. SLE
& majority of DM pts had nailfold changes in all 10 digits
Dermoscopy is a simple alternative to capillaroscopy
@rheumNow #ACR24 ab2404 https://t.co/6tEXAlX7lt
sheila RHEUMarampa ( View Tweet)
A systematic review & meta-analysis by Dr. JBCorrea et al show that the ff immune-mediated dses are assocd w/⬆️ ocurrence risk after covid19 infection 👇
Behcets
SpA
SS
SLE
PMR
Pso
RA
Sjogrens
T1DM
Vasculitis
IBD
Ask prior covid infexn in pts history
@RheumNow #ACR24 abs2614 https://t.co/TIEglPrmvL
sheila RHEUMarampa ( View Tweet)
Neuropsychiatric manifestations in SLE.
Susanne Benseler MD @RheumNow #ACR24 https://t.co/subiykC5Q4
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
A#2586
EBIO study - secukinumab on entheseal bx in PsA. Compare b/l to 3+ mo on SEC
Biopsy: change of entheseal cell composition on IL-17A Rx
- decr Il-17A producing cells in responding pts
Spatial transcriptomics - colocalizarjon of ILC2, CD200+ fibroblasts
@RheumNow #ACR24 https://t.co/kMiqpBRxuE
Eric Dein ericdeinmd ( View Tweet)
Neuroimaging is done to support the diagnosis of CNS #lupus but only 75% reveal abnormal brain MRI.
📌 It is more useful in pts with local deficits than diffuse.
📌 poorly correlated with cognitive dysfunction & psych phenotypes.
@Rheumnow #ACR24 @rheumarhyme @theactiverheum https://t.co/HjNbVBaOHv
sheila RHEUMarampa ( View Tweet)
The different NPSLE syndromes 👇
Highlighted in yellow are the most common manifestations. 🧠
- Cognitive dysfunction
- Mood disorder
- Anxiety disorder
@RheumNow #ACR24 https://t.co/1I7OVPT6DK
sheila RHEUMarampa ( View Tweet)
A higher number of axSpA pts enrolled in BE MOBILE 1&2 who were treated with BKZ achieved remission accdg to the OSI vs. ASDAS ID (40.5% vs 15.2%) at wk 16 until wk 52.
OSI a better measure of remission?
@RheumNow #ACR24 abs2362 https://t.co/GCHjXQi9S9
sheila RHEUMarampa ( View Tweet)
Diagnostic work up for neuropsychiatric SLE. Zahi Touma MD @RheumNow #ACR24 https://t.co/zLX1QHCaSu
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Dr @ZahiTouma discusses the attribution rules for the NPSLE syndromes
Attribute to #SLE if
- onset of NP is near the SLE dx
- absence of concurrent nonSLE factors
- ⬇️ frequency of NP events in the gen pop'n
- diagnostic tools favor NPSLE
@RheumNow #ACR24 https://t.co/e1xBK4Xzsw
sheila RHEUMarampa ( View Tweet)
Very informative slide describing the 2 NPSLE pathogenetic pathways & their differences in mediators, mechanisms and NP events.
@RheumNow #ACR24
@rheumarhyme @theactiverheum https://t.co/D3XFDqxMBq
sheila RHEUMarampa ( View Tweet)
Walsh et al. Direct mailing of PEST questionnaire to psoriasis patients. 13% PEST+, 4% seen by rheum (to date). 75% deemed appropriate for rheum to see - breakdown in picture. @RheumNow #ACR24 Abstr#2635 https://t.co/vlGJ977SV7 https://t.co/dbDUpwDZxy
Links:
Richard Conway RichardPAConway ( View Tweet)
Sharma @Amansharmapgi et al. DADA2. Clinical manifestations of 101(!) patients. @RheumNow #ACR24 Abstr#2647 https://t.co/Tkk6Rz6rtT https://t.co/frvFPYy4xf
Links:
Richard Conway RichardPAConway ( View Tweet)
A#2647
DADA2 cohort 101 pts in India
Median delay dx 5 years - 5 pts of >20 yr
- 39 pts w GI involvement- bad outcomes
Skin most common - largely livedo, then ulcers/nodules
CNS common w ischemia
Many Rx before dx
12 deaths (11.8%) - 8 GI, 3 CVA, 1 suicide
#ACR24 @RheumNow https://t.co/Q8kiVbJq8I
Links:
Eric Dein ericdeinmd ( View Tweet)
A call to action in diagnosing and treating NPSLE 👇
Wonderful talks by Dr @ZahiTouma Dr. Betty Diamond and Dr. Susanne Benseler
@Rheumnow #ACR24 #lupus https://t.co/046ArRMP1a
sheila RHEUMarampa ( View Tweet)
Medeiros-Ribeiro et al. Holding MTX for 2 weeks after recombinant zoster vaccine increases response with no increase in flare. @RheumNow #ACR24 Abstr#2612 https://t.co/NEop0XB5Ak https://t.co/P4S2qzbkTs
Links:
Richard Conway RichardPAConway ( View Tweet)
SmPCs recommend interrupting immunosuppression (IS) in infection
What happens if you continue the drug?
Ab2611 found no difference in infection outcomes btwn temp interruption & continuation of IS in infection
Could continuation be a safe option in some pts?
#ACR24 @RheumNow https://t.co/14SN6a4Wm8
Mrinalini Dey DrMiniDey ( View Tweet)
RIP to Glucocorticoids in GPA
For many years glucocorticoids were the mainstay of our treatment of granulomatosis with polyangiitis (GPA).
https://t.co/WqpO6ACqtu https://t.co/vb8qx3uHA0
Dr. John Cush RheumNow ( View Tweet)