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ACR Convergence Preview (11.10.2023)
Dr. Jack Cush reviews this past week's news on RheumNow.com and suggests a learning plan for those wanting to consume the upcoming ACR Convergence 2023 meeting.
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Methotrexate in OA (10.20.2023)
Dr. Jack Cush discusses the news, journal articles and regulatory actions. This week we discuss JAKne, DLE and SLE and more.
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PMR & Popeye's Spinach (10.6.2023)
Dr. Jack Cush reviews the big PMR reports from this week along with other journal reports from RheumNow.com.
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Predictive FDG-PET in Newly Diagnosed GCA
Annals of Internal Medicine reports that the use of 18F-fluorodeoxyglucose (FDG) PET imaging at the time of a giant cell arteritis (GCA) diagnosis may help estimate the risk for aortic aneurysm formation.
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⭐️Real world data on use of #avacopan presented by @zach_wallace_md
#vasculitis
Important observations to inform the practice and management of #AAV https://t.co/gtZORcnt9t
KenWarringtonMD MdWarrington ( View Tweet)
Real-life data about the PEXIVAS reduced-dose glucocorticoid regimen in #granulomatosis with polyangiitis and microscopic #polyangiitis (Abstract 0725 https://t.co/7x34Hr0OMP)
@TerrierBen
#ACR23
#ACRambassador https://t.co/D8UfZvXQCl
Alessia Alunno ( View Tweet)
Reduced-dose GC regimen in severe GPA or MPS (creatinine >300 umol/L, RTX as induction) associated with increased risk of death, ESKD, progression before remission requiring treatment modification or relapse, Nagle S Abst#0725 #ACR23 #ACRBest @RheumNow https://t.co/ZVZYRnSy3n
Dr. Antoni Chan ( View Tweet)
LTE of REOVAS of RTX in EGPA. Relapse free survival 64% vs 51%, major relapse free 90% vs 79%. If MPO+ relapse free survival 92% vs 50%. Abstr#0854 #ACR23 @RheumNow https://t.co/76hlYRxWhY https://t.co/RSsgxxQKVC
Richard Conway ( View Tweet)
Clinical pearls in #CNS vasculitis: Dr. R.Hajj-Ali
🧠Clinical dx is difficult bec it presents w/ an array of clinical features
🧠CSF analysis essential in dx; can r/o infexns
🧠Nonvasc imaging highly sensitive
🧠biopsy is valuable esp when alt dx is considered
#ACR23 @RheumNow https://t.co/QOAfSHn8ND
sheila ( View Tweet)
Risk factor for 1st Thrombosis in OB APS
Ab#0115 #ACR23 @RheumNow
186 OAPS pts, followed mean 5.4 yrs. 11 thrombotic events
Risk factors: Triple pos APS Abs (OR 11.6), hypocomplementemia (OR 9)
Low dose Aspirin (OR 0.14), HCQ (OR 0.11) reduced thrombosis
#ACRBest https://t.co/y4KaEAZzA7
Eric Dein ( View Tweet)
Important plenary re:reduced vs standard GC for AAV... IRL
PEXIVAS & recent guidelines supported low dose taper
Real world data w/severe dx? Increased risk of death & ESKD for REDUCED pts
Need full data but yikes...
@RheumNow #ACR23 #ACRBest https://t.co/3S23O9d1ok
Mike Putman EBRheum ( View Tweet)
Abst#0725 #ACR23 @RheumNow
PEXIVAS Real life data!
GPA & MPA pts - Retrosp observ study
⭐️Reduced-dose GC regimen ass w/ INCREASED risk of death, ESKD, progression
Greatest risk: pt w Cr levels >300 umol/L, RTX induction Rx
⚠️Caution w/ reduced GC, RTX, severe kidney dis
#ACRBest https://t.co/7qI5c1ZiqO
Eric Dein ( View Tweet)
Interesting study on PEXIVAS reduced steroid use from today's plenary session!
Reduced steroid dose in GPA/MPA pts associated w/
INCREASED risk of death, ESKD, progression of dz
Even greater risk in pts with higher Cr lvls or RTX induction use
@RheumNow #ACR23 Abs#0725 #ACRbest https://t.co/frsOrANKhf
Robert B Chao, MD ( View Tweet)
Real world data on low dose PEXIVAS steroid by Nagle et al. Increased risk of progression/relapse/death/ESKD in those with severe GPA/MPA HR 1.72. More marked in those with creat>300 or with RTX induction Abstr#0725 #ACR23 @RheumNow https://t.co/vTXVZfjbXx https://t.co/4FuMjxOuyB
Richard Conway ( View Tweet)
Ph 3 360 pt RCT of sarilumab in #GCA was terminated early (COVID). 83 pts Rx'd, only 35%(29) completed. Sustained remission @wk 52:
- SAR 200: 6/13
- SAR 150: 3/7
- PBO: 0/6
All had 26wk GC taper
Sm sample size & COVID ruined RCT interpretation https://t.co/axOvJGpUti #PMR https://t.co/Xpabxn1IjZ
Dr. John Cush RheumNow ( View Tweet)
Universal Imaging for GCA in #PMR? Not So Fast
https://t.co/p581kXSzAb https://t.co/UIQjCxAzym
Dr. John Cush RheumNow ( View Tweet)
Tocilizumab Use in #GCA. In 10 yrs, 114 GCA pts started on TCZ after mean 4.5 mos & Rx for 2.3 yrs. GCA Relapse rates:
- before TCZ 0.84/PY
- on TCZ 0.28/PY (P<0.001)
- post TCZ D/C 0.64/PY
52 pts D/C TCZ after 16.8 mos & 27 (52%) relapsed after 8.4 mo https://t.co/D3INiMdC4U https://t.co/aD2rijR6xd
Dr. John Cush RheumNow ( View Tweet)
#PMR: Is There Hidden GCA?
Dr. Anisha Dua, asks the question: in PMR should you worry about occult GCA?
https://t.co/Cd6u2GwJuo
@anisha_dua https://t.co/dWUH4zudPc
Links:
Dr. John Cush RheumNow ( View Tweet)
Subclinical GCA prevalence in newly Dx #PMR ranges from 23 to 29%; best by Vessel imaging or temporal artery Bx. #PMR & GCA share common genetic/pathogenic inflammatory mechanisms & an IL-6 signature; BUT there are differences; further research needed! https://t.co/MhuIs068NG https://t.co/1BeeP3RY0H
Dr. John Cush RheumNow ( View Tweet)
GCA pts w/ prior #PMR Dx had 2 fold more Lg vessel dz & signif more vasculitic stenoses. Study of 311 GCA pts, 16% had prior PMR ~ 31 mos before. prior PMR had more LVV (51 vs 25%) & stenosis(18 vs 3%). Prior PMR incr LVV (OR 7.65) https://t.co/1kqtkPnPaz https://t.co/oVs084NfmV
Dr. John Cush RheumNow ( View Tweet)
