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Tired of getting referrals for symptomatic patients with 1/80+ ANAs antibodies?
This new risk model for systemic AID is very welcome!
Variables: age, female, higher ANA titer, higher platelet count, disease-specific autoantibody & billing code count.
#ACR23 @Rheumnow ABST0131 https://t.co/q8rYjjtZ89
Aurelie Najm ( View Tweet)
Year in Review: Dr. P Seo
Dr. Seo gave a moment of silence to Baricitinib use in SLE given studies showing it is not efficacious for SLE
#ACR23 @RheumNow https://t.co/8GKUlfJdbe
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Year in Review: Dr. P Seo
Novel PsA therapy on the horizon:
⭐️Bimekizumab
➡️ Anti-IL17A, ANti-IL17F ab
🚩BE COMPLETE
➡️ TNFi failures
➡️Phase III, 400 pts, bimekizumab, PBO
➡️ Wk 16: improvements in joint and skin
#ACR23 @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Year in Review: Dr. P Seo
Novel PsA therapy on the horizon:
⭐️Bimekizumab
➡️ Anti-IL17A, ANti-IL17F ab
🚩BE OPTIMAL
➡️ tx-naive
➡️Phase III, 852 pts, bimekizumab, PBO, ADA
➡️ Wk 16: same as ADA for joints, BETTER FOR SKIN
#ACR23 @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Year in Review: Dr. P Seo
Novel PsA therapy on the horizon:
⭐️Brepocitinib
➡️ Tyk-2 inhibitor: IL12/23 & type I IFN
➡️ Phase Ib, 218 pts, 8% TNFi failure
➡️ 71% on concurrent MTX
➡️ Wk 16: ACR 50/70 & PASI75/90 improved, maintained through week 52
#ACR23 @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
These US Medicare data show us what we've all suspected:
PMR patients stuck on steroid get the fractures, heart attacks, & infections that land them in hospital.
And it costs $$$
Hopefully PMR steroid-sparing Rx can change this!
@RADoctor @SattuiSEMD #ACR23 ABST0718 @RheumNow https://t.co/XAWmf2qZAU
David Liew drdavidliew ( View Tweet)
Year in Review: Dr. P Seo
Novel RA therapy on the horizon:
⭐️ABBV-3373
➡️ Adalimumab (ADA) + GC receptor modulator vs ADA
➡️ Phase II, 48 pts, previously failed MTX
➡️ Wk 12: better DAS28-CRP, ACR20/70
🚩71% of responders stayed in remission after switch to PBO
#ACR23 @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Difficult to treat RA is not an homogeneous group!
Trajectory analysis 60months shows 4 different clusters
Cluster 2 = 1/3 of patients, do better but never reach LDA.
The ones Fibromyalgia, OA and other conditions blurring assessment?
#Abstract0382 #ACR23 @RheumNow https://t.co/dxxS7vCcMt
Aurelie Najm ( View Tweet)
Dr. Arbeeva explains how a "modern diet" can lead to MetS, intestinal dysbiosis & obesity - risk factors assoc w/ development of #osteoarthritis
Modern diet:
⬆️calorie processed food
⬇️proportion of fruits & veggies
⬆️ratio of omega-6 FA:omega-3FA
#ACR23 @rheumnow @rheumarhyme https://t.co/biVSE103S0
sheila ( View Tweet)
Year in Review: Dr. P Seo
⭐️Low dose colchicine assoc w/ ⬇️ incidence of hip/knee replacement
➡️ 5522 pts w/ stable CAD: colchicine 0.5 mg vs PBO for median of 28.6 months
➡️ Hip/knee: 2.5% vs 3.5%
➡️HR 0.69
Similar finding in 2020 CANTOS trial using Ilaris
#ACR23 @RheumNow https://t.co/PD26zoolDB
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Calling #rheumtwitter program directors! #ACR23 Plenary 0726 details considerations for developing MSUS curriculum from Canadian experts. Details below. https://t.co/VmbxkYwlcr @rheumnow https://t.co/5nrpDk0Dsc
Dr. Rachel Tate ( View Tweet)
Thinking beyond immunosuppression for SLE Nephritis management:
SGLT-2i
GLP-1RA
ERAs
@RheumNow #ACR23 https://t.co/RdmKnm08YY
Robert B Chao, MD ( View Tweet)
Love teaching about the PsA-AxSpa-IBD venn diagram of disease manifestations
Interesting idea, using fecal calprotectin to trigger colonoscopy in pts w/PsA/axSpA
~40% w/pathologic finding, 4.4% dx w/IBD
Jives w/my clinical experience
@RheumNow #ACR23 Abstr0495 #ACRBest https://t.co/rIQpJnup9v
Mike Putman EBRheum ( View Tweet)
Year in Review: Dr. P Seo
Novel RA therapy on the horizon:
⭐️Peresolimab
➡️ stimulates PD1
➡️ Phase II, 98 pts
➡️ tx-resistant to other therapies including biologics
➡️ Wk 12: better DAS28, ACR20, not ACR 50/70
#ACR23 @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
A possible curative therapy of an autoimmune disease via selective depletion of a TRBV-defined group of T cells. This could be potentially applicable to other HLA-B*27-associated spondyloarthropathies. Year in review, Seo #ACR23 @RheumNow https://t.co/NxxkpJhweH. https://t.co/41Po5CHid3
Dr. Antoni Chan ( View Tweet)
YR in Review: Dr. Seo
🚩GLORIA Trial
RA pts > 65yo: prednisolone 5 mg/d x 2 yrs vs PBO + std care
➡️decr dz activity (DAS ⬇️0.37) but 24% incr ADE
🚩Extension:
➡️Tapered off pred over 3m and..
⭐️NO ADRENAL INSUFF
But, small incr in dz activity (DAS ⬆️0.23)
#ACR23 @RheumNow https://t.co/YQbS6C8ZT5
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
#ACR23 Memorable Quote as reminded to us by Dr. P Seo during Year in Review:
"What you think of as a rare manifestation of a common disease is probably a common presentation of a disease you are not aware of (yet)!"
- Prof Seza Zen, MD
@RheumNow https://t.co/Xhwb1brLKG
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Yet another (mostly) reassuring report about lymphoma and DMARDS
The skin cancer signal in the CIRT trial was weird; would be worth looking into that in observational studies as well @NamrataRheum
#ACR23 Abst0438 @RheumNow https://t.co/Beg8UUe2mn
Mike Putman EBRheum ( View Tweet)
It seems so simple. We should be able to use proteomics to better pick winners when it comes to b/tsDMARDs in RA.
Why is it hard? I guess:
- theory ≠ practice
- too many other factors
- it's too easy not to
Yet I hope/believe, one day we'll do better.
#ACR23 ABST0427 @RheumNow https://t.co/5VBVp3KOJN
David Liew drdavidliew ( View Tweet)
If you're >65 years old & have new RA, you start a DMARD, right? At worst, sometime in the first year?
US Medicare data 2008-17
n=33,373
only 30% have a DMARD on file
(of which bDMARD <10%)
>5% on PNL alone
Do we hate old people with RA?😔
@JihaRheum #ACR23 ABST0433 @RheumNow https://t.co/1CUXAh3fi0
David Liew drdavidliew ( View Tweet)