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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
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)
Proof-of-concept study: when PsA pts w/Achilles enthesitis & +US findings underwent pain induction, they showed ⬆️activity in the OBF gyrus, ant cing, left PCG, SMG, STG an left PC lobule vs. US- grp.
PsA pts w/+US process pain differently than US-
#ACR23 ABST1388 @RheumNow https://t.co/ScXA17LHPa
sheila ( View Tweet)
#GreatDebate #ACR23 @RheumNow
Advanced Rx 1st line in PMR/GCA
@philseo
IL-6 research in RA (STREAM, MOBILITY): safety of toci, sarilumab - compares to ADA
Ifn risk driven by GCs
GUSTO: TCZ w/ only 3d GC pulse - 13/18 in remission 24, 52w
PMR: "its not just a little bit of pred" https://t.co/sAlQ0pttcq
Eric Dein ( View Tweet)
@RheumNow https://t.co/WmHt6c12TG
TheDaoIndex KDAO2011 ( View Tweet)