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ACR24: Rheumatology Roundup

Jack Cush, MD

Join Drs. Jack Cush and Artie Kavanaugh as they review 15+ presentations and abstracts from the 2024 ACR Convergence meeting in Washington, DC.

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Stills,continuum

​​Standardizing Still’s Disease Research: Global Data Harmonization Needed

Bella Mehta, MBBS, MS

A recent study presented at #ACR24 convergence highlights significant gaps and inconsistencies in the research of systemic juvenile idiopathic arthritis (sJIA) and adult-onset Still’s disease (AOSD).

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ICYMI: Taking AI Out of AutoImmunity: Predicting disease before it develops

Akhil Sood, MD

the predictive value of a positive ANA test—especially in the absence of other clinical symptoms—remains a challenge. A positive test often leads to further testing, yet it does not necessarily indicate whether a patient truly has an underlying autoimmune disease. The development of AI and machine learning algorithms presents an opportunity to interpret autoantibody tests and predict autoimmune diseases. Here are three studies looking at this issue.

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Cognitive Impairment: The Hidden Burden in Lupus Care

Akhil Sood, MD

Suppose you have a patient with lupus returning for follow-up. Their joint symptoms are well controlled. The kidneys—managed with a combination of biologic DMARD and mycophenolate—show no signs of active urinary sediment or protein. Yet, during the routine visit, your patient brings up fatigue and difficulty remembering things. How do you address this? Several studies presented at ACR24 focused on cognitive impairment in lupus.

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A useful urinary biomarker for lupus nephritis Dr. Andrea Fava discusses plenary abstract 1642, presented at #ACR24 https://t.co/5kFXUn3xlF https://t.co/mWTX9SbDGm

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Dr. John Cush RheumNow ( View Tweet)
Is Frequent Lab Monitoring Necessary? Dr. Bella Mehta discusses abstract 2619, Safety Outcomes of Routine Blood Tests for Monitoring of Biologic and Targeted Synthetic Therapies in Inflammatory Arthritis Patients, presented at #ACR24. https://t.co/vwPueeAVhO https://t.co/5wyTahjMAu

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Dr. John Cush RheumNow ( View Tweet)
Beyond the Needle: Redefining the Assessment of Lupus Nephritis Lupus nephritis is one of the most silent and severe manifestations of systemic lupus erythematosus (SLE). https://t.co/JD6z4VTfJn #ACR24 https://t.co/7gEK8acRl0

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Dr. John Cush RheumNow ( View Tweet)
ICYMI: Precision medicine in Ssc ILD? Yes! -Watch and wait approach can cause irreversible lung damage. -⬆️CRP: biomarker of response (predicts mortality) -⬆️KL-6: biomarker of severity (predicts progression of fibrosis) -FAPI-PET: can eval disease activity vs response to ttx.… https://t.co/bTepwrsuNN https://t.co/e6xjtuquka

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Adela Castro AdelaCastro222 ( View Tweet)
Beyond the Needle: Redefining the Assessment of Lupus Nephritis Lupus nephritis is one of the most silent and severe manifestations of systemic lupus erythematosus (SLE). https://t.co/fvGG0BZbOL #ACR24 https://t.co/wPXQz9Vese

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Dr. John Cush RheumNow ( View Tweet)
Finding the Right Combination Therapy in RA Dr. Jonathan Kay interviews Dr. Ernest Choy about abstract 0521, Transcriptome Analysis of Drug Response in a Large Cohort of Immune-Mediated Inflammatory Disease Patients Supports Advanced Combination Therapy in RA, presented at… https://t.co/yPmDIZ6aKI https://t.co/cairKrbDDu
Dr. John Cush RheumNow ( View Tweet)
Prior studies have shown that IFN is increased in non-lesional skin of SLE pts. In this study, they found a ⬆️ expression of IFN stimulated genes (ISGs) in pts w/ a history of CLE. No correlation w/ CLASI act & IFN scores but only few pts. @RheumNow #ACR24 abs2678 https://t.co/cPT6yPkoCb

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sheila RHEUMarampa ( View Tweet)
Data from the RISE registry show that 9.3% of SLE pts had thrombocytopenia and a smaller percentage with mod-severe TP (2.7%). Severe TP was much rare. Large data, but well represented grp? @RheumNow #ACR24 abs2680 https://t.co/Y1Lo9lJGtO

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sheila RHEUMarampa ( View Tweet)
Severe thrombocytopenia (TP) is rare but linked to major organ involvement and poor prognosis in #SLE. Data from the RISE registry shows TP in 9.3% of SLE patients, with higher prevalence in males, African-Americans+ those with multiple comorbidities. #ACR24 @RheumNow abst#2680

Bella Mehta bella_mehta ( View Tweet)

In order to have a #DMOAD in knee #osteoarthritis ➡️ early detection may be v important Study of early pt Symptoms was done 2/3 had pain 1/2 #joint Swelling Need biomarkers & sensitive imaging in early #OA as symptoms are NOT uniform #ACR24 @RheumNow @ACRheum abst2111 https://t.co/K94m9rOjtP

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Janet Pope Janetbirdope ( View Tweet)
Paraoxonase-1: Possible Biomarker for Progression to RA Dr. Jonathan Kay discusses abstract 0464, Increases in Paraoxonase-1 Activity over Time Associates with Reduced Risk of Incident Inflammatory Arthritis in an Anti-Citrullinated Protein Antibody-Positive Population,… https://t.co/yhcCrrvjxH https://t.co/caf5dUvrOQ
Dr. John Cush RheumNow ( View Tweet)
A#2651 Vasculitis w VEXAS 81 men, median age 67 - 27% had evid of vasculitis, variable size vessel 22% SVV- 17/18 cutaneous, one peritubular capillaritis on renal bx 2.5% MVV (2 cutan), LVV (2 carotid thickening, 1 had +TA bx), ANCA+ @RheumNow #ACR24 https://t.co/puablIBLCP

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Eric Dein ericdeinmd ( View Tweet)
Study on #SLE and ESRD using machine learning: Developed model to identify patients with SLE and ESRD Used NIH 'All of Us' dataset XGBoost outperformed Random Forest SDOH data improved model precision #ACR24 @rheumnow #MachineLearning abst#1876 https://t.co/PQ7u4Pj5OH

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Bella Mehta bella_mehta ( View Tweet)
Interesting! Study of pts w/ ANA(-) & dsDNA(+). 1 in 5 dx with APLS! Have others seen that? I have been disgregarding this pattern, though some of that is related to my in-house assay (seems overly-sensitive) & my bias against overdiagnosis #ACR24 @RheumNow Abstr#2391 https://t.co/FWgCjEwPDK

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Mike Putman EBRheum ( View Tweet)
Abstract 1876: Developed a machine learning model w/ #SDoH covariates to accurately identify patients with SLE and ESRD in NIH All of US dataset @RheumNow #ACR24 https://t.co/TLDSiBZZPs

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Akhil Sood MD AkhilSoodMD ( View Tweet)
Provocative study suggests SLE has changed. Big picture: less physical manifestations, more serologic @andreafava why isn't this just more-testing & more-sensitive testing shifting the phenotype of who we diagnose? #ACR24 @RheumNow Abstr#2413 https://t.co/o2e9TFMsUp

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Mike Putman EBRheum ( View Tweet)
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