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Day 2 Report - ACR Plenaries: Changing the Practice of Rheumatology

Kathryn H. Dao, M.D. Nov 14, 2023

Over the years of navigating the annual meeting, I found the sessions with the most impact to my practice were the Plenary Sessions. During these sessions, the latest research is presented, new ideas are floated, and old myths debunked. Here are the top ACR2023 Plenary abstracts I found impactful for my practice.

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#ACRbest Abstracts – Day 2

Jack Cush, MD Nov 13, 2023

Our reporters have been prolific in finding the hot abstracts, those that were most attended or those that are getting the most buzz on social media. Here are RheumNow's #ACRbest abstract reports from Monday, November 13, 2023 at #ACR23, covering The Great Debate, SGLPT2 inhibitors in SLE, the SMART Study of MTX, TMP/SMX Prophylaxis, RA-ILD & TNF Inhibitors, cancer research and more.

Kaymakci et al. 49 GCA patients in clinical remission undergoing thoracic aortic surgery. Active aortitis in 82%. Abstr#2557 #ACR23 @RheumNow https://t.co/WQh47LThGD https://t.co/DeORKmjYP7

Pregnancies outcomes in vasculitis: - Higher frequency of spontaneous abortion and preterm delivery - 12% had pre-eclampsia - Risk higher in multiparous > nalliparous - Risk highest in small vessel vasculitis Rector A, Abst#2425 #ACR23 #ACRBest @RheumNow https://t.co/TgbRWw9il5

MANDARA -52wk,ph3 non-inferiority study comparing efficacy & safety of benralizumab & mepolizumab in EGPA receiving SOC 👉Benralizumab was non-inferior to mepolizumab in achieving remission at wks 36 & 48 (2.71%; 95% CI –12.54, 17.96; p=0.7278) #ACR ABSTL14 @RheumNow #ACRbest https://t.co/S3aa3g5mnN

Vasculitis patients associated with increased pregnancy risks Large study of >600 pregnancies in >500 pts Vasculitis pts higher frequency of spontaneous abortion, elective termination, ectopic and molar pregnancy, preterm delivery 12% pre-eclampsia @RheumNow #ACR23 Abs#2425 https://t.co/Nqa77nxSFu

Pregnancy outcome in Vasculitis - Claim database study A#2425 #ACR23 @RheumNow 665 vasculitis pts, LVV 60, MV 160, SVV 217, variable 250 Incr risk of preterm delivery, particularly medically-ind deliv, esp Small vessel vasc (5x risk med-induced) Higer risk pre-eclampsia/eclampsia https://t.co/bWMyY5oqNK

Important data re:ADVOCATE study and health related quality of life Interesting question: is this due to AVA or just simply giving less steroids? I discuss this on recent podcast: https://t.co/7Jm6ArFpsB @RheumNow #ACR23 https://t.co/53T1p2Vvyb

MANDARA: Benralizumab v Mepolizumab in EGPA A#L14 #ACR23 @RheumNow P3, 52w RCT, 140 pts Remission rate: 59% Ben, 56.5% Mep Relapse rate 30% in both 86% Ben, 74% Mep had reduction of GC dose 50%+, 41% v 26% tapered off SAEs: 6% Ben, 13% Mep Concl: Non-inferiority of Ben v Mep https://t.co/mSIFsDq8eL

MANDARA phase 3 RCT Benralizumab vs Mepolizumab in relapsing/refractory EGPA receiving SOC. Non-inferiority met. Abstr#L14 #ACR23 @RheumNow https://t.co/UnpF3RDHMa https://t.co/076SeynJx3

Dx: Necrotizing Sarcoid Granulomatosis (NSG) ➡️rare dz entitiy ➡️common features: cough, F, dyspnea, CP, or wt loss ➡️Bx can be necrot or non-necrot granulmoas ➡️Ddx: TB, GPA #ACR23 @RheumNow https://t.co/zBGVriB8ka

#irAE Baseline immune suppression does NOT protect against worsening synovitis flares when using check point inhibitors in Pts with established #inflammatory #arthritis #ACRbest #ACR23 @ACRheum @RheumNow abst1075 Data from #CanRIO database https://t.co/lOCf8Tbgta

1-PJP prophylaxis or not in ANCA? 2-MTX single dose or split dose? 3-IL6 blocker early on in GCA/PMR? 4-SGLT2 in DM/Lupus nephritis? 5-Cervical cancer screening in Lupus? 6-TNF induced ILD? https://t.co/mzGXajmQqE @RheumNow , Daily recap #ACR23

Abst #1584 TMP-SMX⬇️PJP ⬇️SIE,⬇️outpt infx in GPA on RTX. 919 patients: 31% had TMP-SMX, 40% on pred >20 mg/day followed median 496 days. SIE (aHR 0.5, 95%CI 0.3-0.8), outpt infx (aHR 0.7, 95%CI 0.5-0.9), & PJP. Thirteen PJP (all not on TMP-SMX). #ACRbest #ACR23 @rheumnow

Trimethoprim sulfamethoxazole (TMP-SMX) negatively associated with serious infections. Rates for adverse events possibly attributable to TMP-SMX per 100 person-years were 29.6 during and 13.4 post exposure. Mendel A, Abst#1584 #ACR23 #ACRBest @RheumNow https://t.co/hHY2bZXrkS https://t.co/2YMoCi1zrx

Vasculitis in SLE A#1443 @RheumNow #ACR23 804 SLE pts, 74% black, 9.5% h/o vasculitis 45% visceral vasculitis, 43% cutanous, 8% both Pts w vasculitis: younger age of SLE dx- 27 v 31y Risks: other SARD, renal dx, neuro dx, low compl Trend to higher mortality 21 to 14% (no signif)

Ultrasound (and specifically intima-media thickness) might not just be for diagnosis in GCA - it might be a GCA disease activity measure for monitoring: - improves over time - increases with flares Valentin Schaefer #ACR23 ABST1649 @RheumNow https://t.co/QWdIVGrHbn

Ross et al. Ultrasound assessed Optic nerve sheath measurement in GCA. Previously shown increased in GCA. Here decreases with treatment shown in 9 patients Abstr#1650 #ACR23 @RheumNow https://t.co/fcrS4tT6U0 https://t.co/ylnPKzdUe0

FDG-PET uptake at baseline in GCA predicts future risk of future thoracic aneurysm In print here: https://t.co/2SQm18y6zP Could this help stratify aneurysmal screening? #ACR23 ABST1647 @RheumNow https://t.co/p1Dhkm2WTX

Association Between Vascular 18F-Fluorodeoxyglucose Uptake at Diagnosis and Cha…

Wolfgang Schmidt presenting @eular_org large vessel vasculitis imaging recommendations at #ACR23, acknowledging @ACRheum on the way. Great to see a master (& a new ACR Master) navigate with clarity, uniting different sides of the Atlantic. @RheumNow https://t.co/hyAcX8GSWf

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Day 2 Report - ACR Plenaries: Changing the Practice of Rheumatology

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