All News
Why is there female predominance in #SLE - the extra X chromosome in females (XX) may not be inactivated properly- usually maintained by the long non-coding RNA #Xist
#ACR24 abst#2599 @RheumNow https://t.co/C9Qj5zSnpN
Bella Mehta bella_mehta ( View Tweet)
Updated ACR guidelines on management of lupus nephritis (LN). Consider early biopsy. Focus on triple therapy in LN. From the panel discussion, Tacrolimus can be an alternative to CNI (Voclosporin) where there is no access to this. Manage comorbidities such as CV risk, bone… https://t.co/4R02YnRXDP https://t.co/3J7YcF5ucQ
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Galloway et al. 117,050 individuals. VTE risk in RA consistently increased, irrespective of age, sex, BMI. Risk VTE 46% higher in RA! @RheumNow #ACR24 Abstr#1901 https://t.co/SQPcPiBeF2 https://t.co/BQkERUsGlL
Links:
Richard Conway RichardPAConway ( View Tweet)
Abstract 1842: Off the shelf CAR T therapy
No lymphodepletion needed, delivering robust, targeted CD19+ B cell elimination in multiple in vitro assays
@RheumNow #ACR24
Akhil Sood MD AkhilSoodMD ( View Tweet)
Do pts w autoimmune disease (AID) respond differently to immune checkpoint inhibitors (ICI) & have different mortality or iRAE risk vs pts without AID?
Study of pts on ICI showed no significant difference in mortality in pts w & without pre-existing AID
Ab2532 #ACR24 @RheumNow https://t.co/suywDdGIB1
Mrinalini Dey DrMiniDey ( View Tweet)
Applying the guidelines to Cases- Dr M Dall’Era for a pt wit extrarenal lupus and active LN. #ACR24 @rheumnow https://t.co/lvOUWjEdEz
Links:
TheDaoIndex KDAO2011 ( View Tweet)
Non-pharm tx in TAK - not something we always think about but…
Impressive effect of resistance exercise!!
Not just in symptoms but also inflammatory markers
Per Dr. Springer - even a stress ball could be enough for UE vascular health in these pt
@RheumNow #ACR24 https://t.co/3O46gobbMX
Links:
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
The updated 2024 ACR Guideline for Dx and Tx of #lupus nephritis is here!
Dr. Lisa Samaritano discusses the key recommendations 👇
For all pts: screen for LN, give HCQ and RAAS for pts with ⬆️ proteinuria
GCs in pts w/ LN class III/IV &/or V.
@Rheumnow #ACR24 @rheumarhyme https://t.co/wLVRGktR59
Links:
sheila RHEUMarampa ( View Tweet)
The overview for #lupus nephritis tx.
Triple therapy is preferred as first line due to:
1. RCTs (BLISS-LN & AURORA 1) showing improved outcomes w/ triple txs
2. Nephron loss happens with ongoing LN - time is kidney!
@RheumNow #ACR24 https://t.co/IQo3q3O1pt
Links:
sheila RHEUMarampa ( View Tweet)
Overall very reasonable, aligning ACR recs w/other guidance groups & updated data
Remember: guidelines are meant to be broken. Some patients can likely avoid pulse, others may need more steroid on the back end, biopsies are not benign
#ACR24 @RheumNow
Mike Putman EBRheum ( View Tweet)
Recommend "Triple Therapy" = Glucocorticoids + two other agents
Practically, that means MMF + belimumumab OR CNI for most pts
For the CYC afficionados, the lower-dose EUROLUPUS protocol is preferred
#ACR24 @RheumNow https://t.co/0gRISXSw0c
Mike Putman EBRheum ( View Tweet)
Happening now, new guidelines for mgmt. A few highlights:
Recommend prompt GC therapy, pulse x1-3d followed by oral pred (<0.5mg/kg/d) w/taper to <5mg by 6 months
Aligns with EULAR recs for a much-lower dose than most clinicians currently doing
#ACR24 @RheumNow https://t.co/B71i7FBYlQ
Mike Putman EBRheum ( View Tweet)
Applying the #ACR24 #LupusNephritis: Case 2 by Dr M Dall’Era @RheumNow https://t.co/A7i103uHZT
Links:
TheDaoIndex KDAO2011 ( 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
Mike Putman EBRheum ( View Tweet)
Abstract 2503: Clofutriben (HSD-1 inhibitor) minimizes adrenal suppression. Adding clofutriben to prednisolone boosts ACTH & cortisol levels with fewer patients with suppressed morning cortisol (≤5.0 mg/dL) (34% vs 14%).
@RheumNow #ACR24 #GCTox
Akhil Sood MD AkhilSoodMD ( View Tweet)
Biosimilar switching in practice
Hyrich: UK experience
Switching to biosimilar has no immediate benefit to patients but saves NHS money
Allows for gain share that can be re-invested in pt care
Transparency in switching in explaining to pts and offering resource
@RheumNow #ACR24
Eric Dein ericdeinmd ( 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
Akhil Sood MD AkhilSoodMD ( View Tweet)
Low uveitis rates in patients with axial spondyloarthritis and psoriatic arthritis treated with bimekizumab (BKZ) over the long term.
Key findings:
- AxSpA: 3.7% incidence (1.3/100 PY) with BKZ.
- PsA: Only 0.2% incidence (0.1/100 PY).
- All events were mild/moderate, with no… https://t.co/jkUwHJk3FJ https://t.co/gTcCzeC88e
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
If you’re starting with DMARD (according to ACR/VF guidelines) tx in TAK - MTX and AZA are probably equivalent options… MMF not so much
@RheumNow #ACR24 https://t.co/jn52ujtspo
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Hyrich:
ETN originator vs biosimilar initiation
- DAS28 - no signif change at B/L, 6mo, 12 mo.
Switch?
Matched pts in ETN switch v cont originator - good b/l control on Rx
-DAS28 maintained w switch
10% did go back to originator, felt less good tho similar DAS
#ACR24 @RheumNow https://t.co/RHRit5CtUu
Links:
Eric Dein ericdeinmd ( View Tweet)