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Are Emulation Trials a Fantasy?
Are emulation ‘trials’ helpful, despite the biases that occur with observational data, or do they truly mimic the results of randomized controlled trials (RCTs)?
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🫁RP-ILD a/w high morbidity and mortality
How to Predict RP-ILD Development?
➡️AutoAb: anti-MDA5, anti-ARS, anti-Ro52
➡️Biomarkers: CRP, LD, Ferritin, KL-6
➡️CT: Lower consolidation/GGO
#ACR24 @RheumNow https://t.co/OIrHfVTZcM
Links:
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Abstract 333 showed that in a cohort of patients with IIM-ILD increased age, PH, FVC decline at 1 yr, SOB at 2 years were predictors for mortality and lung transplant ! #ACR24 @RheumNow https://t.co/NgOj7WKeE3
Gabriela Martinez Zayas, MD MartinezZayasMd ( View Tweet)
How does #cardiovascular risk vary with #ACPA & #biologics in #RA?
⬆️BMI assoc with ⬆️MACE risk in ACPA+ pts
In ACPA- pts, BMI inversely assoc with MACE risk among pts on biologics
Further evidence to consider ACPA, BMI & MACE as part of RA management
Ab0870 #ACR24 @RheumNow https://t.co/UkkC146DWS
Mrinalini Dey DrMiniDey ( View Tweet)
Cross-sectional study finds metabolic dysregulation in RA-ILD is indicative of poor prognosis- FGF-21 assoc w. poor survival.
Another link btwn CV risk factors, metabolic syndrome & RA? Should we be doing more to manage metabolic risk factors in RA-ILD?
Ab0803 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
Don’t miss the “window of opportunity” for aggressive treatment in early RA!
with active RA, risk of ILD 6x and RA-related lung disease 4x higher
#ACR24 @RheumNow ABST#0802 https://t.co/yxlfInte6A
Jiha Lee JihaRheum ( View Tweet)
How often should #scleroderma #ILD pts have #PFTs? 🤷♂️
Data from SENCIS RCT of SSc-ILD
25% worsened FVC by 6/12
Are we UNDER a ordering PFTs in an ILD #SSc population
👇
Because if worsening we would consider a change in background #immunesuppression
@RheumNow #ACR24 #678 https://t.co/a9ybO3FwDd
Janet Pope Janetbirdope ( View Tweet)
Results from MANDARA- #EGPA pts treated with benralizumab or mepolizumab
Eosinophil-targeting biologics rapidly control airway- & non-airway-related manifestations
Few pts had worsening of disease that progressed to organ damage over 52W
Ab0828 #ACR24 @RheumNow https://t.co/hIn9iyNVWQ
Mrinalini Dey DrMiniDey ( View Tweet)
What's the assoc between RA disease activity & ILD?
Results @MassGenBrigham show early active RA is assoc with
➡️6x incr risk of #ILD
➡️4x incr risk of RA-related lung disease
Early DMARDs are vital to reduce articular & extra-articular manifestations!
Ab0802 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
McDermott @jeffsparks et al. SAIL-RA prospective study. 172 early RA patients. RA lund disease in 16%, RA-ILD in 11%. Disease activity strongest predictor RA lung disease, HR 4.89, and RA-ILD, HR 6.17. @RheumNow #ACR24 Abstr#0802 #ACRbest https://t.co/ia0koG64mL https://t.co/U1KdgcUfOy
Links:
Richard Conway RichardPAConway ( View Tweet)
This interesting systematic review showed that the prevalence of ILD was 15% in patients with SLE. This higher than previously reported! #ACR24 @RheumNow https://t.co/O1aZUUL4Ho
Gabriela Martinez Zayas, MD MartinezZayasMd ( View Tweet)
Can we predict who will develop #RA-#ILD?
Wheeler et al showed a combination of genetic risk score, peripheral protein #biomarkers & clinical risk factors can help identify RA-ILD in RA patients.
Does this bring us closer to #PersonalisedMedicine?
Ab0799 #ACR24 @RheumNow https://t.co/JZkJNGmLM1
Mrinalini Dey DrMiniDey ( View Tweet)
Data from the French DESIR cohort reveals no significant link between high-dose NSAID use and incident hypertension in patients with axial spondyloarthritis. Two thirds were high dose NSAID users at baseline. Incident hypertension occurred in 11% individuals during follow-up.… https://t.co/EAICDwzxNT
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Serrano-Combarro et al. Abatacept in RA-ILD. 343 patients. In 23.3% ILD progressed on abatacept. Is that good or bad? We need comparative studies! @RheumNow #ACR24 Abstr#0475 https://t.co/nUEDdjGguA https://t.co/sXEF72MafK
Links:
Richard Conway RichardPAConway ( View Tweet)
Cardiology 🤝 Rheumatology
#Abstract0611 highlights Subclinical atherosclerosis (carotid plaque > 1.5 mm) associated with ↑ risk of CV events in SLE longitudinal cohort
@RheumNow #ACR24 https://t.co/jLLYNOfFZ2
Akhil Sood MD AkhilSoodMD ( View Tweet)
#0477 🌍 Global prevalence of RA-ILD
➡️21.38% (95% CI 0.15 - 0.29),33 studies, n=14,281
🔬 Higher RA-ILD risk in smokers, low-income regions, DMARD use.
⛔️Wide CI = heterogeneity main limitation
💡 Screening & lifestyle changes key for high-risk groups.
#ACR24 @RheumNow
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
CKD keeps a persistent low grade inflammatory state! Implications: CKD ⬆️risk for CV dz through different mech @RheumNow #ACR24 https://t.co/KcCvyTVaav
TheDaoIndex KDAO2011 ( View Tweet)
Différent patterns of organ involvement in sarcoidosis @RheumNow #ACR24 #Sarcoidosis https://t.co/xigkS3vpUh
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Where do SGLT2i have proven benefits for CVD?
👉 Diabetes w/high CV risk
👉Heart failure (all EF)
👉CKD
Dr Weber @rheumnow #ACR24 https://t.co/vFYddrLP1Y
TheDaoIndex KDAO2011 ( View Tweet)
SELECT trial noted reduction in CV death, MI and stroke in obese pts without diabetes (other benefits: reduction in waist circumference, BP, lipids) @rheumnow # ACR24 https://t.co/GPK4Vg5bOt
Links:
TheDaoIndex KDAO2011 ( View Tweet)
