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Taking AI Out of AutoImmunity: Predicting disease before it develops

d 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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#2259 💊 Anti-Obesity Meds in RA 📊 152 RA patients on semaglutide/tirzepatide 🔑 Findings 💥Significant ⬇️weight, BMI, ESR, CRP, lipids, pain VAS 💥Improved CVD risk ⛔ 15% GI side effects, 27% discontinued 🔎Study of impact on RA outcomes needed #ACR24 @RheumNow #ACRBest https://t.co/6LCTZl5173

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Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
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Mike Putman EBRheum ( View Tweet)
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sheila RHEUMarampa ( View Tweet)
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Brian Jaros, MD Dr_Brian_MD ( View Tweet)
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Akhil Sood MD AkhilSoodMD ( View Tweet)

Study of 25K+ patients using TrinetX on immune checkpoint inhibitors shows no significant mortality difference between those with pre-existing autoimmune disease (AID) and those without. Mortality rates: AID: 39.8% Non-AID: 40.2% Large-scale evidence supports ICIs in AID… https://t.co/BI5jK9jsoM

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)

A#2531 @AlisaMueller CRISPR deletion of fibroblasts, gave cytokine activation to mimic inflamm Are there gene depletions that affect inflamm pathways? 👉SIX1 reduces inflamm potentiation 👉NFIL3 deletion promotes inflamm, degradation @RheumNow #ACR24 https://t.co/Nqghb5UaBR

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Eric Dein ericdeinmd ( View Tweet)
A#2532 Pre-existing AID for immunoRx? Excluded from trials 4 prior studies showed no diff in mortality w AID Propensity-matched cohort study Followed median 250 days Hazard ratio: 1.07 (unmatched), 0.97 (matched) - no diff. Mortality about 40% in grps @RheumNow #ACR24 https://t.co/zyVCPts6s6

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Eric Dein ericdeinmd ( View Tweet)
#ACR24 Guidelines #LupusNephritis for refractory dz @RheumNow https://t.co/LlSixkggKK

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TheDaoIndex KDAO2011 ( View Tweet)
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Patricia Harkins DrTrishHarkins ( View Tweet)
Mental health, sex, and comorbidities are key factors in determining recalcitrant psoriatic arthritis (PsA). Key findings: - 21.7% of patients required ≥4 biologic/targeted synthetic DMARDs. - Female patients and those with depression were more likely to be recalcitrant. - No… https://t.co/I9YYoRnLwh https://t.co/VtnPceVLOZ

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#ACR24 - Featured Industry Presentations Many of the great presentations for this meeting come from industry sponsored clinical trials and reports. Often these become the pivotal studies for regulatory approval and the annual congresses are their first look.… https://t.co/I6LMQ5xMUx https://t.co/UzTeqWUSdo
Dr. John Cush RheumNow ( View Tweet)
The precise mechanism of action of GIOP is not known. Decrease in osteocyte LCN is observed. Abstr#2528 @RheumNow #ACR24 https://t.co/fazUUy03fQ

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
In earlier studies of Vit D, there were conflicting evidence as to whether it reduced or increased the risk of RA and #SLE @RheumNow #ACR24 @rheumarhyme https://t.co/PvjjmhHaOd

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sheila RHEUMarampa ( View Tweet)
A Bayesian Network Meta-analysis Phase II/III/IV, placebo-controlled, randomised clinical trials and long-term extension studies of JAKi and TNFi, in adults with RA, PsO, PsA, axial spondyloarthritis axSpA and IBD showed the following: - TNFi was associated with a significantly… https://t.co/FWHgemEAvG https://t.co/3D0nldwmwA

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Gottenberg et al. A positive RCT in pSS! DAHLIAS study. Phase 2. 163 patients. Nipocalimab, anti-neonatal Fc receptor (FcRn) mAb. @RheumNow #ACR24 Abstr#2527 https://t.co/M7li4ZoKeY https://t.co/gV9MGnswdR

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Richard Conway RichardPAConway ( View Tweet)
Nipocalimab, an anti-neonatal Fc receptor (FcRn) mAb, reduces circulating IgG including specific autoantibodies (AAb), by selectively blocking IgG–FcRn interactions. DAHLIAS, the first study of a FcRn blocker in SjD, showed that nipocalimab led to significant improvement vs PBO… https://t.co/zl1tEsEMAj https://t.co/qrkOD2Ccc3

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)

A#2527 DAHLIAS, P2 Nipocalimab: Anti-FcRn Ab in Ro+ SjD IV 5 or 15 mg/kg Prim Endpt: 15 mg/kg has ClinESSDAI at w24 -6.4 v -3.7 PBO p=0.002 Improv dryness, fatigue, pain Better unstim salivary flow Best response in higher Ab titer pts Safety data good #ACRBest #ACR24 @RheumNow https://t.co/O7zahPul66

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Eric Dein ericdeinmd ( View Tweet)

Phase 2 DAHLIA study in Sjogrens Anti-neonatal Fc receptor an “nipocalimab” w/remarkably encouraging results clinESSDAI significantly better at wk24, notably met QOL domains as well Finally getting good news in SjS! #ACR24 @RheumNow #ACRbest Abst#2527 https://t.co/e3uQmqJZ1o

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Mike Putman EBRheum ( View Tweet)

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