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kidneys

Beyond the Needle: Redefining the Assessment of Lupus Nephritis

Akhil Sood, MD

Lupus nephritis is one of the most silent and severe manifestations of SLE. When not captured early, patients are at high risk of progressing to end-stage renal disease, which would require dialysis or transplantation. Renal biopsy remains the gold standard for diagnosis and disease classification. However, the procedure is invasive and very painful. Non-invasive measures are critical for early detection and continuous monitoring.

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Meeting audience conference

ACR 2024 - Day 1 Report

Jack Cush, MD

ACR Convergence 2024 opened today with a full slate of presentations, posters and specialty meetings.  The meeting began with a flip: the plenary sessions started at 9AM and the poster session began at 1030 AM. Below are some of the highlights from day one in Washington, DC.

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pregnant, pregnancy, mother, fertility

Is Pregnancy Truly the Solution for RA?

Eric Dein, MD

Pregnancy is perhaps the oldest treatment in rheumatoid arthritis (RA) and has been associated with a natural improvement in disease control in 50-75% of patients. Others, however, are not as successful with unchanged disease activity or worsening of their autoimmune disease.

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#1326 🔬 Predicting Imminent Inflammatory Arthritis ➡️543 anti-CCP+ at-risk (high/low) tracked 🔑Predictors for IA in high-risk: 🔴EMS≥30min(OR 11) 🔴RF+(OR 6) 🔴US PD(OR 5) 🔴smJTC (OR 5) 🔑Predictors for IA in low risk: 🔴RF+(OR 8) 🔴Anti CCP >3xULN(OR 7) #ACR24 @RheumNow https://t.co/ou9HNcNb8X

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Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Harkins @DrTrishHarkins et al. Novel diagnostic cytokines in treatment naive PMR. Elevations CXCL-9 (100%), MCP-1 (93%), IL-17A (83%), vs TNF (7%) and IL-6 (67%) @RheumNow #ACR24 Abstr#0881 https://t.co/DbYOn81QJH https://t.co/3eyre00D5d

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Richard Conway RichardPAConway ( View Tweet)
The future use of a panel of immunological urinary biomarkers as a liquid biopsy for the management of lupus nephritis. Plenary Abstr#1642 @RheumNow #ACR24 https://t.co/waSRVd7FV7

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Dr @andreafava presents their noninvasive biomarker panel that predicted the probability of histologically active LN. Panel outperformed UPCR, C3, C4 & antidsDNA. Aid in clinical-decision making? Lots of potential for monitoring tx response. @Rheumnow #ACR24 abs1642 #ACRbest https://t.co/C7ZNdvbIQ7

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sheila RHEUMarampa ( View Tweet)

Impressive Plenary @andreafava just finished Novel urine protein panel id 12 proteins that predict NIH activity on renal bx better than existing options Improving at 3 mos predicts response at 1 year Could reduce biopsies / modulate tx! #ACR24 @RheumNow Abstr#1642 #ACRbest https://t.co/Gi6u6hAGzj

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Mike Putman EBRheum ( View Tweet)
A study presents a novel urinary biomarker panel that predicts histologically active lupus nephritis (LN) with high accuracy. Key findings: - AUC of 90% for predicting NIH Activity Index > 2, outperforming traditional biomarkers. - Identified 12 critical proteins linked to… https://t.co/6ZhqNaxpQM

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)

🫁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

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Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
This is very true. We showed a number of years ago that patients with gout have increased platelet activation at baseline, which then dramatically increases during flare. Treating gout properly may ameliorate this. #ACR24 @RheumNow https://t.co/VL8fy3ezjx https://t.co/9XdrG1NG9c

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Richard Conway RichardPAConway ( View Tweet)

171 SSc pts w/ hand Xrays and US found 20% w/ Joint involvement. Active Synovitis & tenosynovitis predicted by CRP>10mg/L (p = 0.013), fibrotic tenosynovitis on US (p = 0.005), anti-RNA polymerase III antibodies (p = 0.043) https://t.co/DZrM5aQpJ7 https://t.co/CkGP6H8J6x

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Dr. John Cush RheumNow ( View Tweet)
Is it pre-eclampsia or lupus nephritis flare? Abstract 0809: The sFlt-1/PlGF ratio may help distinguish preeclampsia from lupus nephritis in pregnancy. A low ratio ruled out preeclampsia, while a high ratio ± proteinuria suggests increased risk. @RheumNow #ACR24

Akhil Sood MD AkhilSoodMD ( View Tweet)

Not just the presence but higher levels of biomarkers predict RA-ILD progression. #ACR24 @RheumNow ABST#0804 https://t.co/5jhBjXDUeY

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Jiha Lee JihaRheum ( View Tweet)
High serum BAFF as a novel RF for dev't of preeclampsia in pregnant SLE pts? This study by Dr. C Sims et al showed that SLE pregnancies w/preeclampsia had significantly higher BAFF levels during the 1st trimester, and likely w/ ⬆️dsDNA or ⬇️ complement @RheumNow #ACR24 abs424 https://t.co/kNzyuT03r2

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sheila RHEUMarampa ( View Tweet)
FDA recently approved - fms-like tyrosine kinase 1 (s-Flt1) / placental growth factor (PlGF), for diagnosing preeclampsia. sFlt1:PlGF≤38 rules out preeclampsia in SLE sFlt1:PlGF>85 modestly predicts preeclampsia Proteinuria impacts prediction accuracy #ACR24 abst#0809 @RheumNow

Bella Mehta bella_mehta ( 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

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Mrinalini Dey DrMiniDey ( View Tweet)
Puechal et al. Serial ANCA testing may predict relapse in a large group of AAV patients but is NOT useful for individual patients. @RheumNow #ACR24 Abstr#0721 https://t.co/ClvTk2Tlar https://t.co/k4vc7l9jzK

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Richard Conway RichardPAConway ( View Tweet)
Prevalence of HLH among pts w/SLE: lower than consults would suggest! Observational study using NIS: 139 cases out of >100k pts w/SLE (0.13%); 6 fold increase in mortality Fits my priors; HLH is overdiagnosed, but bad when it happens @RheumNow #ACR24 Abstr#0619 https://t.co/iz3BlUOJb9

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Mike Putman EBRheum ( View Tweet)
Harkins @DrTrishHarkins et al. Serum disease activity markers in PMR. ROC analysis for active vs remission - fibrinogen (1.000), ESR (0.986), Haptoglobin (0.976), CRP (0.986), ALP (0.854). @RheumNow #ACR24 Abstr#0741 https://t.co/f8cX68Ov9Y https://t.co/zp5c7aQwxr

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Richard Conway RichardPAConway ( View Tweet)
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