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#ACR 2024 BEST Abstracts from Day 2
Here’s a collection of some of the best abstracts presented on day 2 of ACR 2024 as selected by the RheumNow faculty.
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ACR 2024 - Day 2 Report
Plenary sessions began the day, followed by thousands on the abstract floor. Here are a few of my favorite presentations from day 2 at ACR 2024.
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Systemic polyarteritis nodosa looks creepily/scarily beautiful on PET/CT. Look at that Christmas tree!
but sensitivity can be affected by pred, & isn't great even without (48%).
By itself, a good rule in test, but not a good rule out test.
#ACR24 ABST1962 @MayoClinic @RheumNow https://t.co/y28J6VKja4
David Liew drdavidliew ( View Tweet)
Always looking for cancer/CV signals from JAKi in big observational datasets w extensive JAKi use nationwide 🇯🇵 claims data RA pts n=52k (JAKi n=4.3k) Cancer with JAKi vs TNFi: aHR 2.2 (esp lung, lymphoma) This is a problem. Watch these data. #ACR24 ABST1336 @RheumNow #ACRBest https://t.co/vsnT46De6T
David Liew drdavidliew ( View Tweet)
Can you build systems that stop that ANA neg ENA pos anxiety? Plus $$?
Lehigh Valley, Allentown, PA:
lab would run ENA+dsDNA automatically, but only when ANA >1:80
(i.e. leave the ENA order to the lab)
first voluntary, then compulsory
it's possible!
#ACR24 ABST1931 @RheumNow https://t.co/UQjWwve7DV
David Liew drdavidliew ( View Tweet)
ANA neg, but ENA pos
should we care about that result?
PPV 5.5% here
(similar to 6% prev @EricFMorand: https://t.co/Hyaued3rw2)
and how many really needed the serology? Anxiety?
Surely pos ENA w neg ANA might be more hassle than help. So what to do?⬇️
#ACR24 ABST1930 @RheumNow https://t.co/rE7RmgOGey
Links:
David Liew drdavidliew ( View Tweet)
Fantastic interview from @RheumNow from #ACR24 of @DrTrishHarkins talking to @bososhea from @stjamesdublin @tcddublin @TrinityMed1 about carotid doppler ultrasound screening in AxSpA https://t.co/HN1nA5lNTj
Richard Conway RichardPAConway ( View Tweet)
Should you worry about giving TNFi to RA pts after a cancer diagnosis?
Medicare data with colorectal, lung, prostate Ca:
TNFi pts survival no worse (numerically better) than csDMARDs
Cancer pts deserve good RA treatment!
#ACR24 ABST0202 Suarez-Almazor @MDAndersonNews @RheumNow https://t.co/w58MNqRt1T
David Liew drdavidliew ( View Tweet)
Probably no surprise, but if you can navigate the digital world, it portends work for your rheum disease.
all @MedUni_Wien rheum clinic pts did an eHealth survey
high eHealth literacy did much better
We can't leave digital stragglers behind!
#ACR24 ABST1942 @Stiddyo @RheumNow https://t.co/c9IyPz6ujJ
David Liew drdavidliew ( View Tweet)
Now we have GWAS, we are getting polygenic risk scores for RA, and we can see what disease risks cluster with RA risk.
RA genetic risk clusters with risk for:
type 1 diabetes
thyroiditis
multiple sclerosis
What draws these diseases together?
#ACR24 ABST1365 @RheumNow https://t.co/28gU1nBEUG
David Liew drdavidliew ( View Tweet)
Upadacitinib in Behcet's disease - would be very much welcomed, and this open label 8 patient pilot from China is encouraging.
We saw similar data for tofacitinib before @ARD_BMJ: https://t.co/YlAQVXpnTY
JAKi (?generic) could be a fantastic option!
#ACR24 ABST2515 @RheumNow https://t.co/65friNLUOK
Links:
David Liew drdavidliew ( View Tweet)
Effective RA therapy is about more than just joints
🇪🇸 RA cohort
TNFi for first 24w led to:
Lean mass index i.e. muscle going up
Fat mass index i.e. fat trending down
Muscle & fat composition are important
Systemic Rx can deliver systemic benefits
#ACR24 ABST1348 @RheumNow https://t.co/mZjcHwxMgW
David Liew drdavidliew ( View Tweet)
Steroids in checkpoint inhibitor rheumatic irAEs need to be approached with caution.
Persistent higher doses earlier on might dampen ICI response.
@HSpecialSurgery ICI-IA (inflamm arthritis) cohort
big diff in survival based on early steroid exposure
#ACR24 ABST1989 @RheumNow https://t.co/3WAZ3ZLbFw
David Liew drdavidliew ( View Tweet)
Dentition is important in RA, but it's easy to forget it's a matter of life or death.
NHANES data shows fewer teeth strongly correlates with higher mortality (esp cardiovascular).
Missing teeth = CV death HR >30
Holistic dentition is holistic RA care
#ACR24 ABST1325 @RheumNow https://t.co/Z40bSFybuS
David Liew drdavidliew ( View Tweet)
Rheumatic irAEs can get on the CAR-T bandwagon, too!
CAR-T can invoke new rheumatological issues (not just cytokine release) - see @DrGomezPuerta's experience.
Infrequent, but if CAR-T in general becomes common, yet another job for us to attend to...
#ACR24 ABST2004 @RheumNow https://t.co/xBSlhUdkNr
David Liew drdavidliew ( View Tweet)
Now that nipocalimab is approved for Sjogren's Disease, what about vaccination response whilst on this FcRn inhibitor (inherently lowers IgG)?
Actually, not bad: takes a little longer to get there, but reassuring!
(always fun to get to know a new med)
#ACR24 ABST1988 @RheumNow https://t.co/IYqIGo5xVP
David Liew drdavidliew ( View Tweet)
Active early RA accentuates regional MSK pain.
Non-articular pain:
easy to ignore & focus on active RA
yes, some is related to RA dx activity
BUT actually it becomes a bigger issue over time
Worth identifying to:
clarify what isn't RA
Rx appropriately
#ACR24 ABST1335 @RheumNow https://t.co/iN5rsyr7Bx
David Liew drdavidliew ( View Tweet)
Here's a meta-analysis of MACE/malignancy in JAKi vs TNFi in observational cohort studies.
All the epidemiological challenges here aside, it's a good reminder that with ORAL Surveillance it's *cardiovascular risk enriched pts* we're concerned about.
#ACR24 ABST2264 @RheumNow https://t.co/vIXlrI3V2d
David Liew drdavidliew ( View Tweet)
Post hoc analysis of SPIRIT H2H evaluated nail involvement as a measure of ttnt response in PsA.
-Pts with nail involvement treated with IXE or ADA had higher SJC and TJC improvement vs those without involvement at W12, W24 and W52.
-IXE achieved rapid response for DAPSA-LDA as… https://t.co/SR36qCthQo https://t.co/hI3tD5hATJ
Links:
Adela Castro AdelaCastro222 ( View Tweet)
3D management of Sscl from @delgaldoFrances
-Time
-Severity
-Type of organ involvement
*Identify phenotypes: fibrotic vs vascular damage.
*Raynaud’s red flags: +ANA, puffy fingers, abn capillaroscopy.
*Early ttnt of of digital ulcers delays onset of PAH.
*High IFN-I =marker of… https://t.co/ByfuV0MJds https://t.co/GdRVwuRf4E
Links:
Adela Castro AdelaCastro222 ( View Tweet)