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#ACR 2024 BEST Abstracts from Day 3
Lots of lupus research and the New ACR Guidelines on Lupus Nephritis management were presented today. These and other highlights as featured on our Twitter (X) feed from ACR24 in Washington, DC.
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Potential Impact of Weight Loss Drugs in Rheumatic Diseases
Dr. Arthur Kavanaugh highlights a session regarding weight loss and improvement in disease outcomes, specific weight loss drugs (SGL-2 and GLP-1), along with downsides when patients stop these medications. Reporting… https://t.co/Ilu2FXK2xi https://t.co/7CKSnfuey4
Dr. John Cush RheumNow ( View Tweet)
Yang et al. Cranial vessel wall MRI in GCA. Quantitated with PEG score. PEG score ocular GCA>non-ocular GCA>non-GCA. Decreases with treatment. @RheumNow #ACR24 Abstr#2650 https://t.co/e26urOpb7V https://t.co/eekQbzmKYm
Links:
Richard Conway RichardPAConway ( View Tweet)
A#2651
Vasculitis w VEXAS
81 men, median age 67 - 27% had evid of vasculitis, variable size vessel
22% SVV- 17/18 cutaneous, one peritubular capillaritis on renal bx
2.5% MVV (2 cutan), LVV (2 carotid thickening, 1 had +TA bx), ANCA+
@RheumNow #ACR24 https://t.co/puablIBLCP
Eric Dein ericdeinmd ( View Tweet)
What factors are assoc with uptake of newer meds in RA?
➡️Incr use of b/tsDMARDs over 10yrs
➡️Use of newer drugs lower in older ppl, socioeconomic deprived & Asian/Black ppl
Could this indicate disparities in access to meds? How can we best address this?
Ab2608 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
Subsets of lupus arthritis. Kenneth Kalunian @RheumNow #ACR24 https://t.co/ZmHui126zr
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Sullivan et al. Vasculitis in VEXAS. 81 patients. 27% vasculitis. Cutaneous SVV 20%, AAV 2.5%, cutaneous MVV 2.5%, LVV 2.5%. @RheumNow #ACR24 Abstr#2651 https://t.co/AV3RcuSKpV https://t.co/xrax025TzP
Links:
Richard Conway RichardPAConway ( View Tweet)
How often do you ask about #fatigue, #depression & #anxiety in pts with RMDs?
Study of >1000 pts found anxiety symptoms in 1/3 pts and significant association between fatigue & anxiety and depression
Highlights importance of regular review of MH symptoms
Ab2657 #ACR24 @RheumNow https://t.co/0zMOMybrCI
Mrinalini Dey DrMiniDey ( View Tweet)
A#2652
NEWTON study 🇫🇷 Retrosp cohort
51% relapse. Median @8.7 mos, dose 9mg pred
Rf: limb art involv- HR 1.9
Pred taper speed not risk for relapse
Most relapse -> incr GCs
Toci 1/3 at dx, 50% stopped
-61% d/c due to remission, 39% SEs
-1/3 relapse after d/c
@RheumNow #ACR24 https://t.co/NP0wieDmvo
Eric Dein ericdeinmd ( View Tweet)
Peyrac et al. 211 GCA. Relapse in 52% at median 261 days (so 1st year). 83% on GCs at relapse, median dose 6.5mg pred. 36% relapse post-toc discontinuation, at median 133 days. 64% no relapse when toc stopped, at median 511 days @RheumNow #ACR24 Abstr#2652 https://t.co/NqtdDNGGoc https://t.co/mXD8x7O6Ww
Links:
Richard Conway RichardPAConway ( View Tweet)
What is the effect of cs/bDMARDs on weight in #PsA?
⬇️Weight loss seen with:
IL17i
IL23i
csDMARDs
⬆️Weight gain seen with:
TNFi
IL12/23i
Important to consider #comorbidity & #BMI in management decisions in PsA
Ab2639 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
A New ACR
Dr. Jack Cush highlights a few notable changes to the ACR meeting format this year, and offers pointers on the best way to stay informed and abreast of reporting from the #ACR24 Convergence meeting in Washington, DC.
https://t.co/YmI6s1TanV https://t.co/hsByGEBtnz
Links:
Dr. John Cush RheumNow ( View Tweet)
A#2648
PET for GCA
Delayed imaging at 180 min improve dx performance for pts on GCs
Optimal PET w/in 3 days of GC, most patients unable to do w/in that window
Delay has sensitivity 92% even on prednisone - may be good tool for pts unable to get early PET/CT
#ACR24 @RheumNow https://t.co/kxpNfRqkGN
Links:
Eric Dein ericdeinmd ( View Tweet)
Study by Maria Dall'Era et al. compared voclosporin-based triple immunosuppressive therapy with high-dose GC in active lupus nephritis.
- Fewer adverse events in the voclosporin group, despite a higher incidence of specific issues like decreased GFR and hypertension.
- 25%… https://t.co/ToRu2rdErC https://t.co/uUXzNNuLDb
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
@YooJinKimYJK @andreafava et al: 20% of pts in their #lupus cohort had recurrent pericarditis.
Majority had 1 recurrence (51%)
Independent predictors of recurrence:
Younger age
Prednisone tx
Active dse
Time from initial episode
🔅regular ffup is 🔑
@RheumNow #ACR24 abs2372 https://t.co/UELwE31X0u
sheila RHEUMarampa ( View Tweet)
➡️More DMARD-exposed pts w late-onset RA reduce long-term GC use than DMARD-unexposed
➡️Persistent GC use is common
➡️In DMARD-exposed, GC use may be related to limited access to high-cost drugs
➡️In DMARD-unexposed, comorbidity burden may limit DMARD use
Ab2606 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
How do you manage DMARDs when giving the recombinant #zoster #vaccine (#RZV)?
➡️75 pts with ARDs
💉2-week #MTX discontinuation after each dose of RZV
⏩Significant boost in immune response without difference in flare rates
Ab2612 #ACR24 @RheumNow https://t.co/o4iqj3e1Be
Mrinalini Dey DrMiniDey ( View Tweet)
A#2649
Relapsing Polychondritis
Latent Class Analysis to define clinical phenotypes of heterogeneous dx
Type 1- ear, nose, subglottic stenosis
2- tracheo/bronchomalacia
3- absence tracheomalacia
Decision tree to classify pts in subgroups
#ACR24 @RheumNow https://t.co/xpZedPVl7f
Links:
Eric Dein ericdeinmd ( View Tweet)
Loiseau et al. 4700 pSS, 47000 comparators. pSS associated with increased risk of every CV/VTE outcome. Did not have that in my priors! @RheumNow #ACR24 Abstr#2631 https://t.co/QKemUhbcG8 https://t.co/twpjdS2L63
Links:
Richard Conway RichardPAConway ( View Tweet)
A#2650
MRI can show extent of vessel wall inflamm to guide severity of GCA
Brain & orbital MRI performed
Assessed 7 arteries bilaterally -> CAMRIS-GCA MRI score (0-10)
33 GCA (17 ocular), 41 not GCA
CAMRIS-GCA ass w/ ocular GCA, higher severity. Improved w Rx
@RheumNow #ACR24 https://t.co/19XCuZJXqF
Links:
Eric Dein ericdeinmd ( View Tweet)