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ACR Best

ACR Best Abstracts - Day 2

Jack Cush, MD

Day two at ACR 2022 was full of great sessions on imaging, vasculitis, lupus, vasculitis, spondyloarthritis, COVID, pregnancy, microbiome, economics and more.

Here are the RheumNow faculty selections for #ACRbest abstracts today:

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Do biologics help taper steroids in Adult Still’s Disease?

Bella Mehta, MBBS, MS

A Japanese large scale claims data study was able to collect 5-year data to study the treatment patterns in Still’s. In May 2019, intravenous tocilizumab was approved in Japan for Still’s disease. The study was designed to see patterns of steroid exposure before and after the approval of this therapy.

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Older woman

Polymyalgia rheumatica: more than just steroids at ACR22

David Liew, FRACP

After decades of having little else proven apart from glucocorticosteroids with which to treat polymyalgia rheumatica (PMR), evidence for steroid-sparing options has grown in recent years, and this crescendo is set to continue at ACR Convergence 2022 in Philadelphia, PA.

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Target,T2T,bullseye

SLE T2T - Lupus Low Disease Activity State Predicts Outcomes

Jack Cush, MD

Treat-to-target management of SLE has been shown to protect against organ damage and to improve quality of life. Now a prospective study shows that T2T with a goal of lupus low disease activity state and remission has been shown to improve mortality risk.

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bacteria,infection,color

Infection: a Leading Cause of Death in Lupus

Jack Cush, MD

 Analysis of a national database of hospital discharges from Spain shows that infections accounted for 25% of lupus deaths, making infection the most common cause of death in SLE.

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undifferentiated,arthritis,early,RA

Second Efforts in Treating RA Partial Responders

Jack Cush, MD

The results of a treat-to-target (T2T) combination therapy trial in patients with early rheumatoid arthritis (RA) show that if patients fail to respond initially, then a second, more intensified regimen can turn initial nonresponders into responders.

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Intravenous Immune Globulin in Dermatomyositis

Jack Cush, MD

Few drugs have been studied well in the treatment of dermatomyositis (DM) and only recently has intravenous immune globulin (IVIG) been granted FDA approval for the treatment of DM, based on this pivotal trial.

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Heavy Metal Rheumatology (9.23.2022)

Jack Cush, MD

Below are this week’s highlights from RheumNow, as discussed by Dr. Jack Cush. Thanks to all of you for your kind comments and great reviews of our weekly podcast. Please let us know how we can improve by emailing me or recording your suggestion using the "Ask Cush Anything" link on our website.

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CD19 CAR T Cell Therapy in SLE (9.16.2022)

Jack Cush, MD

The big news this week: the approval of deucravacitinib (a new class of drug?) for psoriasis; the 2022 ACR guidance on glucocorticoid-induced osteoporosis; a national poll of older adults over the age of 50 who claimed self-reported or doctor-diagnosed arthritis; and much more. Let's review these and other news, journal reports and announcements from this past week.

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Kaneko et al. Tocilizumab leads to significantly lower steroid doses in Adult onset Stills Disease @RheumNow #ACR22 Abstr#0826 https://t.co/jc1S6sdfkm https://t.co/z0cHB4wYu6

Links:

Richard Conway RichardPAConway ( View Tweet)
Very cool initiative @Robsonjo4 1. I love patient reported outcomes (PROs) 2. I think we under-appreciate how much steroids affect our patients quality of life Looking forward to seeing this live! #ACR22 #Vasculitis22 @RheumNow https://t.co/1akO1k7VgU
Mike Putman EBRheum ( View Tweet)
Yr in review #ACR22 @RheumNow 🌟GLORIA 2 yr data: 👉Pred 5mg OD vs PBO >65y/o RA ✅⬇️ disease activity (DAS28 -0.38) ✅⬇️ joint damage (sharp/van der heijde -1.7) ❌ 24% ⬆️ a/e “Weigh success in benefit and failure in harm 2 individualise use of low dose pred in RA >65y/o”

Patricia Harkins DrTrishHarkins ( View Tweet)

Dr. C Langford #YearinReview: RDBPCT on benefits/harms prednisolone 5 mg/day for 2 years added to SOC in 65yo+ with active RA. Results: improvement in DAS28 (0.37) but AEs occurred in 24% (infection, low bone density)—NNT 9. Study does not apply to younger pts. #ACR22 @rheumnow https://t.co/p2C6IfSje1
TheDaoIndex KDAO2011 ( View Tweet)
Year in Review #ACR22 GLORIA Low steroid usage: lower DAS28, reduced joint damage BUT 24% increased adverse effects ⁦@RheumNow⁩ https://t.co/vYTAhoQEqr
Eric Dein ericdeinmd ( View Tweet)
Short-term intra-articular steroids are effective (unclear- long term benefits) - no increase risk for knee replacement with repeat steroid injx #osteoarthritis @rheumnow #acr22 #acrreview https://t.co/MJHXWePF70
TheDaoIndex KDAO2011 ( View Tweet)
Medicare will cover #DXA testing for these diagnoses ⁦@RheumNow⁩ #acr22 #acrreview https://t.co/keZg0fxyz9
TheDaoIndex KDAO2011 ( View Tweet)
Think about checking Ig levels prior to Rituximab administration. Low IgM was most common after RTX in RA. The following are risk factors for hypogammaglobulinemia: 🧪 Older age 🧪 Use of steroids 🧪 Repeated doses of RTX 🧪 Low Ig at baseline https://t.co/oOjqnmFdYt
Catherine Sims, MD DrCassySims ( View Tweet)
Anakinra in Pericarditis: A Systematic Review (comprehensive, full read) -Options include steroids, colchicine, NSAIDs, pleuropericardial window, IL-1 inhibitors. ANAKINRA - 11 studies, 259 pts, all showing significant rapid resolution. https://t.co/mEkaa7Yjt1 https://t.co/BaMYHiG5Pb

Links:

Dr. John Cush RheumNow ( View Tweet)
Difficult to treat RA (D2T-RA) study of 48 D2T-145 non-D2T-RA pts. D2T-RA was predicted by Not starting MTX w/in 3 mos (17% vs 33% non-D2T-RA;p= 0.011) &being on steroids > 6 mos (71% vs 34%, p< 0.001). https://t.co/Ugbr7z7mia https://t.co/TCU7wSfMrS

Links:

Dr. John Cush RheumNow ( View Tweet)
Is PMR the Next Indication for Tocilizumab? About half of patients with steroid-dependent PMR were able to get off steroids altogether when they were started on tocilizumab (Actemra) infusions, a randomized phase III trial showed. https://t.co/LUMG4NnZzs https://t.co/zdFacyYyud

Links:

Dr. John Cush RheumNow ( View Tweet)
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