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Here’s what will change my practice in Rheumatoid Arthritis
Here's what I learned at ACR23 that will change the way I practice in rheumatoid arthritis.
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Withdraw DMARDS after remission?
The possibility of withdrawing DMARDs after patients achieve remission has been in our minds for a while. Yet when our patients ask whether it is a good idea to taper or stop their DMARD when they are doing well, most of us don’t have a black or white answer for them.
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Race to the top: how high will treatment response rates in RA reach?
We have become accustomed to the 60/40/20% rule for the outcome of ACR 20/50/70 respectively for biologics and targeted synthetic DMARDs.
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Swedish national cohort study cohort study suggests #RA pts at incr risk for Autoimmune thyroid Dz, but decreases after RA Dx & Rx. n=13,731 RA vs 63,201 matched pop. controls. Lower rates AITD w/ biologics & TNFi (HR 0.54, 0.67) https://t.co/ZfputgDJQE https://t.co/Z1r0eGFcX9
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Last chance for early bird savings! Our early bird special closes on 11/30. Join us for RheumNow Live THIS JANUARY!
https://t.co/uD01S8rgrh https://t.co/29u3wz5PHK
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National pharmacovigilance database review (1992 to 2021) identified 2217 "Falls", most serious, most in women (61%), & 38% in 18–64 yr olds. Falls attributed to immunomodulators (17%), 24% Fxs & 1 in 7 classified as adverse drug rxns (343) https://t.co/tpUPDc8x09 https://t.co/jdssH7oCjF
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UK study 336 GCA pts shows after 12 mos of tocilizumab, TCZ stopped (w mean pred 2mg/d) & GCA flares at 6, 12 & 24 mos was 21%, 35% & 49% respectively; requiring prednisolone dose increase to 20 (10-40) mg/day (34% were major relapses) https://t.co/EZ78ciNK0R https://t.co/R1qFsvnhoF
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"Protein kinases: drug targets for immunological disorders". Great full-read review from J Shea et al. Reviews Hx, biology, clinical use and safetey of Kinase targeted therapy. https://t.co/qBc0ng1Z9h https://t.co/Qm8PFpNxQF
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NEJM Clinical Images: Scleromyxedema (cutaneous mucinosis w/ a paraproteinemia).53-yoM w/ itchy rash, Raynauds, dysphagia, burning dysesthesia hands; Waxy papules across forehead & hands w/ skin thickening & finger contractures. Skin Bx & SPEP done https://t.co/vkpYGNd3Uw https://t.co/T5gVPRBrhh
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Cancer and TNF inhibitors
Cancer risk minimisation is a high priority for people with rheumatic diseases, as it is for the general population. Tumor necrosis factor inhibitors (TNFi) have a long history of association with cancer risk discussions
https://t.co/iWnBTqX1eV https://t.co/lDEyM0c2yo
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How early is early in psoriatic arthritis? Is there a window of opportunity for treatment in PsA to ensure optimal outcomes? https://t.co/jHrA1M05Qr https://t.co/jcU13Y4CRm
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Effective Treatments for Rheumatoid Arthritis ILD
The ACR guidelines for the diagnosis and management of interstitial lung disease, which includes RA-ILD, has been one of the most controversial topics in the runup to ACR Convergence.
https://t.co/qJBeM0jdom https://t.co/vdhcHOvHBI
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Reduction of AxSpa-Associated Acute Anterior Uveitis with Certolizumab
Acute anterior uveitis (AAU) is the most common extra-musculoskeletal manifestation in axial spondyloarthritis (axSpA), affecting up to 50% of patients in some age groups.
https://t.co/uhlnpmLwoP https://t.co/NRW0PlD43a
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Undiagnosed IBD in AxSpA
Dr. Eric Dein (Summit, New Jersey) discusses Abstract #0495 presented at the ACR 2023 Convergence meeting in San Diego.
https://t.co/QAC6fhSQ7Q https://t.co/BxNQwQ9nwc
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The impact of SGLT2-inhibitor on SLE outcomes
SLE is associated with increased risk of cardiovascular events due to both traditional and disease-specific risk factors.
https://t.co/hyyMVQg3xV https://t.co/fLxh0vlTze
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Are Rheumatologists doing Enough for Cervical Cancer?
Should rheums be counseling patients on cervical cancer prevention and screening? The data from Abstract #1479 at #ACR23 suggests this should be an important conversation with our lupus patients.
https://t.co/VFobM0T3u7 https://t.co/L45N3tsTdN
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Substudy of the ADVOCATE trial looked at 214 ANCA assoc vasculitis pts treated with #RTX; avacopan Rx showed improved recovery of renal function, faster reduction in albuminuria and lower glucocorticoid toxicity compared to a prednisone taper. https://t.co/91PtvQfoIr https://t.co/ZjYCVP5lqG
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Long term F/U of early RA, T2T RCTs (n 1616) finds excess mortality > 10yrs for BeST (SMR 1.32) & IMPROVED (SMR 1.33) RCTs; highest in ACPA+ smokers (SMR 2.80 & 2.14); Cancer main cause. SMR incr 34% & 13% for ea 1 pt incr in DAS https://t.co/2DdHMGIlOk https://t.co/7bnCOzB8vd
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Infections During Treatment of GPA with Rituximab
Dr. Richard Conway (Dublin, Ireland) discusses abstract 1584 presented at the 2023 ACR Convergence meeting in San Diego, CA.
https://t.co/eKi3KExEnk https://t.co/b9G9w5e9tc
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Watch and Weigh In: Upadacitinib for Pain: Is That Real?
Dr. David Liew reports on abstract 0429 at the 2023 ACR Convergence meeting in San Diego, CA.
https://t.co/AbD9UpXQfY https://t.co/iRgUnNInuD
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