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Where there’s smoke, there’s flare: how pollution fuels RA
Associations between air pollution and disease activity in rheumatoid arthritis have previously been demonstrated. Abstract 0978 sought to determine the association between fire smoke and other pollutant exposures with the risk of RA and RA-associated interstitial lung disease (RA-ILD).
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How does #race & #ethnicity impact mortality in RA?
Study in CDC national mortality database
➡️RA mortality differed by race & ethnicity
➡️Highest premature mortality in Native Americans
Findings may be used to inform resource allocation & management
Ab1747 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
In this systematic review & metaanalyis by Dr. RFarhat et al, tacrolimus whole blood levels decrease in the 1st & 2nd trimesters then increase back to pre-pregnancy levels postpartum.
Needs further studies to guide dose adjustment.
@RheumNow #ACR24 abs1535 https://t.co/5MovzPJoFc
sheila RHEUMarampa ( View Tweet)
Dr. BDinneen et al reported predictors that can help screen axSpA pts w/o traditional CV RFs for carotid doppler utz:
- shorter dse duration
- no family hx of IHD
- HLAB27+
- ⬆️ dBP, WHratio, ferritin, TC, LDL and TC:HDL ratio
Small size, more data reqd
@RheumNow #ACR24 abs1440 https://t.co/3pZxFmutJz
Links:
sheila RHEUMarampa ( View Tweet)
Andreasson et al. High intensity interval training provides greater improvements in exercise capacity than standard moderate intensity training in IIM. @RheumNow #ACR24 Abstr#1735 https://t.co/baj7Cq2QjO https://t.co/yiE1vuk2me
Links:
Richard Conway RichardPAConway ( View Tweet)
A#1748
Fracture incidence in RA - RISE registry
Incidence rate of MOF, hip Fx by disease activity
50% did not have CDAI available
IR 12 per 1000py hip, 43 for MOF
High activity worst, low/mod similar, remission is best
Supports remission is better than LDA
@RheumNow #ACR24 https://t.co/78FCLemfZD
Eric Dein ericdeinmd ( View Tweet)
Ab1676 discussed an intervention to change patient mindsets about side-effects of #methotrexate. Watch my video for @RheumNow on this abstract here:
https://t.co/NxuxQ5wYda
#ACR24
Mrinalini Dey DrMiniDey ( View Tweet)
Interesting comparative effectivness study, TOFA vs calcineurin inhibitors in MDA5-dermato
Expansion of prior publication @NEJM that used historical controls: https://t.co/AzA8ybCqYH
Encouraging data for JAKs in this disease; need proper trials
#ACR24 @RheumNow Abstr#1736 https://t.co/BHVMZLu6Ip
Links:
Mike Putman EBRheum ( View Tweet)
Wu et al. MDA5-DM. Propensity-score cohort study. 672 patients. Tofacitinib vs CNI. Primary outcome 1 year death or lung transplant. HR 0.70 favouring tofacitinib. @RheumNow #ACR24 Abstr#1736 https://t.co/A0aHhp1q9c https://t.co/LbutJDBllr
Links:
Richard Conway RichardPAConway ( View Tweet)
Can we do more to routinely assess fracture risk in RA?
In RA pts ≥65, hip fracture & MOF are more common in pts with active disease, worse with higher disease activity
➡️Need better and more frequent bone health assessments in our RA pts
Ab1748 #ACR24 @RheumNow https://t.co/whfnLnkpLd
Mrinalini Dey DrMiniDey ( View Tweet)
A#1747
RA mortality by race/ethnicity
Database study
>200,000 pts had RA as contributing cause of death
5.1 ASMR in American Indian >>> all other groups
No decr over time in grp, unlike other grps
Odds of death 1.67 compared to white pop
10.8x higher in pts <44
#ACR24 @RheumNow https://t.co/nXLcQkQPu4
Links:
Eric Dein ericdeinmd ( View Tweet)
On now: The Great Debate - is MCTD a distinct clinical entity?
@DrLisaCS reviews the history of MCTD classification criteria and its evolution
Kasukawa criteria may be most sensitive in one cohort
@RheumNow #ACR24 https://t.co/rDHafZVL1I
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
A study showed the sex differences in serum proteomic profiles of males and females with PsA.
Key findings:
-Identified 741 unique proteins in male PsA patients vs. controls vs. 31 in females.
- Several sex-specific pathways, including immune cell functions and cytokine… https://t.co/erC599Zbuj
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Chinoy et al. Baricitinib in IIM. Delayed-start clinical trial. 15 patients. 14/15 improved at 24 weeks (the other withdrew). 50% vs 100% at week 12 (delayed start group initiation). Stats confuse me a bit here but promising. @RheumNow #ACR24 Abstr#1731 https://t.co/orewsxbPpL https://t.co/5AyRpYJdec
Links:
Richard Conway RichardPAConway ( View Tweet)
A#1746 companion for RA
Like plenary for PsA, PBO response incr w time 1%/yr
More trials in less affluent countries may be related to increasing PBO response in trials
Possible reason: access to health care improves PBO in less affluent areas
@RheumNow #ACR24 https://t.co/S3LffF8vPH
Eric Dein ericdeinmd ( View Tweet)
RA patients on TOF with h/o ASCVD have 4x higher risk of MACE without statin (vs. TNFi).
Prioritize statins for heart health in RA!
#ACR24 @RheumNow ABST#1745 https://t.co/jRqXNU2T6d
Links:
Jiha Lee JihaRheum ( View Tweet)
The odds of axSpA patients developing fractures was lower among those on TNFi vs DMaRDs or NSAIDs accdg to this study by NGeorge et al.
axSpA pts are at high risk of fractures & drugs that mitigate these risks are important. More robust data are needed
@RheumNow #ACR24 abs1439 https://t.co/ZSV3og5N5x
sheila RHEUMarampa ( View Tweet)
A#1745
Post-hoc ORAL Surveillance - statin
<1/4 on a statin, only 53% h/o ASCVD on statin
Incr in LDL was less on Tofa pts on statin
Among those on b/l statins, there is no incr risk compare to TNFi, esp pts h/o ASCVD
If high risk on tofa, statin helps!
@RheumNow #ACR24 #ACRBest https://t.co/7MGgUk7tfI
Links:
Eric Dein ericdeinmd ( View Tweet)
Wallace et al. Case control study. 648 cases 1241 controls. Cumulative glucocorticoid dose and risk MACE. Dose dependent increase in risk, OR 1.01 for 10% increase GC, 1.21 for 10-fold increase GC. @RheumNow #ACR24 Abstr#1719 https://t.co/wraiWOl1dv https://t.co/feht58RDNc
Links:
Richard Conway RichardPAConway ( View Tweet)
Single cell TCR sequence study explores the limitations of TRBV9-depleting therapies in axial spondyloarthritis.
Key findings:
- Identified a clonally expanded TRBV5-5+ TCR in HLA-B27+ acute anterior uveitis.
- Alternative TRBVs may retain pathogenicity and evade anti-TRBV9… https://t.co/Aj8oslsTNX
Antoni Chan MD (Prof) synovialjoints ( View Tweet)