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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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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.
David Liew
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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
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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
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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
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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
Richard Conway
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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
David Liew
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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
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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
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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
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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
David Liew
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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
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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
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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
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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
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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
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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
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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
Adela Castro
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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
Adela Castro
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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
