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Reduction of AxSpa-Associated Acute Anterior Uveitis with Certolizumab
Acute anterior uveitis is the most common extra-musculoskeletal manifestation in axial spondyloarthritis (axSpA) affecting up to 50% of patients in some age groups. AAU can have a significant impact on quality of life with risk of permanent visual deficits if not adequately treated.
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Development of New classification crieteria to target patients earlier in thier #OA disease course!
One tatget molecule will not solve this heterogeneous disease! @rheumnow #ACR23 https://t.co/waynA6RdUg
Bella Mehta bella_mehta ( View Tweet)
Intriguing data on #GCA treated with tocilizumab
#aneurysm still occurs
#vasculitis https://t.co/6cPlFRReLJ
Links:
KenWarringtonMD MdWarrington ( View Tweet)
A#2546 Anti-IFX Ab in AS
#ACR23 @RheumNow
Anti-IFX in 45% in f/u, 85% in 1st yr
MTX decr anti-IFX (18 v 42%)
Anti-IFX - higher inflamm markers, infus rxn, lower serum levels and Rx fail
Pt w/o anti-IFX Ab more likely to tolerate tapering https://t.co/eN9SqGyGgm
Eric Dein ( View Tweet)
Nepal et al. No increased risk of GI perforation for tocilizumab in GCA HR 1.05 . Diverticulitis (RR 3.51), IV methylprednisolone (RR 5.41) risk factors. This fits with my priors, steroids are a bigger risk than tocilizumab. Abstr#2560 #ACR23 @RheumNow https://t.co/BAmBQA0kEP https://t.co/zRjmDIkOHp
Richard Conway ( View Tweet)
After attaining #remission or #LLDAS after a flare - HALF flare over f/u esp if tapering pred to <7.5 or 5 mg. #HCQ was protective. 65% got LLDAs and 45% rem in 1/2 yr - longer time to get #remission #2553 #ACR23 @RheumNow @ACRheum #ACRbest Asian cohort of #SLE largest@in world https://t.co/yBBqYJZVOe
Janet Pope ( View Tweet)
Great work @HoromanskiMd on a vasculitis in pregnancy plenary session! #ACR23 https://t.co/WSmqJjfBes
Mike Putman EBRheum ( View Tweet)
TM65 @ #ACR23
65 yo white M p/w 9mo of cryptogenic strokes.
PMH: HTN, Crohn's
- 07/2022: CRAO, BMRI: L frontal lobe infarct --> ASA, Atorvastatin started
- 09/2022: weakness, vision changes
--> BMRI: multifocal subacute infarcts --> Apixaban started, Vedolizumab started for… https://t.co/pjoCv7PH9Y https://t.co/YUN78nn6Xb
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Synovial tissue histology correlates w/ several clinical parameters in early naive RA
Combination ohigh CD68 infiltrate
Fibrinoid Necrosis in tissue asso w/
-better DA reduction
-higher EULAR moderate/good resp
Included in a prediction model (AUC0.7)
@RheumNow #ACR23 ABST2483 https://t.co/2jCMSzV7ak
Aurelie Najm ( View Tweet)
Fantastic presentation by Desh Nepal from MCW on risk of GI perforation in patients with #GCA
Low incidence , no association with TCZ, but increased risk with IV methylprednisolone and h/o diverticulitis.
@EBRheum #ACR23 https://t.co/bgvmjAXBEY
Sebastian E. Sattui MD, MS SattuiSEMD ( View Tweet)
Kaymakci et al. 49 GCA patients in clinical remission undergoing thoracic aortic surgery. Active aortitis in 82%. Abstr#2557 #ACR23 @RheumNow https://t.co/WQh47LThGD https://t.co/DeORKmjYP7
Richard Conway ( View Tweet)
#ACR23 Abs 2463 data from first 3 pts suggest CD19 CAR-T provides possible drug-free remission and resolution of lung/muscle inflammation in antisynthetase syndrome. https://t.co/7udqkDBgqT @rheumnow https://t.co/LSHcI0HMTM
Dr. Rachel Tate ( View Tweet)
A#2547 #ACR23 @RheumNow
Diff 2 Treat (D2T) AxSpa
D2T: fail 2+ b/tsDMARDs w 2 MoA
Very D2T: failure of Rx in less than 2 yrs
28% D2T, 3.8% Very D2T (Compare to 7-10% D2TRA)
More likely: peripheral, uveitis, higher BASDAI, FM
Very D2T also w IBD, higher CRP, longer dis duration https://t.co/HcIXnDRrIq
Eric Dein ( View Tweet)
*not a cappuccino. The dregs of the coffee pot that the kind lady refused to charge me for.
But jet lag is kicking in hard & so is desperation for any caffeine. If it wasn’t irAE friends @cappelliMD @jeffsparks et al up next, I would go to bed.
#ACR23 must roll on! @RheumNow https://t.co/RdCOZlZMbZ
David Liew drdavidliew ( View Tweet)
Another infusion option for axSpA!
INVIGORATE-1: Phase 3 RCT of IV Secukinumab in axSpA
Efficacious - ASAS40 response sustained thru 52 weeks
Safety profile similar to subq version
@RheumNow #ACR23 Abs#2545 https://t.co/biC8p3p6dl
Robert B Chao, MD ( View Tweet)
Pregnancies outcomes in vasculitis:
- Higher frequency of spontaneous abortion and preterm delivery
- 12% had pre-eclampsia
- Risk higher in multiparous > nalliparous
- Risk highest in small vessel vasculitis
Rector A, Abst#2425 #ACR23 #ACRBest @RheumNow https://t.co/TgbRWw9il5
Dr. Antoni Chan ( View Tweet)
Wouldn’t it be great to assess immune changes in #SLE before #clinical #lupus #flare? Without over treatment too! YOU CAN
Lupus flare risk index calculated prior to disease activity change or stable pt. Results combined for score 11 mediators
#ACR23 @RheumNow @ACRheum abst#2554 https://t.co/gUimJLrJ33
Janet Pope ( View Tweet)
Body mass is associated w/ ttmt response in RA
Data from RACAT & TEAR studies
TNFi > triple th in underweight gpe but not in overweight gpe
Similar result in gpe w/ low leptin levels
& low adipokine scores
True biology or confounding bias?
@RheumNow #ACR23 ABST2541 https://t.co/OhKj6QNaSa
Aurelie Najm ( View Tweet)
Baker et al. TNFi vs triple therapy by BMI. 907 patients from TEAR/RACAT. Those under/normal weight have a better response to TNFi, overweight/obese respond equally to both. Abstr#2541 #ACR23 @RheumNow https://t.co/SROD3esMCD https://t.co/ni3I8tD7wI
Richard Conway ( View Tweet)
Is rituximab still a problem with COVID - esp if our patients have been vaccinated pre-ritux?
Antibody titres better when not getting regular ritux around boosters
Maybe boosters 9mo (or so) gap after ritux helps immunogenicity
@TroldborgAnne et al #ACR23 ABST2511 @RheumNow https://t.co/dE0uC6B9hx
David Liew drdavidliew ( View Tweet)
