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Atul Deodhar's "3-4-5" Rule for MRI Sacroiliac Jts (SIJ)
Erosion in 3+ SIJ quadrants
Bone marrow edema 4+ SIJ quadrants
Fat lesion in 5+ SI joint
@Rheumnow #RNL2023 https://t.co/AHZUhhEmmC
Eric Dein ericdeinmd ( View Tweet)
Dr. Deodhar reminds us of his "3,4,5 rule" for diagnosing AS.
*Erosions in 3 or more SIJ quadrants
*BME in 4 or more SIJ quadrants
*Fat lesions in 5 of more SIJ quadrants
#RNL2023 @RheumNow https://t.co/2m8TmkQo0A
Dr. Rachel Tate uptoTate ( View Tweet)
Dr. Atul Deodhar on AxSpA
- 5-40% of nr-axSpA progress to r-axSpA over 2-10 years
- is non-radiographic axSpA a misnomer?
@RheumNow #RNL2023 https://t.co/bhwlbg6eWN
Robert B Chao, MD doctorRBC ( View Tweet)
Risk factors for radiographic progression:
Men ♂️
Smoking 🚬
Active inflammation🔥
Blue collar workers 💪
HLA-B27+ 💉
Pre-existing syndesmophyte 🩻
Atul Deodhar at #RNL2023 @RheumNow https://t.co/9ibHTEhi9k
Eric Dein ericdeinmd ( View Tweet)
No significance difference in radiographic progression in patients with IL17-TNF , BY Atul Deodhar #RNL2023 @RheumNow https://t.co/S3NQ4mWgjt
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
SURPASS: SEC vs ADA for axSpA
Outcome: %pts with no radiographic progression
Not benefit- Secukinumab not better than adalimumab
Though negative study, in all groups the progression was very low (<1 mSASS) - both interventions did well!
@RheumNow #RNL2023 https://t.co/Vt58jSXCMd
Eric Dein ericdeinmd ( View Tweet)
First Head-to-Head bDMARD study in axSpA to assess radiographic progression
- secukinumab vs. adalimumab biosimilar
- 66% of either arm prevented radiographic progression
- no difference between two arms but good news is radiographic progression is low!
@RheumNow #RNL2023 https://t.co/xq8GhN7kzr
Robert B Chao, MD doctorRBC ( View Tweet)
Late breaking ACR abstract '22 SURPASS study (H2H TNFi vs IL17 in AS radiographic progression.) Primary endpoint was not met.
However, Dr. Deodhar's take away: spinal radiographic progression over 2 years is very low despite high disease activity in both txs! #RNL2023 @RheumNow https://t.co/TsukRs29pC
Dr. Rachel Tate uptoTate ( View Tweet)
Bimekizumab is a dual IL-17A and IL-17F inhibitor, for nr-axSpA and AS
- it works but is it different from existing IL-17i?
- appears to work well in TNFi-inadequate responders
- are TNFi-IR pts immunologically different? niche category for IL-17A and F use?
@RheumNow #RNL2023 https://t.co/dWkakahHAi
Robert B Chao, MD doctorRBC ( View Tweet)
Dennis Poddubnyy #RNL2023
MRI sequences for axSpA:
Semi-coronal- T1 weighted, T2 STIR, T1 weighted w fat suppression
Semi-axial- T2 STIR
@RheumNow https://t.co/ySk4hU5lMY
Eric Dein ericdeinmd ( View Tweet)
To differentiate mechanical from inflammatory lesion:
1-Site matters
2-Structural changes matter
Denis Poddubnyy #RNL2023 @RheumNow https://t.co/iQ1gHPnkqO
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
Cost-Effective Use of Biological and Targeted Synthetic DMARDs
An international task force of experts have developed evidence-based points to consider regarding the cost-effective use of b/tsDMARDs in the treatment of inflammatory rheumatic diseases.
https://t.co/q3d6kNTVvo https://t.co/FBzZOMVlIK
Links:
Dr. John Cush RheumNow ( View Tweet)
PAISLEY: Deucravacitinib in SLE
#RNL2023 Year in Review
DEUC: oral TYK2i
P2, 48w DBRCT in active SLE
Primary endpt SRI4 at w32 - meets endpt, no dose response
Phase 3 study results needed, promising results but JAK studies failed for SLE
@RheumNow https://t.co/kKAKHnnG8i
Eric Dein ericdeinmd ( View Tweet)
AAV outcomes in patients with diffuse alveolar hemorrhage , @RheumNow Kavanaugh #RNL2023
I think i will still use it in sever patients. https://t.co/AEDH4diDuU
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
#RNL2023 Year in Review
New Drugs in Old Disease?
GCA - Tocilizumab (GiACTA ), Secikinumab (TitAIN), Mavrilimumab (GM-CSFr mAb)
PMR - Sarilumab (SAPHYR), TCZ (PMR-Spare, SEMAPHORE), Tofacitinib (EAST PMR)
@RheumNow https://t.co/cY2HuaI6uM
Eric Dein ericdeinmd ( View Tweet)
An exciting year and time for GCA and PMR treatment!
- Tocilizumab (IL-6i)
- Secukinumab (IL-17i)
- Sarilumab (IL-6i)
- Mavrilimumab (GM-CSF receptor mAb)
- Tofacitinib (JAKinib)
@RheumNow #RNL2023 https://t.co/d0T2RAssFY
Robert B Chao, MD doctorRBC ( View Tweet)
@RheumNow's review of new drug approvals during 2022 at #RNL2023 https://t.co/IgndlG6lOI
Dr. Rachel Tate uptoTate ( View Tweet)
Extension PEXIVAS study in ANCA vasculitis pts with severe DAH
- no significant effect of PLEX on mortality but do note numerical difference, favoring PLEX in severe DAH
- note difference in curve
@RheumNow #RNL2023 https://t.co/6ktb3Uakw9
Robert B Chao, MD doctorRBC ( View Tweet)
Biosimilars are coming!
Multiple adalimumab biosimilars this year
- will we see a dramatic price difference?
@RheumNow #RNL2023 https://t.co/8vdtXtEGOO
Robert B Chao, MD doctorRBC ( View Tweet)
Biosimilars back on the radar for 2023. Expect to see 17 in rheum. #RNL2023 @RheumNow https://t.co/SNYNM8nmD2
Dr. Rachel Tate uptoTate ( View Tweet)