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ACR Best

ACR21 Best Abstracts - Day 2

Jack Cush, MD

The RheumNow faculty reporters have been scouring and reporting on the best abstracts from the ACR. Here is a sampling of their choice abstract presentations reported during ACR 2020 Day 2 (#ACRbest).

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GCA temporal artery

Novel treatment options for Giant Cell Arteritis

Richard Conway, MBBChBAO, PhD

Giant cell arteritis is associated with significant treatment related morbidity due to the dependence on glucocorticoids as a treatment option. After sixty years of therapeutic stagnation, these are exciting times in the management of GCA. At this year's ACR Convergence meeting, encouraging data will be presented on options for GCA.

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RheumNow Podcast – ACR Convergence Begins (11.5.2021)

Jack Cush, MD

Dr. Cush reviews the news, and kicks off ACR21 learning and how to take in the annual meeting.

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Blacks with Systemic Sclerosis May Have More Severe Disease

ACR

New research presented this week at ACR Convergence, the American College of Rheumatology’s annual meeting, shows that Black people living with systemic sclerosis may have more severe disease and worse prognosis than patients in other racial or ethnic groups, and these worrying disparities may be driven by several socioeconomic factors (Abstract #1854). This poster will be presented Tuesday morning,  November 9, 2021 in the Clinical Poster III (1836–1861) section on Systemic Sclerosis & Related Disorders.

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Management of Immune-Related Adverse Events - ASCO Guideline

Jack Cush, MD

The American Society of Clinical Oncology, Inc (ASCO) has updated its guidelines and recommendations for the management of immune-related adverse events (irAEs) in patients treated with immune checkpoint inhibitor (ICPi) therapy. Below are select statements from this guideline.

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DPGN, lupus, nephritis, GN, glomerulonephritis, biopsy, kidney

NOBILITY: a Trial of Obinutuzumab in Proliferative Lupus Nephritis

Jack Cush, MD

B-cell depletion therapy with obinutuzumab, a type II anti-CD20 monoclonal antibody, in lupus nephritis patients was shown to be effective in in combination with standard lupus therapies.

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Baricitinib for *relapsing* GCA (Th1+Th17) w abbreviated steroid wean (15-22w) Despite being tougher to treat: 100% off steroids at 24w 93% off steroids at 52w no ischemic Sx promising as another GCA Rx option! (post-cessation 4pts flared) @MayoClinic #ACR21 ABST1396 @RheumNow https://t.co/dqFnHQYogk
David Liew drdavidliew ( View Tweet)
If obvious dermatomyositis, you don’t need EMG for dx but may use for severity of involvement or if failing Rx or r/o steroid myopathy. For ?polymyositis ALWAYS do bx and often do EMG as broad differential #ACR21 @RheumNow https://t.co/L1xu3OuRYJ

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Janet Pope Janetbirdope ( View Tweet)

#ACR21 #Abstr0865 It’s time for T2T to achieve LLDAS in #lupus. In a study of N=2040 pts, mortality was 2.3% mainly due to infection. Remission off steroid was the best but only met in 14%. LLDAS-50 achieved in 48% pts and ⬇️mortality by 56% @RheumNow https://t.co/CddqMuFIOM https://t.co/g346Cbybep

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Great talk by @saadhealth #ACR21 & interesting to compare myocarditis irAEs to inflamm arthritis irAEs: similar: - importance of confirming dx well - cautious adoption steroid-sparing Rx different: - clear benefit hard/early Rx - dx metrics aided by tech #ACR21 7S404 @RheumNow https://t.co/mFjM3ZlZaP
David Liew drdavidliew ( View Tweet)
Does #comorbidity burden affect treatment of #InflammatoryArthritis? Abs#0577 #ACR21 👉🏼~6500pts; 11 types of IA 👉🏼Higher comorbidity burden➡️more likely to receive steroids than TNFis 👉🏼Are patients w/ IA & multiple comorbidities receiving suboptimal therapy? @RheumNow #ACRBest https://t.co/iIERb0wL4Y
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR21 #Abstr0866 Data from #COVID19 GRA Registry showed predictors of poor COVID outcome in 1922 #lupus pts: Older age Male Areas outside Europe, 🇺🇸🇨🇦 Infection <June 2020 Any Corticosteroid dose Not on therapy On Rituximab Comorbidities ⬆️disease activity @RheumNow #ACRBest https://t.co/u0GF3aDsFA
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
@benjaminsutu @RheumNow Always steroids first, we learned that the hard way in GUSTO - but yeah, probably something after that, and TCZ is our only b/tsDMARD choice... for the time being (at #ACR21 - mavrilimumab, baricitinib, secukinumab...)

David Liew drdavidliew ( View Tweet)

Treatment for VEXAS syndrome. It is steroid responsive. Avoid IL-1 inhibitors severe skin reactions at injection site, bone marrow transplant may be curative @RheumNow #ACR21 Session6S410 L Wilson, DO Cordona https://t.co/eQ1KVDiKKV
Dr. Antoni Chan synovialjoints ( View Tweet)
Study by @BethIWallace @Tuhina_Neogi shows that we seem to treat fibromyalgia symptoms with steroids in RA patients. Its a bad idea in fibromyalgia, and has got to be bad practice in RA too. Abstr#0120 #ACR21 @RheumNow

Richard Conway RichardPAConway ( View Tweet)

ADVOCATE - Avacopan: C5a inhibitor, promising new therapy for ANCA vasculitis as possible steroid sparing therapy. Non-inferior outcome of remission, sustained remission, relapse wo signif adverse effects. @rheumnow #ACR21 https://t.co/m5zexRpeS8
Eric Dein ericdeinmd ( View Tweet)
22 inactive (86%) #RA pts were treated with checkpoint inhibitors & Immune-related adverse events occurred in 7 (32%; two severe AE) leading to 6/22 D/C. RA flares occurred in 12 (55%); 10/12 Rx with steroids & good response. https://t.co/zemGVZOnYL

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Dr. John Cush RheumNow ( View Tweet)

Early RA cohort (CATCH) 1891 early RA, 30% Rx oral steroids as bridge therapy; but 30% of these did not taper or D/C steroids after 24 mos. Early GC use assoc w/ age, unemployment, high Dz activity, later biologic use. https://t.co/dva1A6QHAk

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Dr. John Cush RheumNow ( View Tweet)

Among 825,556 sepsis pts in Taiwan (2003–2017), having SLE increased mortality risk 3 fold (HR 2.8;2.5–3.2), w/ adjustments (HR 1.47). Other risk factors: age (1.02), prednisolone > 5mg/d (1.55), MTX (2.19) & immunosuppressives (1.45) https://t.co/d1OPrjgshz

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Dr. John Cush RheumNow ( View Tweet)

ICYMI: Steroid Poker https://t.co/kJOmCyIpzM https://t.co/A6EkxcIcHG

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Dr. John Cush RheumNow ( View Tweet)
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