For many years glucocorticoids were the mainstay of our treatment of granulomatosis with polyangiitis (GPA). The paradigm shifted with cyclophosphamide and then again with rituximab, and we used less steroids, but we still used lots. Avacopan teased the demise of steroids, but in the trial they, and now we, still use them. Glucocorticoids are our old trusty friend, our comfort blanket. But no more! Good riddance to the medication with the highest long-term adverse event burden that we use. Long-term glucocorticoids in GPA should now be a rarity. The reason for such exuberance is the TAPIR study presented by Dr. Peter Merkel at Saturday’s opening plenary session.
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Richard Conway
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Dhir et al. RCT of increasing folic acid from 5-10mg per week to 15-35mg per week if MTX intolerance. No benefit! Although significant placebo response and folic acid is relatively benign. @RheumNow #ACR24 Abstr#0525 https://t.co/D3yfV6a8t6 https://t.co/QpDa1alvMz
Richard Conway
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Yokose et al. Population study using NHANES. Gout patients had 1.6 higher fold risk of gallstone disease. What? Why do we care? Well, GLP-1s associated with higher risk gallstones also... @RheumNow #ACR24 Abstr#0133 https://t.co/nf4R0hQe50 https://t.co/wDrEDeNbpT
Bella Mehta
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🧬 #SLE patients show major community mobility limits: 50% don't leave their neighborhood weekly without help. Life Space Assessment finds lower mobility vs. other chronic conditions. Better mobility linked to higher SES & lower disease activity. @RheumNow #ACR24 abst#0145 https://t.co/2sfXNlJ9JD
Antoni Chan MD (Prof)
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Data from the French DESIR cohort reveals no significant link between high-dose NSAID use and incident hypertension in patients with axial spondyloarthritis. Two thirds were high dose NSAID users at baseline. Incident hypertension occurred in 11% individuals during follow-up.… https://t.co/EAICDwzxNT
Richard Conway
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Courvoisier et al. JAK-pot study analysis. Which therapies work quicker in RA? JAKi (as expected) and TNFi (what!?) faster than IL6 and abatacept. @RheumNow #ACR24 Abstr#0501 https://t.co/7DPPwHlqpP https://t.co/3mOJ62hZhp
Richard Conway
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Shu et al. Rituximab followed by Telitacicept in refractory/severe APS. Significantly fewer new clinical events in Telitacicept group over 24 weeks (1/21 vs. 6/20) @RheumNow #ACR24 Abstr#0129 https://t.co/hjUQkNNk5w https://t.co/QLQbZ3wQx0
Caoilfhionn Connolly
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#0585 🔬PsA/axSpA: TNFi Cycling v IL-17Ai Switch
➡️470 pts: Switchers to IL-17Ai had similar/better outcomes v TNFi cyclers @ 6 mo
➡️PsA: Switchers had improved arthritis/psoriasis(-5.0, p=0.02)
➡️axSpA: Switchers had improved fatigue(-9.4, p=0.01)
#ACR24 @RheumNow
Bella Mehta
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🔍 Study on lupus & APS highlights key links! APS patients face higher rates of developing SLE, and vice versa. Notable predictors: females, lupus anticoagulant, and specific antibodies. These insights stress the need for vigilant monitoring in both. #ACR24 @RheumNow Abst#0119
Richard Conway
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Serrano-Combarro et al. Abatacept in RA-ILD. 343 patients. In 23.3% ILD progressed on abatacept. Is that good or bad? We need comparative studies! @RheumNow #ACR24 Abstr#0475 https://t.co/nUEDdjGguA https://t.co/sXEF72MafK
Eric Dein
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Are you pts using cannabis?
In Canada - 20% reported using w/in past 2 years
Use for pain, sleep, anxiety
78% noted efficacy
Compare to another study said 57% stopped due to inefficacy, 28% AEs - very diff result
70% did not tell their doc
16S18 @BharatKumarMD
#ACR24 @RheumNow https://t.co/6NAECW5MJK
Richard Conway
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Serrano-Combarro et al. Baricitinib in RA-ILD . 72 patient case series. PFTs in picture. HRCT stable/improved in 72% over 24 months. Dyspnoea stable/improved in 90%. @RheumNow #ACR24 Abstr#0476 https://t.co/aVI2kRZkMN https://t.co/4l5GKsFKtm
Eric Dein
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Medical cannabis in the USA today
Variation in state practice on recreational/medical/decriminalization
16S18 @BharatKumarMD
#ACR24 @RheumNow https://t.co/9Ex3lge6KO
Adela Castro
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PRO-SPIRIT trial data on 1192 PsA pts showed IL-17Ai seemed better than IL-12/23i and IL-23i improving cDAPSA at 3m and as effective as TNFi and JAKi. No much differences seen at 12m. Abst#0076 #ACR24 @RheumNow https://t.co/dScwsmkDOe
Antoni Chan MD (Prof)
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In the SPACE cohort, patients with chronic back pain suspected of axial spondyloarthritis often receive a diagnosis within 35 months from symptom onset. Key determinants for early diagnosis include HLA-B27 positivity and sacroiliitis on imaging. Early diagnosis can be a game… https://t.co/RrcrtRoMfL
Caoilfhionn Connolly
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#0584🔬Real-World PsA Study:Tofacitinib
➡️141 pts:47% mono,53% combo;~70% on Rx @ 6mo
➡️Similar ⬆️in disease outcomes (cDAPSA LDA: 31% mono vs 21% combo; MDA ~16%).
➡️No significant differences mono v combo outcomes
🩺Tofa effective in diverse PsA population
#ACR24 @RheumNow
Akhil Sood MD
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With many treatments for #PsA and #PsO, what are the prescribing trends?
Abstract 0604: TNF inhibitors remain the most common (~60%), but over the past 10 years, IL-17i use rose from 0.2% to 19%, and IL-23i from 0.1% to 39.7%! #ACR24 @RheumNow https://t.co/4TnCAkHfuY
Eric Dein
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Cannabis and Physical Function
Very small effects on meta-analysis
PO cannabis - 4% benefit (0.1-8%) of achieving at least MID of SF36 function scale
16S18 @BharatKumarMD
#ACR24 @RheumNow https://t.co/qQOYt1m3ub
Akhil Sood MD
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Can multidisciplinary clinics improve quality of care for PsA?
Abstract 0596: Multidisciplinary care in PsA associated with ↓ time to first biologic, ↑ dermatology & nurse visits, and better CV risk assessment. #ACR24 @RheumNow https://t.co/2OnUR6te63
Richard Conway
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Pasoto et al. Holding MMF for 1 week after zoster vaccine (RZV) improves response with no increase in flare @RheumNow #ACR24 Abstr#0247 https://t.co/q757bMFp7I https://t.co/rwjz3q3MaO


