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#Methotrexate is a dud in #PMR for benefit above #glucocorticoids !
#RCT MTX25mg/wk + Pred 15
Mg/d tapered to 0 at 1 yr vs #Prednisone + placebo same taper
NO BENEFIT from #MTX
#1697 #ACR24 @ACRheum @RheumNow
As FYI
Poster at #EULAR observed
#Leflunomide better than #MTX https://t.co/RepBmOKIsA
Links:
Janet Pope Janetbirdope ( View Tweet)
Abstract 1686: Urinary proteomics reveals potential markers (MMP-13, M-CSF receptor, CD163, ALCAM, FOLR2) and pathways (neutrophil degranulation, ECM, tissue remodeling) involved in lupus nephritis Class II.
@RheumNow #ACR24 https://t.co/kufd2zl9yc
Akhil Sood MD AkhilSoodMD ( View Tweet)
@kekuchinad A#1689 PFT ref equations -> inequities in SSc ILD Predict FVC uses age, ht, sex & race - higher % pred values -> underdx Race-specific v neutral equations: More black pts meet trial eligibility (69/57%), immunos (56/40), lung t, (14/9) @RheumNow #ACR24 #ACRBest https://t.co/40PFmdk3Xv
Links:
Eric Dein ericdeinmd ( View Tweet)
Is there a less invasive approach to evaluate lupus nephritis?
Abstract 1683 highlights the potential role of 68Ga-FAPI PET imaging in evaluating for lupus nephritis. FAPI uptake ↑ in pts with lupus nephritis vs HC. Correlated with IFN -α and IFN-γ pathways.
@RheumNow #ACR24
Akhil Sood MD AkhilSoodMD ( View Tweet)
Very neat simulated model of GC regimens in AAV pt on fixed RTX by @zach_wallace_md and co
Over 5 years:
- No difference in relapse btwn standard GC vs. minimal GC + avacopan
- Higher DMII rates in standard group
Adds to trial + real world data
@RheumNow #ACR24 Abst 1598
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Will my patient with lupus nephritis respond well to induction therapy?
Abstract 1685: Aundhia et al demonstrate the promising utility of RAIL to predict complete renal response in patients with lupus nephritis (Class III or IV +/- V)
@RheumNow #ACR24 https://t.co/JBldrrwUhN
Akhil Sood MD AkhilSoodMD ( View Tweet)
#1689: race-neutral 🫁 function equations in SSc improve equity:
🔹 Race-specific equations underestimate disease severity in Black patients.
🔹 Switching to race-neutral reclassified 45% of Black patients to more severe, 16% of White patients to less severe
@RheumNow #acr24 https://t.co/BfK2PsCMX5
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Belimumab, anifrolumab and voclosporin exhibited an increase in claims from 2017-2022 for #SLE
Belimumab ~ 600% increase!!
@RheumNow #ACR24 abst#1259 https://t.co/norl1xk2KF
Bella Mehta bella_mehta ( View Tweet)
#SLE treatments #ACR24:
Compared efficacy & safety of belimumab vs. telitacicept (targets B-lymphocyte stimulator (BLyS) and proliferation-inducing ligand(APRIL))
Both improved disease activity with no difference in efficacy
Belimumab had lower infection rates
@RheumNow abst1544
Bella Mehta bella_mehta ( View Tweet)
More data from PAISLEY, deucravacitinib in SLE
Small but significant benefit w/respect to joints, a little disappointing tbh
Would like to see this for all manifestations ie pericarditis, pleuritis, etc
Anyone have an infographic or useful chart?
#ACR20 @RheumNow Abstr#1552 https://t.co/tXUoUtssxo
Links:
Mike Putman EBRheum ( View Tweet)
Low uptake of SGLT2i in Lupus nephritis
SGLT2i users had similar adverse event rates as ACEi/ARB users
SGLT2i users experienced more weight loss
#ACR24 @rheumnow abst#1534 https://t.co/tB5o7tyhu5
Bella Mehta bella_mehta ( View Tweet)
Study on SLE and NMO overlap:
Higher risk of acute cystitis & severe sepsis in hospitalized patients
SLE/NMO overlap patients 3x more likely to develop acute cystitis
2x more likely to develop severe sepsis #ACR24 @RheumNow abst#1529
Bella Mehta bella_mehta ( View Tweet)
Study on SLE treatments:
Compared adverse events of anifrolumab vs. belimumab
Similar risks for mortality, sepsis, herpes zoster, dialysis, MACE, PE/VTE, COVID-19, URI, pneumonia, and mental illness #ACR24 @RheumNow abst#1527
Bella Mehta bella_mehta ( View Tweet)
Smoking and Rx progression in PsA?
-Prospective Canadian cohort of 1736 PsA pts.
-Older age, BL SJC, dactylitis, erosions and high ESR were associated with Rx progression.
🚨Cigarette smoking did not appear to be associated with the Rx progression in PsA.
Abst#1436 #ACR24… https://t.co/J2IogqOlx8 https://t.co/U6SRmbOE6o
Links:
Adela Castro AdelaCastro222 ( View Tweet)
Study on severe lymphopenia in SLE:
- Assessed incidence, risk factors, and outcomes
- 11.52% of SLE patients experienced severe lymphopenia
- Higher infection rates during severe lymphopenia period
= No opportunistic infections observed #ACR24 abst#1519 @rheumnow @HSSProfEd
Bella Mehta bella_mehta ( View Tweet)
Study on pregnancy outcomes in SLE with thrombocytopenia:
Higher disease activity, pregnancy loss, and stillbirth rates
Identified risk factors: Anti-β2GP-I positivity and higher SLEDAI score #ACR24 abst#1487 @RheumNow
Bella Mehta bella_mehta ( View Tweet)
Study on cardiovascular deaths in SLE:
- Analyzed 1999-2020 data
- Overall decline in mortality rates, but recent increase since 2014
- Higher rates in women and African Americans
- Geographic disparities noted
#ACR24 abst#0998 @rheumnow https://t.co/dpjsl0gI0x
Links:
Bella Mehta bella_mehta ( View Tweet)
Post hoc analysis of INVIGORATE-1 trial evaluated predictors of ASAS40 response in axSpA pts who received IV SEC
⬆️back pain, long dse duration, ⬇️BMI: assoc w/ ⬆️ clinical response
BL enthesitis, older age, ⬆️dse activity: assoc w/ ⬇️ clinical response
@RheumNow #ACR24 abs1482 https://t.co/528A5lXVKl
Links:
sheila RHEUMarampa ( View Tweet)
#Upadacitinib rises ‘ Up’ in all subgroups of #GCA Subset of overall #RCT of #rinvoq w more reduction of #steroids vs placebo+ slower #prednisone taper Consistent results best in UPA 15 mg >UPA 7.5mg/d > #placebo #ACR24 #ACRBest @RheumNow @ACRheum abst#1695 https://t.co/dA7RkNmWFd
Janet Pope Janetbirdope ( View Tweet)
RheumNow’s expanded coverage of the #ACR24 annual meeting is sponsored in part by Bristol Myers Squibb and UCB. All content is chosen by RheumNow and its faculty.
Dr. John Cush RheumNow ( View Tweet)