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The Fallacy of Biologic Treatment to Prevent Rheumatoid Arthritis
The window of opportunity concept in RA shifted our focus to trying to treat disease earlier and more aggressively to improve long term outcomes. A natural development of this was to reconsider the possibility of therapeutic interventions aimed at the prevention of rheumatoid arthritis.
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Patient reported outcomes between clinic visits: worth doing?
RA pts starting ADA/UPA, n=150
ArthritisPower/PatientSpot app for PROs between visits
52% of CDAI change explained by PROs
Maybe a helpful tool in prioritising RA clinic reviews?
@RADoctor #ACR23 ABST0380 @RheumNow https://t.co/oTttAlIxQR
David Liew drdavidliew ( View Tweet)
RheumNow’s expanded coverage of the #ACR23 annual meeting is sponsored in part by Novartis. All content is chosen by RheumNow & its faculty
Dr. John Cush RheumNow ( View Tweet)
You should not tire of hearing this! Phase2 RCT of #dazodalibep -CD40L antagonist for #extra glandular & could also have #glandular problems in #Sjogrens was + improving Facit #fatigue & ESSPRI, etc. #GameChanger #ACR23 #ACRbest @ACRheum @RheumNow Pos#L10 https://t.co/DfChrAyslL
Janet Pope ( View Tweet)
PEXIVAS results: the reduced-dose GC regimen associated w/ ^ death, ESRD, and uncontrolled dz risk in severe GPA/MPA pts. Even greater risk in pts w/ creatinine levels > 300 μmol/L & in those tx w/ RTX induction. #ACR23 Plenary 0725 https://t.co/mBMrEaGj5k @rheumnow https://t.co/flAfYEKSXJ
Dr. Rachel Tate ( View Tweet)
DESIR cohort update in Abs #0513 shows axSpA pt imaging doesn't "worsen" after pregnancy. However, following 1st pregnancy, can see slight increase in L SIJ score, but typically not enough to define "worsening." #ACR23 https://t.co/HaYj3RQGFb @rheumnow https://t.co/5MQCXS1Kat
Dr. Rachel Tate ( View Tweet)
Acute pregnancy-related CV event risk found to be highest in pts w/ SLE+ APS, followed by primary APS, and SLE w/ LN. Most importantly, 25-30% of events happen post-partum! Monitor these pts carefully! #ACR23 Plenary 0722 #ACRbest https://t.co/yD5VFJ2SXh @rheumnow https://t.co/PDvzbs19fR
Dr. Rachel Tate ( View Tweet)
Prof Mustelin explains why Basic Science research is important in medicine. New ideas need:
👉discovery
👉explanation
👉 impact
#ACR23 @rheumnow #YearInReview #BasicScience https://t.co/t0W3GdUtWD
TheDaoIndex KDAO2011 ( View Tweet)
Who knew? VEXAS =cluster of findings from a somatic mutation N=110 studying retention of advanced Rx. #JAKi had far better retention than other #Rx. Although there could be channeling bias, I am impressed! Access for off label is a different issue #L03 #ACR23 @RheumNow @ACRheum https://t.co/RE4BVdZeWt
Janet Pope ( View Tweet)
Dr. Seo shares an interesting case report on the use of anti-TRBV9 Ab in a patient with AS.
Another potential treatment option for AS?🧐
Something to watch out for in the future.
#ACR23 @RheumNow @rheumarhyme https://t.co/y6mQ756TKK
sheila ( View Tweet)
A new way to die! #Ferroptosis may be a more important means of cell death. It’s an intracellular iron-dependent form of cell death that is distinct from apoptosis, necrosis, and autophagy #ACR23 @rheumnow #YearInReview https://t.co/DB7iuwuWTX https://t.co/v5Z2Od8mJ7
TheDaoIndex KDAO2011 ( View Tweet)
Q&A from RA-ILD Guidelines Presentation:
Q: "Why was AZA recommended but ABA was not?"
A: "The evidence was not as good for it so it was not included"
Can anyone explain this to me? Where is this amazing data for AZA in RA-ILD?
@RheumNow #ACR23
Mike Putman EBRheum ( View Tweet)
#ACR23 Year in Review. CAR-T cell showed promising results in #SLE based on case series but extrapolation to other RMD may be challenging.
-Myositis recurred after 7days, needing MMF
-No improvement in lung fibrosis #SSc
Longer-term data & trial data are needed @RheumNow https://t.co/4Zmjvr51Ab
Md Yuzaiful Md Yusof ( View Tweet)
More good data for benralizumab (IL5i) in EGPA, @TerrierBen
There may be additional benefit over MEPO given deeper eosinophil depletion
Checkout our recent editorial about this in @TheLancetRheum
@RheumNow #ACR23 https://t.co/1d2nITOuOs
Mike Putman EBRheum ( View Tweet)
Our work showed the PSAID-12 score done remotely correlated with in-person clinic assessment of tender (r=0.58) , swollen joint count (r= 0.51), pain (r=0.84). 21% of patients had low disease activity onPSAID12 assessment, Chan A #Abst0507 #ACR23 @RheumNow https://t.co/vorth2ko39 https://t.co/Q2Y3ApD47E
Dr. Antoni Chan ( View Tweet)
Why do we do translational research?
Dr Mustelin outlines different goals of basic science in #yearinreview
I would emphasize the #1: understanding pathogenesis is key to address clinical challenges
Overall “we have much more work to do than we care to admit”
@RheumNow #ACR23 https://t.co/QtBO3Go3gD
Aurelie Najm ( View Tweet)
Year in review: Long-term outcome of pts in the MAINRITSAN trials
Better outcome in pts who received RTX every 6 months for 18 months.
Implications? May consider shorter duration of maintenance tx (<36mos)?
#ACR23 @RheumNow #vasculitis https://t.co/18cXBlfxSG
sheila ( View Tweet)
Great Dr. Seo presents a great quote from Prof Seza Ozen during #ACR23 YiR "What you think of as a rare manifestation of a common disease is probably a common presentation of a disease you are not aware of (yet.)" A call to arms to continue to be curious! @RheumNow https://t.co/zVcIpHZznt
Dr. Rachel Tate ( View Tweet)
RTX-induction subgroup, ADVOCATE
Encouraging results (remission 71% vs 56% plbo wk 52), but never forget RTX was NOT redosed at month 6, so pts randomized to prednisone had NO TREATMENT from wk 20 - wk 52
Take results w/grain of salt
@RheumNow #ACR23 #ACRBest @anisha_dua https://t.co/zVhRX3IbiL
Mike Putman EBRheum ( View Tweet)
Regarding monitoring of ILD: "TLC takes a lot of time and is not necessary for follow up PFTs" @sclerodermaUM
Very nice pearl; I have been including TLC in subsequent PFTs, probably not necessary
Will change my practice immediately & save patients time
@RheumNow #ACR23
Mike Putman EBRheum ( View Tweet)
