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The first father-daughter session at ACR?
Brilliant session in diagnostic thinking and mimics in rheumatology from @LCalabreseDO and @CCalabreseDO, teasing apart heuristics, biases, and examples straddling the ID-Rheum divide. Well worth catching on the replay #ACR25 @RheumNow https://t.co/16FEqVyDGg
Links:
David Liew drdavidliew ( View Tweet)
Abstract 1657: Can LLMs track medication history? GPT-4 outperformed most LLMs in identifying TNFi start/stop events and reasons for switch. 💊 Common reasons for TNFi switching: lack of effectiveness, adverse events, and insurance/cost barriers. @RheumNow #ACR25 https://t.co/5FUR9tBoyu
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Simultaneous measurements if S100, Ferritin and IL-18 increase diagnostic utility of these biomarkers in Stills disease.
@RheumNow #Acr25 https://t.co/3wmijNcpVY
Bella Mehta bella_mehta ( View Tweet)
Biomarkers in Stills disease and MAS. #ACR25 @RheumNow
IL 6 may not be helpful compared to CRP, and IL 1 beta is difficult to measure
IL-18 seems to be the best one. https://t.co/u3oBTd4eaP
Bella Mehta bella_mehta ( View Tweet)
IL- 18 go together sometimes with glycolytic enzymes such as aldolase
Also MAS may not be a switch on and off mechanism.
Lastly MAS with Stills may have increased IL18 levels but not in other disease like SLE
#ACR25 @RheumNow https://t.co/BW1fD7usBT
Bella Mehta bella_mehta ( View Tweet)
#ACR25 Abstr#1537 Beyond T-cell malignancy, we should be vigilant re: Local immune effector cell-associated toxicity syndrome (LICATS) with CAR-T. - Mostly afect skin & kidneys - Med time of onset 10 days; duration 11 days -Most LICATS were mild & without sequelae @RheumNow https://t.co/EnAWL936oh
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
AOSD And sJIA aren't the same disease!!!. Another take on this by Scott Canna..because the clinical syndrome might have somethings distinct!!
#acr25 @RheumNow
Bella Mehta bella_mehta ( View Tweet)
Dr. Gensler gave a fantastic talk on SpA mimics
☝️Not all IBP is axSpA - interpret in the appropriate context + imaging
WOF other mimics
🔸 Sacral insufficiency fractures
🔸 Infections
🔸DISH
#ACR25 @RheumNow https://t.co/7TIqyp5rYe
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sheila RHEUMarampa ( View Tweet)
Who talks to their neighbour?
+SSA / Ro talk differently to nearby cells in #SjD #salivary #glands vs NEG Ro SjD
Ro52 acts differently than Ro60
?implications for Rx response? 🤷♀️
#ACR25 @RheumNow @ACRheum #Sjogren’s
Abst#1684
#ACRBest!
Elegant work from Sara McCoy https://t.co/UWUKAxi0UW
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Janet Pope Janetbirdope ( View Tweet)
DYK?
A bipartite ilium is a common SIJ variant.
More common among women.
SpA mimics involving biomechanical stress: BME & sclerosis
🔸OCI - assoc w/ multiparity, obesity
🔸Degenerative dse
#ACR25 @RheumNow https://t.co/IoZepAJKJ6
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sheila RHEUMarampa ( View Tweet)
~1 in 6 pts with #sarcoidosis May have #cardiac involvemt
1/3 respond to #MTX + #steroids
Followed by repeat #PET
Failures get
👇
#infliximab >#adalimumab
👇
#JAKi
Better survival >yrs ago
R heart involved ⬆️risk of MTX nonresponse
#ACR25 @RheumNow @ACRheum abst#1664 #ACRbest https://t.co/kYt9JRNSVH
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Janet Pope Janetbirdope ( View Tweet)
New tx for IPF/autoimmune ILD, nerandomilast (PDE4Bi)
Subgroup analysis from FIBRONEER-ILD, marginally less FVC worsening (-65mL tx grp vs -107mL plbo grp) & no clear improvements in dyspnea/fatigue/cough
But also... 6% absolute reduction in overall, persisted (small n) in https://t.co/Faf26UZuDx
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Mike Putman EBRheum ( View Tweet)
In the SERENA study (n=292), secukinumab reduced PsA incidence to 0.49/100 PY over 5 years in PsO patients with nail involvement, an ~82% drop vs historic non-biologic rates (2.7/100 PY). 98.3% remained PsA-free; PASI 90 achieved in 63%. Abstract#1463 @RheumNow #ACR25 https://t.co/ySOuFJiwge
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Survival outcomes in patients with axial SpA and concomitant cancer are the same as those without. #abst1429 #ACR25 @RheumNow https://t.co/wicN3s9JrR
Bella Mehta bella_mehta ( View Tweet)
Classification of sacrioilitis using new york criteria vs a convolutional neural network. Abst#1421 #acr25 @RheumNow
Yes no results - accuracy was 70 percent. But the exact grade was right 22 percent times only! https://t.co/9o8OGesH0n
Bella Mehta bella_mehta ( View Tweet)
Fragoulis et al. Real world study of bimekizumab demonstrates equal efficacy in IL-17i naive and exposed. @RheumNow #ACR25 Abstr#1439 https://t.co/aCcLgnKvFJ
Richard Conway RichardPAConway ( View Tweet)
Gensler et al. Bimekizumab in male and female axSpA patients. Greater benefit in males at week 16, but similar responses at week 52 @RheumNow #ACR25 Abstr#1449 https://t.co/zDYI2zItqT
Richard Conway RichardPAConway ( View Tweet)
Mac Gearailt et al. Depression in axSpA. Depression in 10%. Associated higher disease activity, worse functional status, and increased peripheral manifestations. @RheumNow #ACR25 Abstr#1409 https://t.co/8pnoQiaiQr
Richard Conway RichardPAConway ( View Tweet)
Bimekizumab showed sustained 1-year efficacy in axSpA across age, BMI, CRP, and HLA-B27 subgroups. ASAS40, ASDAS, BASDAI, ASQoL, and MRI scores improved in most groups—especially age ≤35, BMI 25–30, CRP >5, and HLA-B27+. Abstract 1451 @RheumNow #ACR25
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Really useful observational study, 305 pts with TAK
Out of 205 pts w/subsequent imaging, 72 (35%) w/NEW lesions in previously-unaffected territory
Majority of lesions stenotic. Emphasizes importance of regular monitoring
#ACR25 @RheumNow Abstr#1631 https://t.co/zoWjH0lEym
Links:
Mike Putman EBRheum ( View Tweet)
