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#Rheumatoid #arthritis is an independent risk factor for death in nonmetastatic clear cell renal ca !
👇N=32K, 802 w RA also
Caveats
immunotherapy Offered = in RA
Cancer specific mortality not affected
By #RA
Frailty & RA affected outcomes
#ACR24 @RheumNow @ACRheum #1327 https://t.co/rAQ57BPA19
Janet Pope Janetbirdope ( View Tweet)
The Joint Project is a community-based, barangay health worker-led screening program that aims to increase MSK dse awareness, timely referral & treatment or rehab.
The figure below illustrates the conceptual framework for the program
@RheumNow #ACR24 abs0979 https://t.co/yxXsASl2GJ
sheila RHEUMarampa ( View Tweet)
This study by Dr. UGazel et al shows that cervical DISH in SpA is similar to the general population.
Of note, HLAB27+ axSpA pts had more DISH while PsA pts had DISH if they were HLaB27(-)
@RheumNow #ACR24 abs1447 https://t.co/GtcvxVSb8B
sheila RHEUMarampa ( View Tweet)
Gonzalez Molina et al. MANHATTAN observational study. In PsA after 1st TNFi failure should we use guselkumab or 2nd TNFi? Guselkumab slightly better persistence, DAPSA, and improvements in joint counts. @RheumNow #ACR24 Abstr#1469 https://t.co/X3TMCVys6B https://t.co/vvkUYbzVDq
Links:
Richard Conway RichardPAConway ( View Tweet)
Ultrasound guided injections on cadavers improve rheumatology trainees ability to do
#joint #injections
17 trainees -a couple of hrs of cadaver inj
▶️ joint injection confidence improved esp uncommon / difficult areas
Elbow
Ankle
Wrist
@RheumNow #ACR24 @ACRheum abst#1310 https://t.co/ZcER4s8QcR
Janet Pope Janetbirdope ( View Tweet)
No Increase in Cardiovascular Events with JAK Inhibitors in IBD Patients
UMKC researchers have compared the use of JAK inhibitors versus tumor necrosis factor (TNF) blockers in inflammatory bowel disease (IBD) patients, but failed to see an increase in major adverse… https://t.co/IOzckJIfYf https://t.co/8S6FnffVLG
Dr. John Cush RheumNow ( View Tweet)
TYK2/JAK1 in Dermato? Interesting pre-clinical study of brepocitinib... but we really just need clinical data
Glad to see this is headed straight to a Phase 3! Hoping they allow IVIG: has been a problem with many/most/all? recent dermato studies
#ACR24 @RheumNow Abstr#0882 https://t.co/KS8fTMBpPR
Mike Putman EBRheum ( View Tweet)
Kharouf et al. Secondary biologic failure in PsA common - 36% over 5 years. Predictors - higher baseline SJC HR 1.39 and PASI HR 1.14. TNFi did better, HR 0.40, esp golimumab - but ?this as often used as first bDMARD? @RheumNow #ACR24 Abstr#1455 https://t.co/ET0WX6tKMr https://t.co/iVcCkM0hu3
Links:
Richard Conway RichardPAConway ( View Tweet)
In this large 🇦🇺 RA cohort, median time on treatment for upadacitinib was lot higher than other JAKi
(28mo vs 17mo)
Why?
Patient selection, or a real difference between JAKi?
Would really like more comparative effectiveness data between JAKi
#ACR24 OPAL group ABST1370 @RheumNow https://t.co/OU2ayzqIc8
David Liew drdavidliew ( View Tweet)
Spicy network SRMA, 123pts w/JAK-TNF-PLBO
TNF >> JAK w/respect to malignancy (expected) & better than PLBO (spicy!)
JAK > PLBO for heme cancers (makes sense); no significant (but slight trend) toward PLBO > JAK for all cancer
The debate continues
#ACR24 @RheumNow Abstr#0989 https://t.co/tBnb02gyzF
Mike Putman EBRheum ( View Tweet)
Brenac et al. Orbital MRI to distinguish GCA AOIN/CRO from non-arteritic. @RheumNow #ACR24 Abstr#1641 https://t.co/qIwaX3qp02 https://t.co/5CIZ0aV98Z
Links:
Richard Conway RichardPAConway ( View Tweet)
Which RA patients are at increased risk of JAKi adverse events? Does disease activity matter?
in the upadacitinib ph3 trials, high disease activity pts had more:
serious infections
HZ
MACE
VTE
Active RA is a massive contributor to many AEs in JAKi pts
#ACR24 ABST1393 @RheumNow https://t.co/DlFf9Sfbja
David Liew drdavidliew ( View Tweet)
Koc et al. STAMP trial in PsA. Secukinumab+MTX+GC vs MTX+GC(+SSZ if needed). Both could go to TNF if needed. Secukinumab significantly better at week 12 but no longer at week 24. @RheumNow #ACR24 Abstr#1457 https://t.co/4TGSiUPebV https://t.co/eAANkYIpzy
Links:
Richard Conway RichardPAConway ( View Tweet)
Harkins @DrTrishHarkins et al. PROs predict relapse in PMR. pVAS, HAQ health status, FACIT-F all positive predictors. Interestingly PHQ-9 negative predictor. @RheumNow #ACR24 Abstr#1238 https://t.co/kj4WgmI0oq https://t.co/xLDzRZvxoA
Links:
Richard Conway RichardPAConway ( View Tweet)
Gottlieb et al. TYK2i Zasocitinib in PsA. 12 week phase 2 RCT. Skin responses and MDA all favour zasocitinib but maybe not fantastic? PASI75 46%, PASI90 37%, PASI100 26%. MDA in photo. @RheumNow #ACR24 Abstr#1477 https://t.co/iX5iriESV2 https://t.co/RkEmcAZ80x
Links:
Richard Conway RichardPAConway ( View Tweet)
Zhang @jeffsparks et al. Even more evidence that MTX does not cause ILD, and in fact prevents ILD, in RA, OR 0.48 in meta-analysis. @RheumNow #ACR24 Abstr#1384 https://t.co/YvQnmmvNjF https://t.co/crYUwHahDb
Links:
Richard Conway RichardPAConway ( View Tweet)
The idea of patient-initiated follow-up for RA is enticing:
patient & physician time is already stretched
minimize unnecessary visits/improve access
but what actually needs to go into the design, to make it safe/workable?
A: plenty.
🇨🇦 pilot underway
#ACR24 ABST1041 @RheumNow https://t.co/03u4bhnQ0v
David Liew drdavidliew ( View Tweet)
STAR trial of GC w/d in RA LDA
SEMIRA of GC w/d controlled RA on Toci
Very slight disease activity increase, but higher flares
No symptomatic adrenal insufficiency, but data of abnormal ACTH stim
No good evidence of steroid w/d symptoms
Beth Wallace
@RheumNow #ACR24 https://t.co/j6UPWlVNIu
Links:
Eric Dein ericdeinmd ( View Tweet)
Slick poster, but must be careful w/real world data. Big risk of confounding/channeling bias
Pts with MACE risk (not always well-characterized by ICD codes) also less likely to receive JAK & therefore less liekly to have subsequent MACE
#ACR24 @RheumNow Abstr#1394 https://t.co/lilU0byJ1s
Mike Putman EBRheum ( View Tweet)
Zhou et al. Phase 2 RCT of XKH004, IL17A/Fi in AxSpA. ASAS40 50.4% vs 25%. Slightly odd dose response variation, but maybe just noise. @RheumNow #ACR24 Abstr#1453 https://t.co/SsTSThFzro https://t.co/C9yK2G4tqB
Links:
Richard Conway RichardPAConway ( View Tweet)