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DMARDs/TNF for PMR:
MTX- initial benefit, but no 5 year steroid sparing effect
Infliximab - no benefit
Lef - some benefit in case series
Robert Spiera #RNL2023 @RheumNow https://t.co/cmwGEWHQEO
Eric Dein ericdeinmd ( View Tweet)
IL-6 for PMR
SPARE and SEMAPORE (Toci), SAPHYR (Sari)
2/2023: FDA approves sarilumab for PMR for inadequate response to corticosteroids or unable to taper off
Robert Spiera @RheumNow #RNL2023 https://t.co/quOWjJjgB3
Eric Dein ericdeinmd ( View Tweet)
Dr. Robert Spiera on Recent IL-6i in PMR treatment:
SPARE and SEMAPHORE study - Tocilizumab
SAPHYR - Sarilumab (now FDA approved for PMR tx)
@RheumNow #RNL2023 https://t.co/gofe54wSjo
Robert B Chao, MD doctorRBC ( View Tweet)
SAPHYR, presented at #ACR22, unpublished
Robert Spiera at #RNL2023
Phase 3 study for refractory PMR
Sustained remission of disease, less steroids usage, steroid toxicity, and improved PROs
@RheumNow https://t.co/k3w2TQ3yEB
Eric Dein ericdeinmd ( View Tweet)
@anisha_dua reviews considerations for your differential for PMR at #RNL2023 @RheumNow https://t.co/3ZsczB1UKH
Dr. Rachel Tate uptoTate ( View Tweet)
I use US in my practice and since this data was presented last year, I’ve been evaluating subacromial/deltoid bursas my PMR patients. @anisha_dua reviews imaging at #RNL2023 @RheumNow https://t.co/1TYdXNmcx0
Dr. Rachel Tate uptoTate ( View Tweet)
Dr. Anisha Dua on Imaging in PMR:
- US of shoulders to eval for bursitis can increase specificity
- MRI better for pelvic girdle, but expensive
- Consider PET if lack of response to steroids, r/o malignancy
#RNL2023 @RheumNow https://t.co/4yszV9KMA9
Robert B Chao, MD doctorRBC ( View Tweet)
#RNL2023
@anisha_dua:
Temporary artery biopsy still preferred, rec over u/s, especially if not
Early imaging for GCA recommended
@RheumNow https://t.co/41fiQuj2x9
Eric Dein ericdeinmd ( View Tweet)
"Ideally, you should get your TA biopsies within 2 weeks, but that's not always possible. Don't delay tx." @anisha_dua reminds us that bx can still be positive up to 8 weeks after steroid initiation. Just be aware of lesional changes with time. #RNL2023 @RheumNow https://t.co/uOdmlLfdkh
Dr. Rachel Tate uptoTate ( View Tweet)
A reminder by @anisha_dua
➡️15% #PMR patients get #GCA
➡️ up to 50% GCA patients get PMR
#RNL2023
Dr Gurdeep Dulay gurdeep_dulay ( View Tweet)
GCA biopsy: When and How
Early is best, rec'd in first 2 weeks. Findings can be present at 8 weeks but be less prominent
@anisha_dua rec's unilateral imaging in most pts, especially w scalp tenderness on one side
>1 cm length
#RNL2023 @RheumNow https://t.co/HBHBGeFm6J
Eric Dein ericdeinmd ( View Tweet)
Highest pre-test probability for GCA is actually:
1) Limb claudication
2) Jaw claudication
#RNL2023 @RheumNow https://t.co/13tDXMhJKM
Robert B Chao, MD doctorRBC ( View Tweet)
@anisha_dua shares her take home points for PMR. Check out her great review below! #RNL2023 @rheumnow https://t.co/PAqXaXcXAb
Dr. Rachel Tate uptoTate ( View Tweet)
@anisha_dua Table on imaging in LVV
U/S: increase specificity for PMR, operator dependent
CTA: high detail, contrast + radiation
MRA: cost and limitations in CKD, metal
PET/CT: useful but not specific for vasculitis and very high cost
#RNL2023 @RheumNow https://t.co/aTdrlPfN9J
Eric Dein ericdeinmd ( View Tweet)
Long-Term Survival of Idiopathic Inflammatory Myopathies
A single center cohort study analyzed the outcome and survival of IIM patients and showed good 5 and 10 year survival but showed significant declined 15-25 years post-diagnosis.
https://t.co/oEuTNiUANc https://t.co/1lXiStqoEz
Links:
Dr. John Cush RheumNow ( View Tweet)
Should be revisit role of #MTX in OA?
Possibly some benefit in metabolically active #osteoarthritis
#RNL2023 #methotrexate https://t.co/DIxIYQNulv
Dr Gurdeep Dulay gurdeep_dulay ( View Tweet)
MTX as a treatment of OA, by Dr.Conaghan #RNL2023 @RheumNow
Systemic inflammation might also be a part of OA?! https://t.co/grxMKtRLhj
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
⚠️Only 12-43% of #PsA patients achieved remission or very low disease activity
From systematic review in RWE presented by @DrLauraCoates
#RNL2023
Dr Gurdeep Dulay gurdeep_dulay ( View Tweet)
Treat to target approach in PsA
Systematic rev: 12-43% pts achieved target of very low disease activity or remission
Pts and docs agree: remission is primary goal, but Low disease activity is acceptable alternative
@DrLauraCoates at #RNL2023
@Rheumnow https://t.co/hA7JDR7Zyh
Eric Dein ericdeinmd ( View Tweet)
I love a good graphic. Check out @DrLauraCoates’ review of the impact of MDA in PSAID scores in PsA. #RNL2023 @RheumNow https://t.co/iQYuLQobXL
Dr. Rachel Tate uptoTate ( View Tweet)