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Polymyalgia rheumatica immunological puzzle further illustrated
Infiltrating macrophages expressing IL-6 and GM-CSF may drive the subacromial bursitis often seen in polymyalgia rheumatica, according to new research (abstract OP0015) prese
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Padoan et al. Cancer increased in EGPA. SIR 1.99 (1.22-3.08) all cancer, 1.86 (0.98-2.75) exc. NMSC. Higher ANCA+ 2.42 (1.30-4.16) and CYC treated 2.42 (1.11-4.60). 60% within years 1-5 post diagnosis @RheumNow #EULAR2022 POS0838 https://t.co/9GDLsBknO6
Richard Conway RichardPAConway ( View Tweet)
Getting Real on PMR
Dr. David Liew talks polymyalgia rheumatica and how our understanding has evolved over the years. #EULAR2022
https://t.co/BCdOTzeOHx https://t.co/VO95uHaKxg
Links:
Dr. John Cush RheumNow ( View Tweet)
Do different therapies affect GCA PET scores differently?
n=47 LV-GCA pts, Padua, serial PET
(similar to prev @KQuinnRheum @petercgrayson work)
Need more protocolised data
but can't help but feel steroids alone doesn't quite touch the sides for GCA
POS0813 #EULAR2022 @RheumNow https://t.co/Y1sGmpNyDc
David Liew drdavidliew ( View Tweet)
In case there was doubt:
- steroid toxicity is real in GCA
- giving steroid-sparing therapies (TCZ, MTX) early makes a difference
just something to not forget when your next new GCA patient rolls in the door?
POS0805 #EULAR2022 @RheumNow https://t.co/2wGV3M8wZD
David Liew drdavidliew ( View Tweet)
Older age, HTN, dyslipidemia, CKD, cancer hx, and chronic liver disease co-morbidities increased risk of COVID19 severity. PMR was the only R-IMID identified and RTX tx also increased risk of severe COVID19. #EULAR2022 POS0203 @RheumNow https://t.co/TnhRnlWkX2
Dr. Rachel Tate uptoTate ( View Tweet)
PMR/GCA patients: should you be worried about how well your COVID vaccine worked?
Actually, post-two vaccines, pretty good Ab (&cellular) response, esp if not on MTX/PNL>10
Glad to see our PMR/GCA pts protected
@VasculitisUMCG @SleenYannick @ElisabethBrouw3 #EULAR2022 @RheumNow https://t.co/9vy0W4ojOF
David Liew drdavidliew ( View Tweet)
There's nothing like a good physical examination
Temporal artery exam & ultrasound vs temporal artery biopsy
n=97 consecutive ?GCA pts from Carlo Salvarini's group
Very decent PPV
Those TA exam findings can be hard to find, but they're gold dust.
POS0820 #EULAR2022 @RheumNow https://t.co/X9TzIqQBaB
David Liew drdavidliew ( View Tweet)
Dr Patel @NaomiRheumMD et al. Avacopan in AAV at different thresholds toxicity. Minimum clinically important difference for GTI is 10 points. Avacopan assoc lower glucocorticoid toxicity irrespective of threshold used. @RheumNow #EULAR2022 POS0833 https://t.co/8iIIAsMOlI
Richard Conway RichardPAConway ( View Tweet)
Unizony et al. GCA outcome on/after tocilizumab. 36.5% relapse after stopping tocilizumab. Generally stopped due to remission, 10% stopped due to adverse event @RheumNow #EULAR2022 POS0267 https://t.co/jlZDTinfCK
Richard Conway RichardPAConway ( View Tweet)
Schmitt et al. Pharmacokinetic study of IV tocilizumab in 24 patients with known GCA. Using 6mg/kg or 7mg/kg. Effective on lab measures and no GCA flares. @RheumNow #EULAR2022 POS0268 https://t.co/uhxfGZvYTw
Richard Conway RichardPAConway ( View Tweet)
Pan et al. SPI-62 (11beta-hydroxysteroid dehydrogenase inhibitor) minimises steroid side effects in animal studies. Now going on to a clinical trial in PMR. Exciting as steroid adverse events are a huge problem in PMR/GCA @RheumNow #EULAR2022 POS1332 https://t.co/NEoIx971jS
Richard Conway RichardPAConway ( View Tweet)
Visual symptoms in GCA: should we take it on face value?
@cmukhtyar group tertiary rheum/ophthal
n=350 consecutive GCA pts diagnosed (bx/PET)
visual symptoms 29%
ocular signs 13%
Not all symptoms = signs
No doubt not all symptoms of same concern
POS0810 #EULAR2022 @RheumNow https://t.co/TYHylpBhkN
David Liew drdavidliew ( View Tweet)
Mestre-Torres et al. Features at GCA diagnosis that predict permanent vision loss. Age>75, jaw claudication, amaurosis fugax increase risk. Systemic symptoms decrease risk @RheumNow #EULAR2022 POS0271 https://t.co/FPC9R1v8S3
Richard Conway RichardPAConway ( View Tweet)
Check out my thoughts on this work on PMR's immunol signature:
video: https://t.co/7aTJMsR9Te
article: https://t.co/PTDHPv7gZC
for @RheumNow's #EULAR2022 coverage
PS just had a quick chat with @jiemy_william, so much exciting stuff to come from @VasculitisUMCG @ElisabethBrouw3! https://t.co/l94F5qAgDI
Links:
David Liew drdavidliew ( View Tweet)
Watch: EULAR 2022 - Day 1 Faculty Recap Pane
Drs. Jack Cush, Eric Dein and Kathryn Dao discuss highlights from day 1 at #EULAR2022 - Guidelines, Lupus, and more.
https://t.co/OBLt7dOMa3 https://t.co/lHmEOIFIGa
Links:
Dr. John Cush RheumNow ( View Tweet)
Germano et al. Temporal artery abnormality on clinical exam predicts biopsy + . Arterial thickening and reduced pulse strongest predictors @RheumNow #EULAR2022 POS0820 https://t.co/Rs36ALSoJb
Richard Conway RichardPAConway ( View Tweet)
Watch: EULAR Recommendations for ANCA Vasculitis
Dr. Eric Dein reviews the session held on updates to recommendations for ANCA Vasculitis, presented at the #EULAR2022 meeting in June.
https://t.co/1nr0tVIJpn https://t.co/kq0Id7PxyW
Links:
Dr. John Cush RheumNow ( View Tweet)
Sanchez-Martin et al. Tocilizumab in newly diagnosed vs refractory GCA. 471 patients. Appears of relatively similar efficacy in both groups. Surprising that the difference is not greater given refractory GCA inherently more complex @RheumNow #EULAR2022 POS0817 https://t.co/HEWzYCz9YD
Richard Conway RichardPAConway ( View Tweet)
HAS-GCA study @alwinuk @profbdasgupta Southend pretest probability score and Halo score useful in diagnosis and prognosis in GCA. Halo score may be useful for monitoring. @RheumNow #EULAR2022 POS0818 https://t.co/sxYjnQQFA8
Richard Conway RichardPAConway ( View Tweet)
