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Health Literacy: the forgotten social determinant of health?
Nine out of ten adults in the USA struggle to understand basic health-related information. Across the pond, in the UK, 7.1 million adults read at, or below, the level of a nine-year-old, with 60% unable to understand health information. An increasing body of research in rheumatic diseases has sought to understand the impact of health literacy, long neglected as a social determinant of health, on clinical and non-clinical outcomes. Several abstracts at this year’s ACR Convergence focus on this topic.
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#1456
💥In a real-world UK PsA cohort, 25% had joint erosion @ diagnosis
➡️Mean disease duration 34mo. @ diagnosis
➡️Mean disability score = mod. to severe
💥Delay in diagnosis=poor outcomes
‼️Are we doing enough to catch PsA early? ?
🔑Earlier detection key
#ACR @RheumNow
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
#1375🏋️♀️ Strength Training in RA
➡️ 12-week trial 28 ♀️
High-intensity(HIRT) v. Low-intensity+blood flow restriction(LIT-BFR)
🔴Equivalent gains:Lat-pulldown, biceps curl
🔴Knee extension:HIRT>LIT-BFR (non-significant)
✅ LIT-BFR: Alternative for RA sarcopenia
#ACR24 @RheumNow
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
John Stone
Steroid-free AAV
CYCLOPS: steroid tox like “wallpaper on room”
WGET (ETN for GCA) - taper off by 6 mos - neg trial but started tapers
RAVE - low doses 8-9 mg/d over 18 mos
LoVAS - low dose steroid equally eff
ADVOCATE - AVA one month taper, tox score
#ACR24 @RheumNow https://t.co/C7eLK5UNPM
Links:
Eric Dein ericdeinmd ( View Tweet)
It's always so dispiriting to see PMR patients rack up steroid side effects in front of your eyes.
(the intense motivation to do better than pred for our PMR patients)
#ACR24 @SattuiSEMD @RADoctor ABST0975 @RheumNow https://t.co/FTsvrTIt2F
David Liew drdavidliew ( View Tweet)
#1474
🔬Severe PsA? Guselkumab (GUS) has promise!
➡️In bionaive pts with severe disease activity,
GUS v. PBO resulted in:
🔴73% improvement in joints
🔴53% lower disease activity
🔴63% better PtGA by 2 years
➡️Rapid results by W2, sustained through W100.
#ACR @RheumNow
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Is participation in RISE assoc with improved quality of care?
➡️Enrolment assoc w ⬆️performance in several quality measures
➡️Most marked in practices with lower baseline performance
⏩Registry participation has potential to improve quality of rheum care
Ab1644 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
Biosimilar changes
ASP outpacing reimbursement making not affordable to use
Working with CMS but needs further legislation to fix this
FDA may change interchangeability status for medications to no longer require switching studies
@ACRheumDC @RheumNow #ACR24 https://t.co/daYQJvsHRG
Links:
Eric Dein ericdeinmd ( View Tweet)
What’s on tap for Trump health care agenda?
Uncertainty as to what priorities and actions will be
ACR has plans to address legislative, regulatory, and state affairs
@ACRheumDC #ACR24 @RheumNow https://t.co/a5z4RIOjRC
Eric Dein ericdeinmd ( View Tweet)
A meta-analysis of 11 randomized trials shows no significant difference in efficacy of bDMARDs for early vs. established axial spondyloarthritis (axSpA). Treating at different stages yields comparable short-term outcomes. Abstr#1468 #Spondyloarthritis #RheumatologyResearch… https://t.co/QYuTcVj2m1 https://t.co/ADzEEbCvUM
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
@ACRheumDC State Update:
No changes at executive level
Some shifts in state legislation
With political changes and new administration, states will probably take larger role in healthcare legislation
- PBM reform, copay accum, prior auth/step, reprod healthcare
@RheumNow #ACR24 https://t.co/jc77HCLxqQ
Links:
Eric Dein ericdeinmd ( View Tweet)
State Update @ACRheumDC
No executive level changes, some state legislative flips
Political changes will likely lead to more state legislative healthcare legislation
- In the works for PBM reform, copay accum, prior auth/Step, reprod healthcare
@RheumNow #ACR24 https://t.co/94KyHU0Blr
Links:
Eric Dein ericdeinmd ( View Tweet)
#1326
🔬 Predicting Imminent Inflammatory Arthritis
➡️543 anti-CCP+ at-risk (high/low) tracked
🔑Predictors for IA in high-risk:
🔴EMS≥30min(OR 11)
🔴RF+(OR 6)
🔴US PD(OR 5)
🔴smJTC (OR 5)
🔑Predictors for IA in low risk:
🔴RF+(OR 8)
🔴Anti CCP >3xULN(OR 7)
#ACR24 @RheumNow https://t.co/ou9HNcNb8X
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
What is Osteoarthritis? A downloadable patient education page from JAMA. https://t.co/pQgGfI0boe https://t.co/pd3kygUxkH
Dr. John Cush RheumNow ( View Tweet)
Dietary changes are intermittent fasting are common in axial spondylarthritis (axSpA) patients, possibly reducing inflammation. A study found 55% currently on a diet and 31% fasting. Many believe these practices improve disease activity. Abstr#1459 #diet #axSpA @RheumNow #ACR24
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Regulatory update @ACRheumDC
Inflation Reduction
Planned decrease in 10 drug prices including ETN
Expect this may be gutted by new administration. Will follow and advocate for drug pricing
@RheumNow #ACR24 https://t.co/ZrcMaLD6tu
Links:
Eric Dein ericdeinmd ( View Tweet)
Harkins @DrTrishHarkins et al. Novel diagnostic cytokines in treatment naive PMR. Elevations CXCL-9 (100%), MCP-1 (93%), IL-17A (83%), vs TNF (7%) and IL-6 (67%) @RheumNow #ACR24 Abstr#0881 https://t.co/DbYOn81QJH https://t.co/3eyre00D5d
Links:
Richard Conway RichardPAConway ( View Tweet)
119 Congress - prepare for change
Obamacare subsidies set to expire
NIH changes and possible reorg
ACR champions are in gov positions for both parties
Focus on affecting change that is practical, possible and improves rheumatology practice
@ACRheumDC @LennMcD
@RheumNow #ACR24 https://t.co/tcxixdlSWQ
Links:
Eric Dein ericdeinmd ( View Tweet)
@LennMcD @ACRheumDC
Do policies affect medication access, costs, reimbursements, telehealth, or your life as a rheumatology provider or patients?
Contact - quick and easy!
https://t.co/TvMlXiIZQR
@RheumNow #ACR24 https://t.co/plnUtl7Kml https://t.co/lFGx7hzlKy
Links:
Eric Dein ericdeinmd ( View Tweet)
#Blinded by results? 😊
#Ocular #involvement in #GPA
👇
Helped by #rituximab
👁️ #GPA
Difficult
Proptosis
Pseudotumour
Conjunctivitis
Scleritis
Vasculitis
Ocular muscles - diplopia
Small case series ‘author defined’ remission in
80% 👍 #RTX
#abst0726 @rheumnow #ACR24 https://t.co/GHptelOTyv
Janet Pope Janetbirdope ( View Tweet)