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In earlier studies of Vit D, there were conflicting evidence as to whether it reduced or increased the risk of RA and #SLE
@RheumNow #ACR24 @rheumarhyme https://t.co/PvjjmhHaOd
sheila RHEUMarampa ( View Tweet)
Abst#2413 SLE Cohort of > 2900 pts over 50 yrs - Prevalence of proteinuria at the time of SLE dx has not changed over the decades. Prevalence of proteinuria also did not change at 5 and 10 yrs after dx. Earlier use of HCQ has not led to a ⬇️in lupus nephritis. @RheumNow #ACRbest
TheDaoIndex KDAO2011 ( View Tweet)
We know most preexisting autoimmune disease is very mangaeable when checkpoint inhibitors are needed.
So great to see that, in the VA, autoimmune disease pts largely haven't missed out on potentially lifesaving cancer immunotherapy.
Keep on reassuring!
#ACR24 ABST1985 @RheumNow https://t.co/ApOACBLi4K
David Liew drdavidliew ( View Tweet)
Abst#1493 complete renal response (< 0.5 g/g w/< 10 mg/day pred); renal remission (UPCR < 0.3 g/g w/< 5 mg/day pred). 60 LN pts followed 3 yrs: 40% CRR & 19% RR. Pts not in CRR/RR had⬇️eGFR w/more decline in eGFR over time. No difference b/t CRR/ RR @rheumnow #ACRbest #ACR24
TheDaoIndex KDAO2011 ( View Tweet)
Renal biopsies, while painful, remain the gold standard for diagnosing and classifying lupus nephritis. But what if there are less-invasive methods? In this article, I highlight key abstracts exploring innovative approaches.
https://t.co/ZInKmVS2Gn
@RheumNow #ACR24
Akhil Sood MD AkhilSoodMD ( View Tweet)
Can you build systems that stop that ANA neg ENA pos anxiety? Plus $$?
Lehigh Valley, Allentown, PA:
lab would run ENA+dsDNA automatically, but only when ANA >1:80
(i.e. leave the ENA order to the lab)
first voluntary, then compulsory
it's possible!
#ACR24 ABST1931 @RheumNow https://t.co/UQjWwve7DV
David Liew drdavidliew ( View Tweet)
ANA neg, but ENA pos
should we care about that result?
PPV 5.5% here
(similar to 6% prev @EricFMorand: https://t.co/Hyaued3rw2)
and how many really needed the serology? Anxiety?
Surely pos ENA w neg ANA might be more hassle than help. So what to do?⬇️
#ACR24 ABST1930 @RheumNow https://t.co/rE7RmgOGey
Links:
David Liew drdavidliew ( View Tweet)
VERY exciting SLE update from Fava et al. Machine learning used to generate urinary protein panel predictive of intra-renal inflammation BETTER than serum biomarkers C3, C4, dsDNA Also monitoring tool for renal response. Outstanding. @RheumNow #ACRbest #ACR24 https://t.co/YXgKrSU4UQ
Links:
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
What a result!!!
Crowed split 49% against and 51% for MCTD as a unique disease entity
Given pre-debate poll of >70% for MCTD, looks like an overall win for the “NOT” group
Fantastic session from all the presenters
@RheumNow #ACR24 https://t.co/GgTVQ1VNWP
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
The anti-MCTD group strikes back
Of cohort of over 1,000 RNP+ pt, only 17 clinically diagnosed with MCTD
Majority of patients, despite potential overlap, treated for other primary rheum dz
@RheumNow #ACR24 https://t.co/vkQ6UPs34y
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Interesting comparative effectivness study, TOFA vs calcineurin inhibitors in MDA5-dermato
Expansion of prior publication @NEJM that used historical controls: https://t.co/AzA8ybCqYH
Encouraging data for JAKs in this disease; need proper trials
#ACR24 @RheumNow Abstr#1736 https://t.co/BHVMZLu6Ip
Links:
Mike Putman EBRheum ( View Tweet)
On now: The Great Debate - is MCTD a distinct clinical entity?
@DrLisaCS reviews the history of MCTD classification criteria and its evolution
Kasukawa criteria may be most sensitive in one cohort
@RheumNow #ACR24 https://t.co/rDHafZVL1I
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Abstract 1686: Urinary proteomics reveals potential markers (MMP-13, M-CSF receptor, CD163, ALCAM, FOLR2) and pathways (neutrophil degranulation, ECM, tissue remodeling) involved in lupus nephritis Class II.
@RheumNow #ACR24 https://t.co/kufd2zl9yc
Akhil Sood MD AkhilSoodMD ( View Tweet)
Is there a less invasive approach to evaluate lupus nephritis?
Abstract 1683 highlights the potential role of 68Ga-FAPI PET imaging in evaluating for lupus nephritis. FAPI uptake ↑ in pts with lupus nephritis vs HC. Correlated with IFN -α and IFN-γ pathways.
@RheumNow #ACR24
Akhil Sood MD AkhilSoodMD ( View Tweet)
Will my patient with lupus nephritis respond well to induction therapy?
Abstract 1685: Aundhia et al demonstrate the promising utility of RAIL to predict complete renal response in patients with lupus nephritis (Class III or IV +/- V)
@RheumNow #ACR24 https://t.co/JBldrrwUhN
Akhil Sood MD AkhilSoodMD ( View Tweet)
Belimumab, anifrolumab and voclosporin exhibited an increase in claims from 2017-2022 for #SLE
Belimumab ~ 600% increase!!
@RheumNow #ACR24 abst#1259 https://t.co/norl1xk2KF
Bella Mehta bella_mehta ( View Tweet)
#SLE treatments #ACR24:
Compared efficacy & safety of belimumab vs. telitacicept (targets B-lymphocyte stimulator (BLyS) and proliferation-inducing ligand(APRIL))
Both improved disease activity with no difference in efficacy
Belimumab had lower infection rates
@RheumNow abst1544
Bella Mehta bella_mehta ( View Tweet)
More data from PAISLEY, deucravacitinib in SLE
Small but significant benefit w/respect to joints, a little disappointing tbh
Would like to see this for all manifestations ie pericarditis, pleuritis, etc
Anyone have an infographic or useful chart?
#ACR20 @RheumNow Abstr#1552 https://t.co/tXUoUtssxo
Links:
Mike Putman EBRheum ( View Tweet)
Low uptake of SGLT2i in Lupus nephritis
SGLT2i users had similar adverse event rates as ACEi/ARB users
SGLT2i users experienced more weight loss
#ACR24 @rheumnow abst#1534 https://t.co/tB5o7tyhu5
Bella Mehta bella_mehta ( View Tweet)
Study on SLE and NMO overlap:
Higher risk of acute cystitis & severe sepsis in hospitalized patients
SLE/NMO overlap patients 3x more likely to develop acute cystitis
2x more likely to develop severe sepsis #ACR24 @RheumNow abst#1529
Bella Mehta bella_mehta ( View Tweet)
