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ACR22: Polymyalgia Rheumatica in the Spotlight
One of the enduring legacies of ACR 2022 for me will be the emphasis on polymyalgia rheumatica (PMR). Despite being highly inflammatory and relatively common, a remarkable paucity of trials have been run in this space. Read on for a quick PMR-roundup from the meeting!
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UPA tx in prior TNFi tx PsA pts demonstrated consistent efficacy compared to the overall population in SELECT-PsA 2, regardless of number of prior anti-TNF therapies. Abs 2146 #ACR22 @RheumNow https://t.co/xnN4nvZ934 https://t.co/3S6ZzPvqVe
Dr. Rachel Tate uptoTate ( View Tweet)
How to adjust for GC correction when dose >/= 7.5mg/d using FRAX?
Calculate FRAX then
🦴For MOF risk multiply by 1.15
🦴HF risk multiply by 1.2
= adjusted risk (%)
(Adjustment of FRAX accdg to GC dose from Kanis et al., OI 2011)
#ACR22 @RheumNow @Rheumarhyme @PhRheumaJr https://t.co/qap1fFhF0h
sheila RHEUMarampa ( View Tweet)
What happens to #Sjogrens tests over time? Well nothing- serology and tests are stable over time for NIH in >2800 Pts from 1984-2020 in well characterized Pts. Abst#2025 #ACR22 @RheumNow I was surprised as I thought there would be worsening but if prevalent Pts already fibrotic?
Janet Pope Janetbirdope ( View Tweet)
Wheeler et al. MUC5B assoc risk RA-ILD, OR 2.25. No significant additive interaction with race, smoking, disease activity @RheumNow #ACR22 Abstr#2250 https://t.co/Hw2oBawKsd https://t.co/DqCQIPpEyg
Richard Conway RichardPAConway ( View Tweet)
Abstr #2195 COVID PrEP in Rheum pts who did not seroconvert after 3rd dose
- anti-SARS-CoV2 IgG levels ↑ after day 1
- Saliva IgG also ↑ up to day 14
- one reported COVID+ w mild symptoms
@RheumNow #ACR22 https://t.co/um2JFNMhpj
Akhil Sood MD AkhilSoodMD ( View Tweet)
Zuo @RayZuoMD @jasonsknight et al. High levels of anti-NET antibodies in 45% of aPL-positive patients May activate the complement cascade and contribute to brain white matter changes. @RheumNow #ACR22 Abstr#2269 https://t.co/JrjNvQRDim https://t.co/c4yXHLOmBJ
Richard Conway RichardPAConway ( View Tweet)
ILD in #scleroderma. #Scleroderma lung study III - NO DIFF between MMF + Pirfenidone vs MMF alone. Planned for 150 Pts but only 51 enrolled but p=0.9. A trial recruited during #COVID so difficult to enroll Abst#530 @RheumNow #ACR22 https://t.co/CBYEJ2YCVM
Janet Pope Janetbirdope ( View Tweet)
How does #COVID19 impact pregnant women with rheumatic disease? Does vaccination status make a difference? @RheumNow #ACR22
https://t.co/2oJ1RAeciN https://t.co/c9s6QRSOR4
Catherine Sims, MD DrCassySims ( View Tweet)
Baker et al. Optum database study. Tofa assoc reduced incident RA-ILD. aHR 0.33 (vs ADA) @RheumNow #ACR22 Abstr#2251 #ACRbest https://t.co/R5rQ3KcHnq https://t.co/8Nq0t4zqQK
Richard Conway RichardPAConway ( View Tweet)
#Vasculitis #ACR22 highlights. #Rituximab more remission in clinical care for GPA - observational, less infections if 600 mg IV fixed q6 mo how long to continue? Abst#1084 and less flares w Rituximab maintenance in the MAINRITSAN studies abst#527 Ritux is new SoC in GPA @RheumNow
Janet Pope Janetbirdope ( View Tweet)
Aggarwal @docrota et al. ProDERM results on skin and QoL. Statistically significant improvements in CDASI (both activity and damage) and SF-36. @RheumNow #ACR22 Abstr#2239 https://t.co/vsnvYUla13
Richard Conway RichardPAConway ( View Tweet)
Let's review how GCs induce #Osteoporosis 👇(every Rheum should know this!)
💊GCs have bone cell specific effects on:
💠Osteoclasts ⬆️resorption, survival
💠Osteoblasts ⬇️🦴formation & prolif; ⬆️apoptosis
💠Osteocytes ⬆️apoptosis & skeletal fragility
#ACR22 @RheumNow @rheumarhyme https://t.co/n61OXkmRgr
sheila RHEUMarampa ( View Tweet)
Espinosa-Ortega et al. Effect of DM ab on damage (as per MDI) over time. Most damage in PM/Scl>seronegative>other abs @RheumNow #ACR22 Abstr#2241 https://t.co/g8xTRyw6NZ https://t.co/sR1tT2QmU3
Richard Conway RichardPAConway ( View Tweet)
BKZ resulted in clinically meaningful improvements in FACIT-Fatigue and pain (PtAAP) in approximately half of pts w/ active PsA who are bDMARD-naïve or TNFi-IR. Abs 2119 #ACR22 @RheumNow https://t.co/29gzmMZRlG https://t.co/qziqGNxQih
Dr. Rachel Tate uptoTate ( View Tweet)
After 1st TNFi, cycling/swapping strategies both acceptable in PsA w/ similar retention rates. Further studies needed to perform survival subgroup analysis regarding different extra-articular manifestations and PsA subtypes. Abs 2149 #ACR22 @RheumNow https://t.co/SRPhSiGeUI https://t.co/EYDULe52A3
Dr. Rachel Tate uptoTate ( View Tweet)
Luedders et al. Higher plasma MMP-7 and MMP-9 assoc development incident RA-ILD in RA patients @RheumNow #ACR22 Abstr#2252 https://t.co/woVErubytC https://t.co/r916r1AxtN
Richard Conway RichardPAConway ( View Tweet)
More PsA pts on DEUC vs PBO achieved each of the MDA components at 16 weeks. Abs 2136 #ACR22 @RheumNow https://t.co/OrrDWfvGty https://t.co/CdCQzmgOOO
Dr. Rachel Tate uptoTate ( View Tweet)
🌟 COVAX register 🌟
🦠flares of IMRD following covid vax uncommon
👉factors associated with flare:
⬆️disease activity
🙋♀️ female
💊no DMARD @ vax
💊stop/⬇️ DMARD @ vax
👉⬇️ flare assoc with:
💥young
💉RTX
@RheumNow #ACR22 Abst #2274 https://t.co/S892lKcEvS
Patricia Harkins DrTrishHarkins ( View Tweet)
Long term RZB provides durable efficacy response in PsA through 100 weeks. No new safety signals. Abs 2145 #ACR22 @RheumNow https://t.co/HfJvS1HzDW https://t.co/T67lDnxeLy
Dr. Rachel Tate uptoTate ( View Tweet)