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#CurbsideConsult. What would you do? 45 yo female with dSSc and ILD, had been on stable MMF 1500 mg bid. she had increased SOB, new dry cough, hand pain, stiffness.Exam noted synovitis, Labs: ESR 76, Echo RSVP 25 mmHg, HRCT increased ILD compared to a year ago. #ACR22 @rheumnow
TheDaoIndex KDAO2011 ( View Tweet)
Are TNFi or IL-6Ri safe in rheumatic irAEs from ICI Rx?
Multiple big US centers retrospective:
TNFi, IL-6Ri vs MTX
p>0.05, but may be approx 2x risk of cancer progression
Has made me more cautious about TNFi, IL-6Ri - use MTX when you can
Lovely work! ABST1669 #ACR22 @RheumNow https://t.co/cfAT1pQZ7I
David Liew drdavidliew ( View Tweet)
This is how Dr. Berstein manages SSc-ILD #ACR22 @rheumnow #CurbsideConsult https://t.co/vP7m0WpdK6
TheDaoIndex KDAO2011 ( View Tweet)
Abdel-Wahab et al. TCZ in combo with ipilimumab/nivolumab. Very preliminary results of what will be important trial. Appears safe and well-tolerated with no increased risk cancer progression. @RheumNow #ACR22 Abstr#1670 https://t.co/uPBnHJ9BRH
Richard Conway RichardPAConway ( View Tweet)
Messier et al. WE-CAN pragmatic trial of diet and exercise (vs attention control) in knee OA with high BMI. Significant improvement in pain, walk distance, SF-36 with corresponding reduction in body weight @RheumNow #ACR22 Abstr#1675 https://t.co/uSSzx4u2sp https://t.co/upnIVecRjv
Richard Conway RichardPAConway ( View Tweet)
SAPHYR results: SAR + 14 wk GC taper showed efficacy vs comparator arm in steroid refractory PMR, including clinically meaningful improvement in QoL. No new safety signals. Plenary Abs 1676 #ACR22 @RheumNow https://t.co/mHu3e9JbCp https://t.co/93kbczSTfS
Dr. Rachel Tate uptoTate ( View Tweet)
Tonight at 7pm ET! Join our RA Topic Panel with panelists: Drs. Richard Conway, Aurelie Najm, David Liew, Janet Pope, Julian Segan
@RichardPAConway @AurelieRheumo @drdavidliew @Janetbirdope @JulianSegan #ACR22
https://t.co/hIH4WghLwN https://t.co/oKQbBnMiqQ
Links:
Dr. John Cush RheumNow ( View Tweet)
This slide reminds me of a recent case I encountered 🧐
How can we differentiate #vasculitis vs. atherosclerosis? 👇
TAK - stenosis occurs in proximal arteries, thoracic aneurysms, US: conc, smooth thickg w/ long segment stenosis
#ACR22 @Rheumnow #RheumTwitter @rheumarhyme https://t.co/So4VKsfBm4
sheila RHEUMarampa ( View Tweet)
In overweight and obese patients with knee OA, 18-months of diet and exercise delivered in community settings significantly reduced WOMAC knee pain (-0.6) compared to an attention control group. Messier S Abs#1675 https://t.co/GvPCGz0NMN #ACR22 @RheumNow https://t.co/yWAwGwunzT
Dr. Antoni Chan synovialjoints ( View Tweet)
Ab1672 #ACR22 SSc on Women's Health
100 pts - 75% lSSc
59% sexuality aff by SSc (vag dryness 67%, dig ulcers 37%, GI 37%, dyspnea 20%)
48 pts dx during repro ys - 73% never discuss contraception, 30% didn't reach family plan
22 pt - 43 pregn, 33 birth: C-sxn, low bth wt
@Rheumnow https://t.co/JRkyCVEXLB
Eric Dein ericdeinmd ( View Tweet)
More than 25,000 #ACR22 tweets since November 1 - keep going strong today and we will reach 100,000,000 impressions. Congrats to @rheum_cat, @RheumNow and @CreakyJoints for having the most impact with over 10M impressions each. @ACRheum @StevenEchard https://t.co/K2Kr4sAicS
Steven Echard, CAE StevenEchard ( View Tweet)
Sometimes your RA pts are eligible for ICI cancer immunotherapy, but there’s hesitancy because of autoimmune risk/bad irAEs
@DanaFarber @MassGenBrigham:
more RA flares
but similar mortality, severe irAEs rates
Give them what they need!
ABST1667 @jeffsparks #ACR22 @RheumNow https://t.co/WdDP8IeIYG
David Liew drdavidliew ( View Tweet)
Sarilumab (SAR) + 14 wk GC taper demonstrated significant efficacy vs the comparator arm in steroid refractory PMR patients and improvement in quality of life. Sustained remission was 28.3% SAR vs 10.3% comparator arm. Spiera R Abs#1676 https://t.co/gXGJzbYLHK #ACR22 @RheumNow https://t.co/oZBsRtxMUw
Dr. Antoni Chan synovialjoints ( View Tweet)
Very interesting Thieves Market case... which I have also seen!
Don't forget mycoplasma pneumoniae-induced rash and mucositis (MIRM) when patients presen tw/oral ulceration
My patient had +ANA and carried a dx of PFAPA; only responded to abx!
#ACR22 @RheumNow ABSTR#TMO2 https://t.co/B9dBkZyrlN
Mike Putman EBRheum ( View Tweet)
What's your view look like? Are you in-person or virtual? Share a picture from ACR on Twitter and tag #RheumPix and #ACR22 and we'll re-tweet our favorite ones! https://t.co/DE7HhDzyJY
Dr. John Cush RheumNow ( View Tweet)
#abst1679 #acr22 @rheumnow CARRA STOP-JIA early introduction of bDMARD beneficial in polyarticular JIA: in early combination of cDMARD+biologic group > pts able to achieve Clinical Remission& significantly longer T spent in CID& cJADAS10 ID during the 3 year study vs step up Rx https://t.co/xwQJnSeCNE
Olga Petryna DrPetryna ( View Tweet)
Promising data on denosumab in erosive OA
Phase 2 study - less erosive progression, more symptom improvement
Abs# L05 @RheumNow #ACR22 https://t.co/9Fg3r02ZQG
Robert B Chao, MD doctorRBC ( View Tweet)
Wittoek et al. 48-week RCT of Denosumab in erosive hand OA. Prevents structural progression! @RheumNow #ACR22 Abstr#L05 #ACRbest https://t.co/CI6VBERSmn https://t.co/OszJkGeJF7
Richard Conway RichardPAConway ( View Tweet)
L05 #ACR22 High-dose Denosumab in Erosive Hand OA
48Wk, Double-blind PBO Phase 2 100 patients
GUSS change higher in DEN v PBO at w24, incr at w48
New erosions lower in DEN w48 (2% v 7%, OR 0.23, p<0.001)
Open label extension w improvement to baseline
@RheumNow https://t.co/X6MF9q2bKj
Eric Dein ericdeinmd ( View Tweet)
This single ctr retrospective cohort study by AOhayn on antiRo/La+ moms show that the mean timing of first fetal echo for CHB screening was at 20wks AOG.
💠CHB+ in 3 fetuses on 1st echo (done 19, 22.4, 29.3 wks)
Take home msg? Do timely CHB screens
#ACR22 @RheumNow ABST#0957 https://t.co/59crW0uov4
sheila RHEUMarampa ( View Tweet)