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Think Before You Order: Choose Wisely
Early in medical training, we are taught diagnoses are made 90% of the time based only on the history and physical exam of the patient; laboratory tests play a minor role. When ordered, tests are used as evidence to support the diagnosis already made by the physician.
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Thinking Outside the Box: Novel Strategies for Early Detection of AxSpA
Strategies to identify patients with suspected inflammatory back pain in the general population is critical for timely and proper diagnosis.
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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)
Updated ACR GIOP guidelines:
Panel recommends doing Initial fracture risk assessment using the CLINICAL fracture risk assessment then RE-assessing while pts continue on GCs (👇)
☝️Magic nos. GC>/= 2.5mg/d for >3mos
#ACR22 @RheumNow @rheumarhyme #Osteoporosis https://t.co/7oWqHg8Tdv
sheila RHEUMarampa ( View Tweet)
Connolly @CaoilfhionnMD et al. 3 doses SARS-CoV-2 vaccine assoc reduced breakthrough infection in Omicron wave in RMD patients. @RheumNow #ACR22 Abstr#2275 https://t.co/ONXiY8JShK https://t.co/QHNYG9XuJ0
Richard Conway RichardPAConway ( View Tweet)
Wilson et al. Sputum levels of TGF-β1, TNF-α, MCP-1, and IL-4 are significantly elevated in RA-ILD and a portion of these cytokines are also increased in subclinical disease and correlated with lung physiology @RheumNow #ACR22 Abstr#2253 https://t.co/V1fG0QC9od https://t.co/d2YvVIV3Jq
Richard Conway RichardPAConway ( View Tweet)
Should You Repeat the ENA Panel?
Dr. Kathryn Dao ( @KDAO2011) discusses abstract 0725, presented at #ACR22 Convergence. Abstract 0725: Utility of Repeat Extractable Nuclear Antigen Antibody Testing- a Retrospective Audit
https://t.co/6A2ksN6yC2 https://t.co/U62Ab7jj3d
Links:
Dr. John Cush RheumNow ( View Tweet)
Strand et al PROs from SAPHYR (ping @EBRheum ) Significant improvement in SF-36 physical and mental, EQ-5D-3L. Numerical improvement in EQ VAS, FACIT-F, HAQ-DI, PtGA, and pain scores @RheumNow #ACR22 Abstr#2243 https://t.co/RffjBHkjIU https://t.co/0wbnmUhbWy
Richard Conway RichardPAConway ( View Tweet)
"A novel mode of action which has generated a degree of excitement" - Paul Emery
PD-1 agonist - peresolimab in RA
Good impact in b/tsDMARD refractory patients
"Correction of an immune state" - we're shooting for homestasis
Definitely a space to watch!
ABSTL01 #ACR22 @RheumNow https://t.co/W2lWrBgNOT
David Liew drdavidliew ( View Tweet)
McDermott @jeffsparks et al. Subpleural ILAs on CT in 16% RA vs 5% non-RA, OR 3.74. 10 year mortality 53% RA-ILA vs 23% RA non-ILA, 22% non-RA non-ILA. HR mortality 3.20 for RA-ILA vs RA non-ILA @RheumNow #ACR22 Abstr#2248 https://t.co/HZ3y8CANUl https://t.co/nfjFq2REEh
Richard Conway RichardPAConway ( View Tweet)
Figueroa Parra @zach_wallace_md @jeffsparks @AliDuarteMD RA patients have higher risk of severe COVID, especially those with ILD @RheumNow #ACR22 Abstr#2249 https://t.co/xUwStp451C https://t.co/N5A0oo1Kyk
Richard Conway RichardPAConway ( View Tweet)
#ACR22 Abs 2144: JAK inhibition induced different gene profile in circulating immune cells w/prominent downregulation of pro-inflammatory pathways in CD4+naïve T cells AND a shift in their metabolic signaling towards a more quiescent state. @RheumNow https://t.co/qYmr6A3zvS
Dr. Rachel Tate uptoTate ( View Tweet)
Dual Energy CT Study in 32 #gout pts on #allopurinol escalated over 2 yrs to achieve Uric acid <6
- tophus urate volumes and tophus soft tissue volumes reduced
- chronic inflammatory soft tissue within the tophus is slower to respond than crystals
@RheumNow #ACR22 abst#2203 https://t.co/dtHQqg9iFR
Bella Mehta bella_mehta ( View Tweet)
BD-2 novel, PsA-specific predictive biomarker of clinical arthritis response to SEC. Pts w/ high levels of BD-2 at baseline reach and sustain higher rates of clinical response after tx w/ SEC. Abs 2148 #ACR22 @RheumNow https://t.co/9ZJz2C0Pep https://t.co/5gf2O7B0c5
Dr. Rachel Tate uptoTate ( View Tweet)
Abstr #2193 studies invasive fungal infxn in Autoimm/Rheum dx
- PJP most common (41.5%)
- Mortality highest among fungemia (48.7%) and invasive aspergillosis (38.3%) vs PJP (26.1%)
- Older age, cirrhosis, high dose GC assoc w ↑ mortality
@RheumNow #ACR22
Akhil Sood MD AkhilSoodMD ( View Tweet)
Monday: ACR 2022 Daily Recap https://t.co/AKYrkLTPJe
Dr. John Cush RheumNow ( View Tweet)
We'll be going live with our #ACR22 daily recap at 5pm ET. Find us on Twitter, LinkedIn, Youtube and Facebook. https://t.co/hjAyOOynZM
Dr. John Cush RheumNow ( View Tweet)
Aggarwal @docrota et al. RCT abatacept in IIM - 52 week results. IMACS DOI, FI-2, HAQ-DI, CDASI, TIS, MRC response all numerically better, some statistically significant. There looks like a real effect across all subtypes. @RheumNow #ACR22 Abstr#2237 https://t.co/NdkH8BnSEw https://t.co/l7ufagjniX
Richard Conway RichardPAConway ( View Tweet)