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Polymyalgia rheumatica immunological puzzle further illustrated
Infiltrating macrophages expressing IL-6 and GM-CSF may drive the subacromial bursitis often seen in polymyalgia rheumatica, according to new research (abstract OP0015) prese
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Campaniello et al. Ultra-low dose RTX (500/1000mg once a year) vs low dose RTX (500/1000mg 6-monthly) for maintenance in AAV. Comparable relapse free survival 22.7% vs 21.2%, lower severe infection 10.5% vs 26.8% @RheumNow #EULAR2022 POS0837 https://t.co/uBgEmhLUzv
Richard Conway RichardPAConway ( View Tweet)
Dr Terrier @TerrierBen Mepolizumab gives clinical benefit in EGPA in terms of remission at week 36/48 and accrued remission. Benefit irrespective of presence of vasculitic features, ANCA status, clinical features, etc @RheumNow #EULAR2022 POS0836 https://t.co/GHwt1WNZEs
Richard Conway RichardPAConway ( View Tweet)
Padoan et al. Cancer increased in EGPA. SIR 1.99 (1.22-3.08) all cancer, 1.86 (0.98-2.75) exc. NMSC. Higher ANCA+ 2.42 (1.30-4.16) and CYC treated 2.42 (1.11-4.60). 60% within years 1-5 post diagnosis @RheumNow #EULAR2022 POS0838 https://t.co/9GDLsBknO6
Richard Conway RichardPAConway ( View Tweet)
Getting Real on PMR
Dr. David Liew talks polymyalgia rheumatica and how our understanding has evolved over the years. #EULAR2022
https://t.co/BCdOTzeOHx https://t.co/VO95uHaKxg
Links:
Dr. John Cush RheumNow ( View Tweet)
Do different therapies affect GCA PET scores differently?
n=47 LV-GCA pts, Padua, serial PET
(similar to prev @KQuinnRheum @petercgrayson work)
Need more protocolised data
but can't help but feel steroids alone doesn't quite touch the sides for GCA
POS0813 #EULAR2022 @RheumNow https://t.co/Y1sGmpNyDc
David Liew drdavidliew ( View Tweet)
In case there was doubt:
- steroid toxicity is real in GCA
- giving steroid-sparing therapies (TCZ, MTX) early makes a difference
just something to not forget when your next new GCA patient rolls in the door?
POS0805 #EULAR2022 @RheumNow https://t.co/2wGV3M8wZD
David Liew drdavidliew ( View Tweet)
Older age, HTN, dyslipidemia, CKD, cancer hx, and chronic liver disease co-morbidities increased risk of COVID19 severity. PMR was the only R-IMID identified and RTX tx also increased risk of severe COVID19. #EULAR2022 POS0203 @RheumNow https://t.co/TnhRnlWkX2
Dr. Rachel Tate uptoTate ( View Tweet)
PMR/GCA patients: should you be worried about how well your COVID vaccine worked?
Actually, post-two vaccines, pretty good Ab (&cellular) response, esp if not on MTX/PNL>10
Glad to see our PMR/GCA pts protected
@VasculitisUMCG @SleenYannick @ElisabethBrouw3 #EULAR2022 @RheumNow https://t.co/9vy0W4ojOF
David Liew drdavidliew ( View Tweet)
There's nothing like a good physical examination
Temporal artery exam & ultrasound vs temporal artery biopsy
n=97 consecutive ?GCA pts from Carlo Salvarini's group
Very decent PPV
Those TA exam findings can be hard to find, but they're gold dust.
POS0820 #EULAR2022 @RheumNow https://t.co/X9TzIqQBaB
David Liew drdavidliew ( View Tweet)
Dr Patel @NaomiRheumMD et al. Avacopan in AAV at different thresholds toxicity. Minimum clinically important difference for GTI is 10 points. Avacopan assoc lower glucocorticoid toxicity irrespective of threshold used. @RheumNow #EULAR2022 POS0833 https://t.co/8iIIAsMOlI
Richard Conway RichardPAConway ( View Tweet)
Unizony et al. GCA outcome on/after tocilizumab. 36.5% relapse after stopping tocilizumab. Generally stopped due to remission, 10% stopped due to adverse event @RheumNow #EULAR2022 POS0267 https://t.co/jlZDTinfCK
Richard Conway RichardPAConway ( View Tweet)
Schmitt et al. Pharmacokinetic study of IV tocilizumab in 24 patients with known GCA. Using 6mg/kg or 7mg/kg. Effective on lab measures and no GCA flares. @RheumNow #EULAR2022 POS0268 https://t.co/uhxfGZvYTw
Richard Conway RichardPAConway ( View Tweet)
Pan et al. SPI-62 (11beta-hydroxysteroid dehydrogenase inhibitor) minimises steroid side effects in animal studies. Now going on to a clinical trial in PMR. Exciting as steroid adverse events are a huge problem in PMR/GCA @RheumNow #EULAR2022 POS1332 https://t.co/NEoIx971jS
Richard Conway RichardPAConway ( View Tweet)
Visual symptoms in GCA: should we take it on face value?
@cmukhtyar group tertiary rheum/ophthal
n=350 consecutive GCA pts diagnosed (bx/PET)
visual symptoms 29%
ocular signs 13%
Not all symptoms = signs
No doubt not all symptoms of same concern
POS0810 #EULAR2022 @RheumNow https://t.co/TYHylpBhkN
David Liew drdavidliew ( View Tweet)
Mestre-Torres et al. Features at GCA diagnosis that predict permanent vision loss. Age>75, jaw claudication, amaurosis fugax increase risk. Systemic symptoms decrease risk @RheumNow #EULAR2022 POS0271 https://t.co/FPC9R1v8S3
Richard Conway RichardPAConway ( View Tweet)
Check out my thoughts on this work on PMR's immunol signature:
video: https://t.co/7aTJMsR9Te
article: https://t.co/PTDHPv7gZC
for @RheumNow's #EULAR2022 coverage
PS just had a quick chat with @jiemy_william, so much exciting stuff to come from @VasculitisUMCG @ElisabethBrouw3! https://t.co/l94F5qAgDI
Links:
David Liew drdavidliew ( View Tweet)
Watch: EULAR 2022 - Day 1 Faculty Recap Pane
Drs. Jack Cush, Eric Dein and Kathryn Dao discuss highlights from day 1 at #EULAR2022 - Guidelines, Lupus, and more.
https://t.co/OBLt7dOMa3 https://t.co/lHmEOIFIGa
Links:
Dr. John Cush RheumNow ( View Tweet)
Germano et al. Temporal artery abnormality on clinical exam predicts biopsy + . Arterial thickening and reduced pulse strongest predictors @RheumNow #EULAR2022 POS0820 https://t.co/Rs36ALSoJb
Richard Conway RichardPAConway ( View Tweet)
Watch: EULAR Recommendations for ANCA Vasculitis
Dr. Eric Dein reviews the session held on updates to recommendations for ANCA Vasculitis, presented at the #EULAR2022 meeting in June.
https://t.co/1nr0tVIJpn https://t.co/kq0Id7PxyW
Links:
Dr. John Cush RheumNow ( View Tweet)
