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Medication adherence is a problem
Much has been written about tapering medications in rheumatic diseases, often due to high costs of medications, a desire to avoid side effects and patient preference to take less medications (especially if they have side effects).
This is countered by something we all know: medications not taken don’t work, and those that are frequently missed may not provide optimal outcomes for the majority of patients.
Corriere et al Duloxetine and gabapentin have similar rates of MI and stroke in non-cancer pain. There was some theoretical concern that duloxetine could increase risk but not evident here @RheumNow #ACR22 Abstr#1195 https://t.co/E3S9Md5XWq https://t.co/8KMtcU6d1B
Richard Conway RichardPAConway ( View Tweet)
Sattui @SattuiSEMD Treatment patterns in US in 26,102 PMR patients from RISE. Over 24 months <3% used IL6i, 36% DMARD. DM and morbid obese more likely to use. Women, older, and using IL6i/DMARD more likely to have GC>1 year @RheumNow #ACR22 Abstr#1546 https://t.co/Imjsgyo49j https://t.co/8E5Rj5d7Pz
Richard Conway RichardPAConway ( View Tweet)
Data from CorEvitas RA registry shows persistence for first-line monotherapy with etanercept, adalimumab and JAKis no different at 12 months. 20-25% switching at 12-months. Clearly more to secondary failure than anti-drug antibodies.
@RheumNow #ACR22
https://t.co/FeP0UAykUg https://t.co/ad9w9lI0Hu
Julian Segan JulianSegan ( View Tweet)
Nice study on referral strategies for #axSpA in pts w/ chronic LBP by Dr @Nellziade
🔸MASTER strategy-optimal reference strategy: IBP, ✅NSAID response, HLA-B27+ & +SpA family hx
🔸Clinical predictive factors: uveitis, IBP, Pso, enthesitis &🚹
#ACR22 @RheumNow ABST#1512 #ACRBest https://t.co/l6AleXX7Kt
sheila RHEUMarampa ( View Tweet)
Decreased colonic mucus production in HLA-B27 + healthy individuals and axSpA and IBD pts. Abs 1151 #ACR22 @RheumNow https://t.co/CwX4n6PJFy https://t.co/4f1Za0Qhpj
Dr. Rachel Tate uptoTate ( View Tweet)
Biologics to treat gut microbiome dysbiosis??
In axSpA pts treated with bDMARDs for one year, gut microbiome resembled those of controls.
Collinsella remained stable - possible biomarker?
Abs#1162 @RheumNow #ACR22
#ACRBest https://t.co/vmQFJMpNPP
Robert B Chao, MD doctorRBC ( View Tweet)
Abs 1153 at #ACR22 males may have a higher levels of Th17-associated transcription factors. Radiographic progression in men may be mediated by S100 proteins and prostaglandins. @RheumNow https://t.co/mWbsaB8kK8 https://t.co/IkTBZcaqa6
Dr. Rachel Tate uptoTate ( View Tweet)
Arora @BichileT et al. PJP prophylaxis practice among nephrologists and rheumatologists @RheumNow #ACR22 Abstr#1282 https://t.co/3VyJR6k76U https://t.co/VM5rnbmv9h
Richard Conway RichardPAConway ( View Tweet)
We want to see how you are taking in #ACR22! Share your favorite pictures from ACR on Twitter and tag #RheumPix and #ACR22 and we'll re-tweet our favorite ones! https://t.co/iUY4azQQyD
Dr. John Cush RheumNow ( View Tweet)
Raadsen et al. RA-specific CV risk specifically targets pre-existing atherosclerotic vessels. So if no baseline CVD, traditional risk factors are main driver rather than RA. Risk without prevalent CVD (HR 1.16 95%CI 0.88 –1.53) @RheumNow #ACR22 Abstr#1408 https://t.co/1Y6WeEFmim https://t.co/qG3RMNnbqt
Richard Conway RichardPAConway ( View Tweet)
Michailidou et al. PMR has increased neutrophil activation and NET formation. Elevated calprotectin. Immune complexes assoc neutrophil activation. Neutrophil activation inhibited by FcγRIIA blockade @RheumNow #ACR22 Abstr#1545 https://t.co/EAqZ3byMoP https://t.co/T2PmIExSKj
Richard Conway RichardPAConway ( View Tweet)
Sarsam @sclerodermaUM et al. Long term follow up of abatacept in SSc (ASSET). @RheumNow #ACR22 Abstr#1521 https://t.co/BvWSSSIqN0 https://t.co/kc2HxjkVh8
Richard Conway RichardPAConway ( View Tweet)
Another poster from my research group!
Investigated recommendations in ACR/EULAR guidelines
<1/6th informed by head 2 head RCT
We need more comparative effectivness research!
#ACR22 @RheumNow #1284 https://t.co/HQoeKj0cxy
Mike Putman EBRheum ( View Tweet)
Moura et al. 22 case series of VEXAS. Lung involvement common, Symptoms in 95%. HRCT abnormal 73%. PFTs abnormal 20%. Changes non specific inflammatory parenchymal, steroid responsive. @RheumNow #ACR22 Abstr#1569 https://t.co/E6vUnvxSdQ https://t.co/l4aEmpy8OX
Richard Conway RichardPAConway ( View Tweet)
Fukui et al. Association different alcoholic drinks and urate in Japan. Patients always ask about this. We should drink more sake it seems! @RheumNow #ACR22 Abstr#1206 https://t.co/En5pSMUNp7 https://t.co/c67r9fsHJT
Richard Conway RichardPAConway ( View Tweet)
Exciting trial for PMR, SAPHYR RCT of sarilumab (IL6) in relapsing/refractory PMR
I interviewed Robert Speira aobut the trial for @RheumNow, arriving to your podcast inbox!
Overall very exciting, need options for this group and nice to see PMR getting attention
#ACR22 #ACRBest https://t.co/nPurVhpNws
Mike Putman EBRheum ( View Tweet)
Johnson et al. Increased risk of heart failure and heart failure mortality in RA. No improvement over time. @RheumNow #ACR22 Abstr#1204 https://t.co/MGEgmORGuL https://t.co/9zDYjZiCh1
Richard Conway RichardPAConway ( View Tweet)
Ferrada @maferradastrong et al. HSCT in VEXAS. 20 evaluated. Indications refractory disease or haematologic abnormalities. Completed in 2, ongoing in 2. @RheumNow #ACR22 Abstr#1568 https://t.co/01SeHQcIsh https://t.co/XCgz4cTQCJ
Richard Conway RichardPAConway ( View Tweet)
What to do? Should you cycle TNFi in PsA and SpA or move on? 86 Pts from CorEvitas w PsA or Ankylosing spondylitis. TNF switching was not a home run - at 6 mo on 2nd TNF only 15% were in low disease activity. 21% persistence at 2 yrs. Use another Rx! Abst#1499 #ACR22 @rheumnow
Janet Pope Janetbirdope ( View Tweet)