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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.
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)
Inflammation causing HTN in AS?
Abstract #0384 #ACR22 @RheumNow
🫀413 patients followed for median 12 years
🫀14% developed HTN
🫀Baseline disease duration was an independent RF for HTN
🫀ESR > 20 sig. associated with HTN
Catherine Sims, MD DrCassySims ( View Tweet)
Martín-Varillas et al. ADA vs certolizumab in Cystoid Macular Edema in Behcets. "Equally" effective here but 80% of the certolizumab patients were previously refractory to ADA. @RheumNow #ACR22 Abstr#1567 https://t.co/ZKr38i2iA5 https://t.co/Jbtqlv9YAF
Richard Conway RichardPAConway ( View Tweet)