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Difficult to Manage Axial Spondyloarthritis
Studies show that patients with difficult-to-manage axSpA have a higher disease activity; however, the lack of a consensus definition led researchers and clinicians to utilize their own proposed definition, resulting in variability of the characteristics of non-responders.
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🤵♂️Results from BACHELOR
➡️34 PMR pts
➡️18 BARI, 16 PBO
➡️Primary endpoint: CRP PMR-AS≤10 w/o oral GC rescue from W0 to 12
78% BARI pts reached primary endpoint vs 13% PBO
No new safety signals
BARI 4mg 12W, then 2mg 12W➡️36W low disease activity in PMR
Ab0858 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
How does #cardiovascular risk vary with #ACPA & #biologics in #RA?
⬆️BMI assoc with ⬆️MACE risk in ACPA+ pts
In ACPA- pts, BMI inversely assoc with MACE risk among pts on biologics
Further evidence to consider ACPA, BMI & MACE as part of RA management
Ab0870 #ACR24 @RheumNow https://t.co/UkkC146DWS
Mrinalini Dey DrMiniDey ( View Tweet)
JAKs in PMR? "BACHELOR" study randomized 34pts to BARI vs PLBO
Despite small sample, significant benefit at 12 wks (CRP PMR-AS < 10) for bari (78%) vs. PLBO (13%)
Useful, but not for getting regulatory approval. Should have gone straight to phase 3!
#ACR24 @RheumNow Abstr#0858 https://t.co/mmMs6c3AYC
Links:
Mike Putman EBRheum ( View Tweet)
📸 #ACR24 Selfie Highlights!
1️⃣ @Sethsaidso and Jack Cush, MD from @RheumNow – a dynamic duo in rheumatology!
2️⃣ @Sethsaidso and @KenSaag, MD, MSc – renowned rheumatologist and clinical investigator from UAB.
3️⃣ @Sethsaidso and @Dr_ValenzuelaMD – exceptional rheumatologist from… https://t.co/9AseHvXE1V https://t.co/Vr5rxkmCqH
Links:
CreakyJoints.org CreakyJoints ( View Tweet)
How early is early?
Data from SPACE cohort included 548 pts with CBP (<2y duration) and different SpA features followed over 2years.
-At the end of 2 years, 39% pts were dx with axSpA.
-Median time to dx: 35 months.
-HLAB27+, sacroilitis on MR and peripheral arthritis were the… https://t.co/AYtJCp8yno https://t.co/VL7KSrpvp9
Links:
Adela Castro AdelaCastro222 ( View Tweet)
Systematic review suggests (although not provn) that audiovestibular dysfunction may be from APS. Anti-phospholipid & HSP-70 Abs found 25-33% w/idiopathic sudden sensorineural hearing loss,. ACL Abs seen in up to 27% w/ sensorineural hearing loss https://t.co/WcmeCP0ryq https://t.co/DiYX57R0uG
Dr. John Cush RheumNow ( View Tweet)
Is it pre-eclampsia or lupus nephritis flare?
Abstract 0809: The sFlt-1/PlGF ratio may help distinguish preeclampsia from lupus nephritis in pregnancy. A low ratio ruled out preeclampsia, while a high ratio ± proteinuria suggests increased risk. @RheumNow #ACR24
Akhil Sood MD AkhilSoodMD ( View Tweet)
Cross-sectional study finds metabolic dysregulation in RA-ILD is indicative of poor prognosis- FGF-21 assoc w. poor survival.
Another link btwn CV risk factors, metabolic syndrome & RA? Should we be doing more to manage metabolic risk factors in RA-ILD?
Ab0803 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
Stone et al. Phase 3 RCT B-cell depletion with CD19 targeting agent Inebilizumab in IgG4-RD. HR 0.13 (0.06, 0.28) for flare. @RheumNow #ACR24 Abstr#0775 https://t.co/Kd4Xmoc5e6 https://t.co/Al6gOA1F8K
Links:
Richard Conway RichardPAConway ( View Tweet)
Hamroun et al. Meta-analysis of glucocorticoids in pregnancy and breast-feeding. Increase pre-term birth with GCs, adjusted OR 2.24. Dose-dependent effect. Minimal breastmilk transfer. @RheumNow #ACR24 Abstr#0810 https://t.co/H0o9ElsHmc https://t.co/uciFP6UOhF
Links:
Richard Conway RichardPAConway ( View Tweet)
Prof @WalterMaks et al reports the validation of data-driven quantitative MRI cutoffs for a +SIJ MRI perform highly in pts with established axSpA.
- Deep fat lesions & sclerosis: high specificity for #axSpA
@RheumNow #ACR24 abs821 https://t.co/sSAtTt1GGV
Links:
sheila RHEUMarampa ( View Tweet)
Not just the presence but higher levels of biomarkers predict RA-ILD progression.
#ACR24 @RheumNow ABST#0804 https://t.co/5jhBjXDUeY
Jiha Lee JihaRheum ( View Tweet)
Medication-assisted weight loss has boomed in recent yrs. How does weight loss affect disease activity & PROs in RMDs?
≥5% weight loss, after taking a med, led to better disease activity & QoL
Data may inform RCTs to explore effect of these meds in RMDs
Ab0845 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
LTE of deucravacitinib trials in psoriasis. Remarkable & frankly surprising (to me) persistence of benefit Very encouraging for patients who start TYKs, looks like those who respond may have prolonged benefit #ACR24 @RheumNow Abstr#0290 #ACRBest https://t.co/kao4vqpPTQ
Links:
Mike Putman EBRheum ( View Tweet)
Don’t miss the “window of opportunity” for aggressive treatment in early RA!
with active RA, risk of ILD 6x and RA-related lung disease 4x higher
#ACR24 @RheumNow ABST#0802 https://t.co/yxlfInte6A
Jiha Lee JihaRheum ( View Tweet)
Cannabis in Pain:
CBD can help with nociceptive pain
THC better for neuropathic, centralized pain
Perhaps a role in helping decrease other medications like opiates
Clauw 16S18
#ACR24 @RheumNow https://t.co/kaQXrD4GAn
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Eric Dein ericdeinmd ( View Tweet)
How often should #scleroderma #ILD pts have #PFTs? 🤷♂️
Data from SENCIS RCT of SSc-ILD
25% worsened FVC by 6/12
Are we UNDER a ordering PFTs in an ILD #SSc population
👇
Because if worsening we would consider a change in background #immunesuppression
@RheumNow #ACR24 #678 https://t.co/a9ybO3FwDd
Janet Pope Janetbirdope ( View Tweet)
Harkins @DrTrishHarkins et al. 1 year outcomes of 65 PMR patients treated in FTC. 32.7% experienced relapse, 28% still on GCs, 21% on tocilizumab. @RheumNow #ACR24 Abstr#0739 https://t.co/uYBYhPqGQE https://t.co/n9x9BDTPKg
Links:
Richard Conway RichardPAConway ( View Tweet)
Abstract #0805
Data from OTIS Registry shows Certolizumab pegol (Cimzia) exposure during pregnancy was not associated with increased risk of major birth defects, structural defects, or adverse pregnancy outcomes. #ACR24 @RheumNow
Akhil Sood MD AkhilSoodMD ( View Tweet)