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RA-ILD: an update
Interstitial lung disease (ILD) remains a leading cause of mortality in rheumatoid arthritis (RA). Estimates of involvement of ILD in RA remain relatively imprecise (estimated prevalence 5-20%), though this partly reflects the wide spectrum of ILD and differing ascertainment.
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Where are we with treating Pre-Rheumatoid Arthritis?
The ability to prevent RA in individuals at risk is a holy grail in rheumatology. There is a long history dating back to the PROMPT trial of methotrexate and PRAIRIE trial of rituximab. Both otrials showed an effect, but it seemed more likely to be a delaying of RA than prevention or modulation. Framing it another way, there were better outcomes in pre-RA because we were actually treating RA as it emerged with a proven effective treatment. It is in this setting that three trials of ongoing studies in RA preventative therapy are presented at ACR.
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Are MDA criteria created equal in PsA?
Minimal Disease Activity criteria are used to evaluate PsA disease activity and response to treatment. Given that a patient only has to meet 5 of the 7 criteria, should the individual components be weighted equally?
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Fava et al. Urinary biomarkers at 3 months better than UPCR in predicting 12 month treatment response in SLE nephritis . CD163 AUC 0.83 vs 0.75 for UPCR @THKC1 @RheumNow #ACR22 Abstr#0536 https://t.co/YI3JC2uKcv https://t.co/jnkfbI0Z1M
Richard Conway RichardPAConway ( View Tweet)
Here is a quick recap on #ACR22 Abstr#0355 Effect of voclosporin in class V lupus nephritis #lupus https://t.co/0cR8On5UWN via @YouTube @RheumNow https://t.co/E25so6X2fj
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Wilson et al. Sputum ACPA or RF assoc RA development in serum ACPA+ individuals. x4 more likely - 46% vs 12%. @RheumNow #ACR22 Abstr#0533 https://t.co/7kpeXWjeKI https://t.co/Sx41DOJAAX
Richard Conway RichardPAConway ( View Tweet)
Please do catch up on my interview with Dr Amit Saxena, New York on their work. #ACR22 Abstr#2081 Breakthrough COVID infection in SLE during Omicron era https://t.co/4dINWSobxj via @YouTube @RheumNow https://t.co/hIHWGRcu5h
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Riskedal et al. DNA methyllation based biomarker for sero- RA. Accurary 1.0 for sero+ RA and reactive arthritis, 0.75 sero-RA, 0.5 PsA. Promising but not there yet. @RheumNow #ACR22 Abstr#0531 https://t.co/clLR0V33WJ https://t.co/7Hts9gtkW9
Richard Conway RichardPAConway ( View Tweet)
Preliminary results anifrolumab may be effective in highly recalcitrant & RTX resistant CLE and DLE. Abs 0974 #ACR22 @RheumNow https://t.co/FeYrdlwQsA
Dr. Rachel Tate uptoTate ( View Tweet)
Gomez et al. Predictors renal flare in SLE. Adjusted models - low C3, low albumin, proteinuria. @RheumNow #ACR22 Abstr#0540 https://t.co/POfeAa9Ao9 https://t.co/a3JkSP1MkX
Richard Conway RichardPAConway ( View Tweet)
In-person meetings are tough. Virtual meetings are tough. But hybrid meetings are logistical nightmares
Would've liked better WiFi and a live poster hall, but a HUGE credit to @ACRheum on planning a great #ACR22 hybrid meeting. Really amazing job
@RheumNow
Eric Dein ericdeinmd ( View Tweet)
Getting to know the COVID-19 drugs:
◦ Pre-exposure prophylaxis: Tixagevimab and cilgavimab (Evusheld)
◦ Post-exposure treatments: Paxlovid (po), Molnupiravir (po), Sotrovimab (IV), Remdesivir (IV)
Rachael Perritt, COVID-19, #ACR22 @RheumNow https://t.co/bCwxJ9YfIU
Dr. Antoni Chan synovialjoints ( View Tweet)
Show us how you ACR! Share your favorite pictures from ACR on Twitter and tag #RheumPix and #ACR22 and we'll re-tweet our favorite ones! https://t.co/aAUyhmrLPW
Dr. John Cush RheumNow ( View Tweet)
Trend of reduced opioid use when initiating biologics and JAKi in RA though effect size small and very high baseline use (>50%) in this insurance claims database.
Residual pain and harm minimisation still areas of need.
@RheumNow #ACR22 ABST0925
https://t.co/XGHu0fIMF0 https://t.co/PutNNQiKnY
Julian Segan JulianSegan ( View Tweet)
JAK and TYK-2 inhibitors and indications in SpA:
● Tofacitinib ➣ Pan JAKi (AS, PsA)
● Baricitinib ➣ JAK1,2
● Upadacitinib ➣ JAK1 (AxSpA, PsA)
● Deucravacitinib ➣ TYK2 (PsA)
Carol Langford, Year in Review #ACR22 @RheumNow https://t.co/EMLEvptySS
Dr. Antoni Chan synovialjoints ( View Tweet)
Differences between #uveitis pattern in AS vs. PsA and IBD 👇
This is always asked to our rheum fellows during Kelley's hour 🤓
#ACR22 @RheumNow @rheumarhyme @trishiemd @RheumaRamblings @RheumaRambolMD https://t.co/gWxQ9xdb06
sheila RHEUMarampa ( View Tweet)
Jorge et al. @AprilJorgeMD Incidence SLE nephritis - 16% onset, 35% 15 years. 44.7% men vs 28.6% women at 10 years. 40% Black, 38% Hispanic, 40% Asian, 23% White. @RheumNow #ACR22 Abstr#0538 https://t.co/Nbx16jZAN7 https://t.co/BEnAtbcIHt
Richard Conway RichardPAConway ( View Tweet)
GPA pts can have dacryoadenitis (ddx 👇)
where pt's lateral eye/s can be curved due to swelling.
How to examine? Use thumb to retract eyelid & reveal lacrimal gland underneath, ask pt to look medially
#ACR22 @RheumNow @rheumarhyme @doktora_ging @PhRheumaJr #RheumTwitter https://t.co/pJYMffhYWx
sheila RHEUMarampa ( View Tweet)
Deucravacitinib (TYK2 inihibitor) already studied in PsO and PsA, has show efficacy in a phase 2 trial for treatment of SLE.
Improvement in SRI(4), BICLA, LLADS, CLASI-50 and joint count
Abs#1117 @RheumNow #ACR22 https://t.co/XElIuMmud9
Robert B Chao, MD doctorRBC ( View Tweet)
🦋Only 15% of pts with localized DLE develop SLE
Risk factors for conversion:
🔸ANA+ at BL
🔸dsDNA+
🔸Gen'd DLE
🔸Cytopenia
🔸Photosensitivity
🔸abn. UA
#ACR22 @RheumNow @rheumarhyme https://t.co/n7cKjC1oaR
sheila RHEUMarampa ( View Tweet)