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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)
Kayadibi et al. Venous halo sign in Behcets. 86% of Behcets thrombophlebitis vs 13% non-Behcets @RheumNow #ACR22 Abstr#1251 https://t.co/fnSDYhaFa0 https://t.co/luIZH9SHwW
Richard Conway RichardPAConway ( View Tweet)
Ab1011 #ACR22
@SMerjanah: Fracture rates among vets with AS
Increasing fx incidence for AS and comparator groups over time
There was increase in fractures during TNFi era 2004-2021 compared to pre-TNFi, does not show fx sparing effect
@RheumNow https://t.co/fTSYbFcxqo
Eric Dein ericdeinmd ( View Tweet)
Wiebe et al. Steroids <=5mg/day not associated negative effect on BMD. Of course steroid-related increase in fracture risk is not fully captured by BMD effect @RheumNow #ACR22 Abstr#1318 https://t.co/Ond5gzopRa https://t.co/HX2AUyQmsf
Richard Conway RichardPAConway ( View Tweet)
#ACR22 Abstr#1569 Lung complications are common in #VEXAS but what are the common radiologic findings? A cohort study in 22 men showed abnormalities were found in most patients but were non-specific. Most commonly parenchymal changes (73%) @RheumNow https://t.co/kjYSHON2yN
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Carter et al. Case series showing rapid effect of anifrolumab in refractory discoid lupus and SCLE. @RheumNow #ACR22 Abstr#0974 https://t.co/RjnNxjGJoP…
Richard Conway RichardPAConway ( View Tweet)
Pala et al. Increasing disease activity by CDAI associated increasing patient-reported cognitive dysfunction in RA. More pronounced in younger patients. @RheumNow #ACR22 Abstr#1397 https://t.co/eRFxe27qgq https://t.co/NUtTaAcrik
Richard Conway RichardPAConway ( View Tweet)
Meng et al. ESR/CRP and steroid associated increased risk of MACE in IA. NSAIDs/COX-2 and MTX associated reduced risk of MACE in IA. @RheumNow #ACR22 Abstr#1207 https://t.co/OvjNZkpWpy https://t.co/9NMIJPcV9G
Richard Conway RichardPAConway ( View Tweet)
Ab1486 #ACR22
@Keith_Colaco: Disease-specific CV Risk Prediction Model for PsO, PsA
Prediction base model w only traditional CV risks excellent (AUC 85.5)
Expanded model w damaged jts did not improve risk discrimination
@Rheumnow https://t.co/DMlOreW9zK
Eric Dein ericdeinmd ( View Tweet)
Spiera et al. Resolution PMR in SAPHYR trial IL-6i sarilumab. Week 52, 81% vs 57% with no signs/symptoms More in PBO arm needed rescue GCs 58.6% vs 32.2% @RheumNow #ACR22 Abstr#1543 https://t.co/3Sr8aB2SpC https://t.co/mjuzNFWcdn
Richard Conway RichardPAConway ( View Tweet)
Katz @GuyKatzMD et al. Coronary involvement in IgG4-RD. 13 cases, all male, median 11 years disease. All elevated serum IgG4. Aneurysms 8/13, arteritis 9/13 periarteritis 11/13. @RheumNow #ACR22 Abstr#1571 https://t.co/At7Gw2kRUp https://t.co/zcXc6oUS0f
Richard Conway RichardPAConway ( View Tweet)
Singh @NamrataRheum et al. 27,421 RA patients, 8225 on b/tsDMARD. b/tsDMARDs did not increase risk of lymphoma. IR 1.68/1000PY (95% CI 1.5-1.9) on csDMARD vs IR 1.73/1000PY (95%CI 1.4-2.1) on b/tsDMARD. @RheumNow #ACR22 Abstr#1210 https://t.co/3Uvz3mvsGM https://t.co/6k3Vqb21KF
Richard Conway RichardPAConway ( View Tweet)
Are preexisting autoimmune dx pts okay for
PD-1i/CTLA-4i combo immunoRx
(vs PD-1i single agent)?
Common question in practice for your rheum pts who get cancer
Combo ICI means:
de novo irAE: double risk
flares: same risk
Give our pts what they need!
ABST0757 #ACR22 @RheumNow https://t.co/Vs1AoM54Ut
David Liew drdavidliew ( View Tweet)
Ab1508 #ACR22 Enthesitis on PET/CT
20 untreated PsA pts w/ total body PET/CT
All 20 (100%) pts had entheseal inflammation
127/543 (~1/4) entheses showed inflammation
@RheumNow https://t.co/OQCBWW70bt
Eric Dein ericdeinmd ( View Tweet)
Zheng et al. Celiac disease more common in SLE aOR 2.88 (95%CI 2.60 –3.31). More common in white females. Assoc higher hospitalization cost and increased LOS @RheumNow #ACR22 Abstr#1192 https://t.co/kdwLmpIxNN https://t.co/ZdQJQn3QIF
Richard Conway RichardPAConway ( View Tweet)
Abs 1011 examined fracture incidence rates in AS patients over time in VA cohort
- Rate of fractures in AS pts 2.1 per 1000 PY --> 22.8 (1999 --> 2021) vs Comparators 0.4 --> 8.3
- Post TNF era fracture rates increased AS > comparators
@RheumNow #ACR22 https://t.co/eUxoTavHGV
Akhil Sood MD AkhilSoodMD ( View Tweet)
Table by @CuoghiE on how long to wait off #teratogenic meds before trying to conceive: note 2 years fr leflunomide unless a cholestyramine washout is done #ReproductiveRheum #ACR22 @rheumnow https://t.co/l4hIBQ5XN5
TheDaoIndex KDAO2011 ( View Tweet)
A future rheumatologist attending the #ACR22 Plenary session virtually to keep up with the latest information. @RheumNow https://t.co/ttYr4iwTB8
Jonathan Kay, MD RheumKay ( View Tweet)