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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.
Henry @EBRheum et al. Less than 1 in 6 recommendations from ACR/EULAR informed by comparative effectiveness RCT. Many receive strong recommendation despite low/very low LOE. @RheumNow #ACR22 Abstr#1284 https://t.co/1MUM8qiwDl https://t.co/KJcf7rBQAU
Richard Conway RichardPAConway ( View Tweet)
GM-CSF inc'd in active AS pts, particularly in younger ages, and strongly correlates with disease activity, but not with disease duration. TNFi tx does not affect GM-SCF levels, despite improving disease activity. Abs 1156 #ACR22 @RheumNow https://t.co/ndhBGbPsCw
Dr. Rachel Tate uptoTate ( View Tweet)
Don't forget the power of NSAIDs! (esp COX2i)
10 year study from Germany.
NSAID intake associated with lower radiographic progression in axSpA patients (esp r-axSpA)
COX2i may have stronger effect
#ACRBest #ACR22 @RheumNow Abs#1492 https://t.co/vPIaCahmiW
Robert B Chao, MD doctorRBC ( View Tweet)
Prevalence of uveitis in patients with PsA was about 5%. Uveitis rate decreased w/ anti-TNFα monoclonal antibodies and increased w/ ETN and SECU. Abs 1159 #ACR22 @RheumNow https://t.co/BtHMQ6apNI https://t.co/uZEYVQdiOU
Dr. Rachel Tate uptoTate ( View Tweet)
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)