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Updates on Reproductive Health in Women with SLE
Is patient-administered cervical cancer screening an option for women with SLE? Should I prescribe estrogen containing contraceptives to SLE women with APL antibodies? What complications should I be aware of in pregnant women with SLE? Here are three abstracts that provide insight.
Infections in pre-RA: a cause or a consequence?
Rheumatoid arthritis is known to be associated with a higher risk of infections. In abstract 0535, Porter and colleagues have assessed infection rates in the pre-RA and early RA phases as defined by antibiotics prescription and hospital admissions with an infection main diagnostic code in the UK National database.
Read Article![](https://pbs.twimg.com/media/FhMaHPgacAEBsTD.jpg)
P hoc analysis by Dr AGomez et al fr 4 Ph3 RCTs of BEL in #lupus investigated predictors of renal flares
📌Adjusted:⬇️c3, plasma alb & proteinuria levels at BL
📌Non-adj: antidsDNA+, antiSm+ addt'l predictors
🧐p alb & antiSm+ potential predictors?
#ACR22 @RheumNow ABST#540 https://t.co/EYcD7pDYQe
sheila RHEUMarampa ( View Tweet)
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Majority of pts withdrawn from IXE to PBO recaptured at least LDA & over half met ID w/ IXE retreatment. This may help us clinically with pts who have treatment interruptions. Abs 0427 #ACR22 @RheumNow https://t.co/m4c3P8l25m https://t.co/iQshG1oq2Y
Dr. Rachel Tate uptoTate ( View Tweet)
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The CONSUL trial by Dr Proft et al. compared impact of CEL+GOL vs. GOL alone on radiographic spinal progression in AS showed no significant difference bet. the 2 grps in mSASSS change after 108 wks.
Risk stratify pts who will benefit from tx
#ACR22 @RheumNow ABST#0546 #ACRBest https://t.co/jWwX7w85ur
sheila RHEUMarampa ( View Tweet)
![](https://pbs.twimg.com/media/FhZfEARX0AIF0k4.jpg)
Clinical pearl! First-line tx w/ bio-originator or biosimilar ADA/ETA showed similar effectiveness & safety in long-term cohort of axSpA pts. Response to treatment was also similar between groups. Abs 0431 #ACR22 @RheumNow https://t.co/bGGXk51hIG https://t.co/PSsX3MpSXt
Dr. Rachel Tate uptoTate ( View Tweet)
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Presenting our last (virtual) #JAKpot poster at #ACR22 1-3 pm ET (7-10 CET) in the RA treatment session.
Does anyone know what we will are supposed to do? Stay in front of our computer for 2 hours? @rheum_cat @ProftDr @DrMiniDey @EMEUNET @KragstrupTW https://t.co/uCNMezmJ4V
Kim Lauper ☮️🕊️ k_lauper ( View Tweet)
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#ACR22 KNOWLEDGE bowl Dr. Namrata Singh, a judge this year, lead the U Iowa team in their bowl championship 3-peet, 2014, ‘15 & ‘16.
😷Dr. Rebecca Tuetken BeckySueToo ( View Tweet)
![](https://pbs.twimg.com/media/FhY2eVaXgAEWM9I.jpg)
Attending Difficult to treat RA…looking forward to learning new things about this. #Gowithus #ACR22 @IFAiArthritis https://t.co/ChET0ckm0X
Deb Constien debconstien ( View Tweet)
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@erasmusmcintl @RheumNow Data here from @earlyarthritis (CATCH Canada cohort), similar results.
It's not just pain differences - but that's real too. It's lots of things, but whatever the case we ignore sex and gender's impact in RA at our peril.
ABST0532 #ACR22 @Janetbirdope @TheLancetRheum @RheumNow https://t.co/27uQmNAlPF
David Liew drdavidliew ( View Tweet)
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How long do we hold meds for live-attenuated #Vaccines? ACR 2022 vax guidelines:
💉Pre-vax:
💊csDMARDs - hold time 4 wks
💊bDMARDs -hold time of one dosing interval
💉Post-vax: hold DMARDs for 4 wks
#ACR22 @rheumnow @rheumarhyme @doktora_ging https://t.co/MGc422EtIC
sheila RHEUMarampa ( View Tweet)
![](https://pbs.twimg.com/media/FhZYMWTWQAEI_H2.jpg)
#ACR22 Abs 0408 @philipcrobinson et al, nr-axSpA pts achieving long-term clinical outcomes w/ CZP tx after 1 yr were generally sustained over 3 yrs across MRI+/CRP+, MRI−/CRP+ and MRI+/CRP− subgroups; ASDAS-MI numerically highest in MRI+/CRP+. @RheumNow https://t.co/cjpp2qCN4O https://t.co/G2YjF6ubUf
Dr. Rachel Tate uptoTate ( View Tweet)
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Potential disconnect: Objective Inflammatory Response, OIR (MRI/CRP levels) vs Clinical Response,CR (BASDAI/ASDAS). Post hoc analysis AxSpA on Certolizumab. Majority of patients >50% improved OIR, only minority improved CR. Rudwaleit etal https://t.co/WdkmkCWClO #ACR22 @RheumNow https://t.co/qlNUFhnuJQ
Dr. Antoni Chan synovialjoints ( View Tweet)
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I've always presumed biopsy-neg GCA just hit skip lesions sections
What does RNA-Seq of temporal artery bx tell us?
positive bx similar to skip lesions
bx neg GCA very different
Sometimes it's not just the sampling
sometimes it's something different...
ABST0486 #ACR22 @RheumNow https://t.co/QITgkZ21sy
David Liew drdavidliew ( View Tweet)
![](https://pbs.twimg.com/media/FhVKCP4X0AEHWbw.png)
Bimekizumab (IL-17A and IL-17F inhibitor) use in non-radiographic AxSpA resulted in rapid improvement of ASAS40 along with reduction in SPARCC MRI SI joint inflammation
#Abs0544 @RheumNow #ACR22 https://t.co/pOCg0idGsR
Robert B Chao, MD doctorRBC ( View Tweet)
![](https://pbs.twimg.com/media/FhZVz1mUcAA4QaQ.png)
2022 ACR guide for #vaccinations in RMD pts:
💉Influenza:⬆️dose or adjuvant (CR) >=65 & >18<65 on immunosuppressives
💉Pneumococcal: SR for <65 yrs, on immunosuppressives
💉Rec VZV: SR for >18y on immunosupressives
💉HPV: CR for >26y & <45y on meds & no prev vax
#ACR22 @rheumnow https://t.co/2DlIqNUBct
sheila RHEUMarampa ( View Tweet)
![](https://pbs.twimg.com/media/FhZVHS4WAAIQAph.jpg)
What do you look for on temporal artery examination in GCA assessment?
tenderness: minimally useful
reduced/absent pulse or thickening: quite good if there, nearly as good as halo
Good examination is powerful, if you're doing it right!
ABST0483 Salvarani group #ACR22 @RheumNow https://t.co/B3qvSW68at
David Liew drdavidliew ( View Tweet)
![](https://pbs.twimg.com/media/FhZV6H4XEAYxFds.jpg)
Abs 0406 demonstrates stronger relationship between disease activity (using BASFI and BASDAI) and quality of life in men w/ axSpA than women. IMO, it also demonstrates need for better assessment tools for women! #ACR22 @RheumNow https://t.co/B44ZixyeAJ https://t.co/lMzpsGcsFM
Dr. Rachel Tate uptoTate ( View Tweet)
![](https://pbs.twimg.com/media/FhZTwUUXkAEHz48.jpg)
Abs0399 ASAS recs for requesting/reporting imaging in suspected AxSpA pts key takeaway: communication!
Rheum provides pertinent hx (trauma, childbirth, pain location, duration, etc), DDx
Rads summarize hx & give pertinent +/- exam findings
#ACR22 @RheumNow https://t.co/Ucr8B5xfGA https://t.co/F6g15dQhj1
Dr. Rachel Tate uptoTate ( View Tweet)
![](https://pbs.twimg.com/media/FhVIQDQWQAAh3ap.jpg)
2022 ASAS-EULAR Recommendations of AxSpA management
1) NSAIDs still first line
2) Analgesics/opioids contraindicated
3) TNFi, IL-17i first line bDMARDs, followed by JAKinibs
4) Tapering but not discontinuation of bDMARDs in sustained remission
Abs#0542 @RheumNow #ACR22 https://t.co/ffaN2fMc3v
Robert B Chao, MD doctorRBC ( View Tweet)