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Is Pregnancy Truly the Solution for RA?
Pregnancy is perhaps the oldest treatment in rheumatoid arthritis (RA) and has been associated with a natural improvement in disease control in 50-75% of patients. Others, however, are not as successful with unchanged disease activity or worsening of their autoimmune disease.
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Contraception counselling in #SLE post intervention
- Contraceptive counseling rates improved from 33.9% to 55.7%
- Women over 35 were 4.09 times more likely post-intervention
- Non-Hispanic Black women were less likely than Hispanic women
#ACR24 abst#0184 @RheumNow https://t.co/sOZXnAe4ov
Bella Mehta bella_mehta ( View Tweet)
More steroid-sparing options for #IgG4RD!
Abstract 0775: In pts w/ IgG4:
- Inebilizumab (CD19-monoclonal ab) vs placebo associated with reduced risk of flare (HR 0.13; 95% CI 0.06, 0.28)
AEs: infections, infusion reactions, lymphopenia
#ACR24 @RheumNow https://t.co/Vr5hcd2E7E
Akhil Sood MD AkhilSoodMD ( View Tweet)
ASAS definition of Difficult-to-Manage Axial Spondyloarthritis (D2M axSpA) with criteria including treatment failure, suboptimal control, and persistent problematic symptoms. 89% of ASAS members endorsed the definition, including treatment-refractory cases with specific… https://t.co/3qWPQAGZ7c https://t.co/mVQzfLtaiI
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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Is it safe to administer rotavirus vaccine to infants exposed in utero to TNFi?
Abstract#0806 shows no significant ↑ in the risk of diarrhea-related healthcare events among TNFi-exposed infants who received the vaccine compared to those who did not
@RheumNow #ACR24 https://t.co/HpTCgywE4H
Akhil Sood MD AkhilSoodMD ( View Tweet)
High serum BAFF as a novel RF for dev't of preeclampsia in pregnant SLE pts?
This study by Dr. C Sims et al showed that SLE pregnancies w/preeclampsia had significantly higher BAFF levels during the 1st trimester, and likely w/ ⬆️dsDNA or ⬇️ complement
@RheumNow #ACR24 abs424 https://t.co/kNzyuT03r2
sheila RHEUMarampa ( View Tweet)
McDermott @jeffsparks et al. SAIL-RA prospective study. 172 early RA patients. RA lund disease in 16%, RA-ILD in 11%. Disease activity strongest predictor RA lung disease, HR 4.89, and RA-ILD, HR 6.17. @RheumNow #ACR24 Abstr#0802 #ACRbest https://t.co/ia0koG64mL https://t.co/U1KdgcUfOy
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Richard Conway RichardPAConway ( View Tweet)
The 2009 ASAS classification criteria did not meet the set targets of 75% sensitivity and 90% specificity in the CLASSIC cohort, indicating the need for revision of these criteria to increase its performance and validity in classification of axSpA.
Abst#0820 #ACR24 #ACRBest… https://t.co/lF3QbRUpx3 https://t.co/SHPMpCjizS
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Adela Castro AdelaCastro222 ( View Tweet)
This interesting systematic review showed that the prevalence of ILD was 15% in patients with SLE. This higher than previously reported! #ACR24 @RheumNow https://t.co/O1aZUUL4Ho
Gabriela Martinez Zayas, MD MartinezZayasMd ( View Tweet)
Researchers developed a digital messaging program to reduce fatigue in SLE
- Grounded in social cognitive and self-determination theories
- Reviewed 148 messages, refined based on patient feedback
- High patient ratings, future will see more of these #ACR24 abst#0362 @RheumNow
Bella Mehta bella_mehta ( View Tweet)
Ab#0427 #ACR24
HSS: menopause & systemic rheum disease severity
1/3 women report worse disease associated w menopause
Reported more flares, menopausal symptoms
Findings were similar between SLE and RA, but SLE patients were >2x more likely to discuss w their rheum
@RheumNow
Eric Dein ericdeinmd ( View Tweet)
❔Can rheum drugs have beneficial effects on cognition?
💊Possible benefits with MTX and TNFis but certainly an active area of research and more studies needed
#ACR24 @RheumNow https://t.co/lCnIRLwNjK
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR24 abst#0430
- Analyzed 61 SLE pregnancies
- Higher early gestational Mean Arterial Pressure before 20 Weeks linked to increased preeclampsia risk
- MAP trends at 8-10 and 17-19 weeks showed highest predictive accuracy for risk prediction
@RheumNow https://t.co/37mg0WX43v
Bella Mehta bella_mehta ( View Tweet)
Ab#474 #ACR24
Hsieh and @NamrataRheum
Cancer Survival in RA
Unable to do meta-analysis due to lack of data
HR for lung cancer in RA 1.04
No clear evid of increased risk, but more data and studies needed
Great research project by a high school student (!!)
@RheumNow https://t.co/Sfrf2v2UO4
Eric Dein ericdeinmd ( View Tweet)
Global meta-analysis of 61 studies shows TB Preventive treatment (TPT)
- Reduces active TB risk in rheumatic disease patients by 29% (RR: 0.71, CI: 0.57–0.87)
- Best outcomes in high TB-burden countries (RR: 0.51) and with isoniazid for >9 months (RR: 0.52).
- Dual screening… https://t.co/4P1982ngvL
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Gender based response in Axial SpA. A hot topic at ACR @ACRheum @RheumNow @hac28 @SPARTAN_Updates https://t.co/zbnE6kjQhL
Marina Magrey mmagrey1 ( View Tweet)
Ab#0458 #ACR24
10 year outcomes of 176 patients with seroneg RA
32 pts (18%) had change in dx - SpA (11), seropos RA (6), OA (5), crystal (3), CTD (3), Ifn-related/paraneopl/RS3PE, sarcoid (1)
40 (23%) had drug-free remission
30 (17%) started b/tsDMARD
@RheumNow
Eric Dein ericdeinmd ( View Tweet)
FDA recently approved - fms-like tyrosine kinase 1 (s-Flt1) / placental growth factor (PlGF), for diagnosing preeclampsia.
sFlt1:PlGF≤38 rules out preeclampsia in SLE
sFlt1:PlGF>85 modestly predicts preeclampsia
Proteinuria impacts prediction accuracy #ACR24 abst#0809 @RheumNow
Bella Mehta bella_mehta ( View Tweet)
Langford et al. Abatacept NOT effective in GPA in ABROGATE RCT. 65 patients. Relapse/worsening in 62% vs 68%. No difference in any secondary end-point. @RheumNow #ACR24 Abstr#0823 https://t.co/yRFZ2diJFF https://t.co/LgXkPnDArE
Links:
Richard Conway RichardPAConway ( View Tweet)
Gender differences in axSpA extend to dse activity assessment tools.
PREDICT-SpA:
🔶️BASDAI score performed better in women.
🔶️ ASDAS-CRP homogenous performance on both genders.
Consider BASDAI for assessing dse activity in women?
@RheumNow #ACR24 abs571
@rheumarhyme https://t.co/rKJXn2EPXa
sheila RHEUMarampa ( View Tweet)