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Proposed Cancer Screening for Inflammatory Myositis Patients
Today's plenary session features a novel proposal on how and which patients with Idiopathic Inflammatory Myopathy (IIM) should be screened for cancer. Abstract 0002 by Oldroyd et al, entitled "Cancer Screening Recommendations for Patients with Idiopathic Inflammatory Myopathy" took on this thorny practice issue.
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How do we decide which RA patients are best for #telehealth?
Abstract #1291, Ignite session
🖥@DavidLeverenz et. al created a predictive model to answer this question
🖥Patient age, diagnosis, medications, and RAPID3 score impacted the model
@RheumNow #ACR22 https://t.co/JztTbQ4zfZ
Catherine Sims, MD DrCassySims ( View Tweet)
Leung et al @drceowen @drdavidliew persistence of fatigue, sleep and mood disorders in treated PMR patients in clinical remission. higher PSQI (lower quality sleep), higher BRAF (fatigue), higher HAD (depression, anxiety) @rheumnow #ACR22 Abstr#0204 https://t.co/zoeBNO6vVD https://t.co/TGC57kj6of
Richard Conway RichardPAConway ( View Tweet)
RTX vs CYCLO for CTD ILD
🌟RECITAL trial🌟
🫁Best ⬆️ in lung fn seen in IIM + MCTD assoc ILD for both agents
🫁SSc-ILD- lung function stabilisation only (no ⬆️)
👉 In SSc RTX improved skin thickness (mRss 24wks)
⬇️ a/e RTX
#ACR22 @RheumNow
Abst#0003 #plenary https://t.co/XdaaSFfxSP
Patricia Harkins DrTrishHarkins ( View Tweet)
Question is: does early stage PNL protect vs vascular remodelling in GCA? What about TCZ?
Salvarini group:
18 new GCA pts
GUSTO Rx (TCZ +IVMPx3, no ongoing PNL)
PET/CT: 0, 24, 52w
inflamm controlled but aortic diltation
plausible concerns reinforced!
ABST0480 #ACR22 @RheumNow https://t.co/Wnw4oxaZn7
David Liew drdavidliew ( View Tweet)
RECITAL trial #CTD with #ILD RCT of #rituximab vs #cyclophosphamide showed value overall with each Rx. Only 6 months as then maybe you would retreat w rituximab? Not superior on lungs but in #scleroderma-skin improvement better w RTX. #ACRBest #ACR22 @RheumNow abst#3 Impt for Rx https://t.co/lX1YPsr5U6
Janet Pope Janetbirdope ( View Tweet)
I implemented a Fast Track GCA clinic at my hospital (>60 encounters now!)
I have have begun to think the main benefit is ACCESS
Ultrasound is great and I do them, but I recommend starting one REGARDLESS of whether or not you do ultrasound
#ACR22 @RheumNow #0463 https://t.co/4uuotmNnoi
Mike Putman EBRheum ( View Tweet)
#ACR2022 Abstr#0003. Subgroup analysis from RECITAL RCT Rituximab vs Cyclophosphamide in CTD-ILD showed both therapies improved FVC in Myositis and MCTD but not Scleroderma. To interpret with caution (non-powered). Key message: To consider RTX as option for CTD-ILD @RheumNow https://t.co/NhJKXRdw7q
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#acr22 #abst0003 @RheumNow RECITAL: RTX vs CYC for CTD related ILD:comparable in MCTD, CYC better for myositis related ILD. Both stabilize but not improve FVC in SSc ILD. In SSc RTX but not CYC improved skin thickness by mRss at 24 wks. better safety of RTX vs CYC #acrbest https://t.co/6Hry5hy1SS
Olga Petryna DrPetryna ( View Tweet)
What were the most common adverse events in @pfizer funded Xeljanz for AS?
💩diarrhea
😴fatigue
🧠headache
🫀hypertension
📍weight gain
#ACR22 @RheumNow
Catherine Sims, MD DrCassySims ( View Tweet)
@vitortexas @RheumNow Observational data, no doubt some channelling! This data is not definitive, but highlights serious questions.
Our practices need to be challenged - IVMP has questionable biological plausibility, never had clear benefit, but has clear harm.
Thanks for the comment! #ACR22
David Liew drdavidliew ( View Tweet)
Association between RA and coeliac disease: CD pts = 57% higher risk of RA vs. matched non-CD pts. Risk associated w/ age aOR 2, female aOR 2.6, socioeconomic status aOR 1.2, Medicaid aOR : 1.3.
https://t.co/APdWW7f1U6
Abst #0271 #ACR22 @Rheumnow https://t.co/djriO3QMAh
Aurelie Najm AurelieRheumo ( View Tweet)
Neural networks can delineate different forms of inflammatory arthritis (sero+, sero- & PsA) based on structural/inflammation patterns on MRI. Required use of contrast enhancement.
Are we going to be obsolete soon @DrCMcMaster?
@RheumNow ABSR0242 #ACR22
https://t.co/JExk9HiIYu https://t.co/G2tCafE8A7
Julian Segan JulianSegan ( View Tweet)
#ACR22 Abstr#0004 Macrophage Activation Syndrome is associated with Systemic JIA #arthritis but how do they link up? Mice studies show mTORC1 is a key driver. Studies needed to assess mTORC1-inhibitor e.g. rapamycin, sirolimus etc. for SJIA-related MAS @RheumNow https://t.co/sH9seK1n8u
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Why are #sJIA pts prone to #MAS?
Potential new treatment target mTORC1?
mTORC1 gene signature in monocytes
Mice models and human translational studies with evidence
#ACRBest #ACR22 @rheumnow abst#0004 #stillsdisease #autoinflammatorydisease https://t.co/Q2ehfyWMKG
Bella Mehta bella_mehta ( View Tweet)
Safety data from 9 phase 3 UPA trials (RA, PsA & AS). In 11,271 pt-yrs exposure, no increased signal for cancer (excluding NMSC) cf. ADA/MTX. NMSC was higher however.
What data (if any) would reassure people in this space?
@RheumNow ABST0292 #ACR22
https://t.co/tS5r66loqP
Julian Segan JulianSegan ( View Tweet)
MIRROR RCT: Pegloticase + MTX 60% response rate vs. 30% Pegloticase + PBO in uncontrolled gout patients. 1/2 patients w/ resolution of >= 1tophus in MTX gpe vs. < 1/3 in PBO. Safety profile comparable between groups.
https://t.co/oJ6kYw94L3 Abst#0001 #ACR22 @Rheumnow https://t.co/Hmeym3Cy7n
Aurelie Najm AurelieRheumo ( View Tweet)
Beautiful translational work looking at mTORC1 driving systemic JIA to MAS - a deadly escalation.
An already accessible target:
Rapamycin in sJIA a serious proposition!
ABST0004 @BostonChildrens #ACR22 @RheumNow https://t.co/fW3C5ludjc
David Liew drdavidliew ( View Tweet)
RECITAL trial: First line RTX vs. CYC in ILD 🫁 asso w/ SSc, mixed CTD or Myositis.
Primart endpoint FVC 24 wks improved in both mCTD and Myositis associated ILD but only stabilized in SSc-ILD. RTX improved skin thickness 24 wks. https://t.co/MQcqds0jYA
Abst#0003 #ACR22 @Rheumnow https://t.co/pK48716nIg
Aurelie Najm AurelieRheumo ( View Tweet)
#acrbest #abst0004 #acr22 @rheumnow 🐁 model of excessive mTORC1 activation in JIA confirms unrestricted activation of mTORC1 sufficient to trigger sJIA-like syndrome including MAS w/hemophagocytosis. rapamycin prevents MAS & ⬇️ arthritis severity & bone erosion in Il1rn-/- mice https://t.co/2HSXOJ6tX8
Olga Petryna DrPetryna ( View Tweet)