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OPAL dataset 🇦🇺: 55000+ RA pts, 1/10 first line JAKi. Persistence > if 1st line,< x2 if 3rd line.
1/2 switch JAKi->TNFi
1/3 switch JAKi ->JAKi
Why high proportion of JAKi cycling, when AE reason for switch low?
https://t.co/APdWW7fzJE
Abst #0274 #ACR22 @Rheumnow @ClaireDeakin10 https://t.co/3xM3lQO1wI
Aurelie Najm AurelieRheumo ( View Tweet)
Ab#0348 #ACR22: Meta-analysis of Belimumab for CLE w or w/o SLE
13 studies included: 70% with low risk of bias
BEL improved clinical response at W52 vs non-users OR 1.44
Decrease risk of severe cutaneous flare OR 0.51
Most studies against placebo group
@RheumNow https://t.co/2bSwNKRHZZ
Eric Dein ericdeinmd ( View Tweet)
TCZ in GCA: what does it mean for diabetes?
post-hoc GiACTA:
HbA1c obvs better with TCZ (PNL dosing)
but then: even after adjusting for PNL dose, apparent benefit
Is there protective effect?
Interesting observation worth investigating
ABST0461 @MGHrheumatology #ACR22 @RheumNow https://t.co/CF1as5y7Yy
David Liew drdavidliew ( View Tweet)
#ACR22 Year in Review. Dr Varga highlighted work by @Kahlenberglab. Non-lesional skin in patients with #lupus is not normal and is IFN-riched. Also implication for future therapy development to target organ/tissues vs circulation @RheumNow https://t.co/rSnLYrZoMO
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#ACR22 Yr in Review. John Varga says novel vaccination immune therapy may reverse #fibrosis - at least in mice. Hope for #scleroderma & other fibrotic diseases. Data need to be transferred into human experiments @RheumNow https://t.co/ybFRXheQq3
Janet Pope Janetbirdope ( View Tweet)
Ab0343. #ACR22 Severe non-adherence of HCQ associated with FLARES, DAMAGE and DEATH
7.3% had "severe non-adherence" by HCQ levels
Hazard ratio of flare 3.3, damage 4.26, and death 5.4
Not surprising, but very useful for pt discussion
Checking HCQ levels are helpful!
@Rheumnow https://t.co/S7P9oTPRGJ
Eric Dein ericdeinmd ( View Tweet)
Study showing Evusheld can protect our patients who are immunosuppressed; it saved alot of live. One of Dr. C Langford's pick for #YearinReview @rheumnow #ACR22 https://t.co/6ekWvA6Ruw
TheDaoIndex KDAO2011 ( View Tweet)
ACR Year in review J. Varga
What drives TNF superproduction in RA?
Study mice 🐁 model grafted w/ human synovial tissue suggests
important role of mitochondrial stress through aspartate deficiency
A potential new therapeutic target 🎯 RA?
@RheumNow #ACR22 #ACRyearinreview https://t.co/lKrOn05sFp
Aurelie Najm AurelieRheumo ( View Tweet)
Was delighted to be a (very) small part of the fantastic work by the covid GRA getting a special mention by Dr Langford at yr in review #ACR22 @RheumNow
Congrats @RichardPAConway @EBRheum @jeffsparks @SattuiSEMD @rheum_cat 🎉 https://t.co/W0n7rW9pma
Patricia Harkins DrTrishHarkins ( View Tweet)
Dr. C Langford's pick for #YearinReview; she is impressed with the novel mechanistic approaches to #SLE @rheumnow #ACR22. https://t.co/5GrtMYYZSv
TheDaoIndex KDAO2011 ( View Tweet)
Role of acquired mutations in #gout
Risk factor for gout CHIP?
Individuals with CHIP are more likely to developed acute episodes of gouty episodes
More IL-1B in cells with somatic mutations like CHIP
@rheumnow #ACR22 #yearinreview https://t.co/k3VeZuTCln
Bella Mehta bella_mehta ( View Tweet)
Tissue-resident memory T cells (Trm):
☝️Do not recirculate by blood or lymphatics
☝️Can drive recurrent inflammation
☝️Fixed-drug eruption is an example
CD8Trm - abundant in late stage non-inflamed RA synovium
#ACR22 @RheumNow #yearinreview #RheumTwitter https://t.co/LfTI0LamkN
sheila RHEUMarampa ( View Tweet)
CHIP- need to know! Somatic mutations fondly known as CHIP - not the salty ones. Clonal hematopoeisis of uncertain significance. Older Pts getting somatic mutations account for more CVS, malignancies , one change in TET2 increased gout #ACR2022 @RheumNow John Barga Yr in Review https://t.co/6bnqnkDFpL
Janet Pope Janetbirdope ( View Tweet)
#ACR2022 Year in Review. Dr Varga highlighted work by @GeorgeTsokos. In #lupus mice, adding CD38-i in a CD8+ T cell–targeted manner improved effector function, reversed the defects and improved viral clearance. CD38 as a target could reduce infection in SLE @rheumnow https://t.co/XlmvysjkDP
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Ab0344 #ACR22
CKD2+ a/w incr HCQ levels by 149 ng/mL vs CKD1
400 mg/d dose: incr HCQ levels by 448 ng/mL vs 200
Incr body wt by 15 kg -> decr HCQ levels by 82 ng/mL
Social determinants didn't effect data
>750ng/mL and >1000 predicted of 75% decr flare risk
@Rheumnow #ACRBest https://t.co/p21rqnO4ym
Eric Dein ericdeinmd ( View Tweet)
Abstr 0373 created a scoring system to predict outcomes in SpA pts w/ uveitis
- Poor outcomes seen among smoking hx, females, +HLAB27, axial & peripheral involvement, high disease activity, inflammation, and b/l eye involvement
https://t.co/mGAn0Eel1O
@RheumNow #ACR22 https://t.co/qtJsavtG9z
Akhil Sood MD AkhilSoodMD ( View Tweet)
New 2022 EULAR Recommendations for the Management of RA
The updated '22 EULAR recommendations for the mgmt of RA were initially presented at EULAR '22, and are now in press delineating the most recent developments and perspectives in RA treatment.
https://t.co/xnpOUnpgvy https://t.co/OWcRq7nZ57
Links:
Dr. John Cush RheumNow ( View Tweet)
Talking a lot about CAR-T these days! Upcoming @Figure1 newsletter, blog post @RheumNow, and interview w/@MaxKonigMD comping soon!
I'm actually skeptical of this in SLE; are B cells really the answer?
w/better targeting & dx selection, this could be game changing
#ACR22 https://t.co/Z6t99ZIeMy
Mike Putman EBRheum ( View Tweet)
A group of older patients w/ multimorbidity (5+) drives higher mortality risk in RA.
Crowson et al. stratification 4 clusters. Each cluster = different outcome, younger cluster w/ few comorbidities = no > mortality
https://t.co/IYccicjcyy
Abstr #0246 #ACR22 @Rheumnow #ACRBest https://t.co/ee9sgG3g0l
Aurelie Najm AurelieRheumo ( View Tweet)
2022 has been a great year for development of novel therapies in Phase 2 RCTs in #lupus as highlighted by Dr Langford #ACR22 Year In Review. I'd add Deucravacitinib to those lists. Look forward to Phase 3 results soon @RheumNow https://t.co/yH25KFDGdd
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)