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Avoid Abatacept in RA patients with a history of cancer?
The management of RA patients with a history of cancer continues to be an area of concern. General recommendations are to treat patients with a history of solid organ cancer as no different to any other RA patient. Recently, the ORAL-Surveillance study demonstrated evidence of a greater risk of cancer with tofacitinib than with TNF inhibitors. In this setting, two posters both reassure and raise a new cause for concern.
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“The Stone Age did not end because we ran out of stones, it's because we found better technology.” – Dr. A. Verghese on how we need to be smarter about the practice medicine to accomplish more without being bogged down by logistics. #scribes @cuttingforstone @rheumnow #ACR22 https://t.co/20fP8cRRrv
TheDaoIndex KDAO2011 ( View Tweet)
#ACR22 Abstr#0063 How can we improve adherence of #lupus patients to therapy? Dr Sun et al. showed reviewing prescription record in clinic and ~4min honest discussion on non-adherence improved uptake in 44% at next visit @RheumNow https://t.co/jGuK4Th1lg https://t.co/62u07jDNav
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#ACR22 Abstr#0343 Data from SLICC cohort showed non-adherence to hydroxychloroquine (detected by HCQ level) was associated with increased risk of flares, early damage and 5-yr deaths. It’s time to monitor level in patients who are not doing so well @RheumNow https://t.co/CdFIRcSYQD
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
The new IL-17A/F inhibitor, bimekizumab, was comparable to current established therapies in active #AnkylosingSpondylitis. Check our NMA poster today. #ACR22 #SpA #medtwitter @TheBold_MD @cplch19 @UTSWRheum @ACRheum @RheumNow @DrCassySims https://t.co/vxa05r0GvS
Adela Castro AdelaCastro222 ( View Tweet)
#ACR22 Abstr#0359 Is 2021 DORIS remission attainable in #lupus? Pooled analyses of Anifrolumab RCTs showed this was met in ~10% patients in treatment group vs 3% placebo. Faster and sustained too @Rheumnow https://t.co/5MY2O8i2gA https://t.co/PUeUY25JZl
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#ACR22 Raynaud’s:
💡Primary RP is the most common
💡Autoimmune RP is rare! Other causes more common: metabolic, trauma, vibration, Buergers.
💡NMA showed that both CCB and PDE5i reduced frequency and severity of symptoms
💡Supportive measures are cornerstone!
@ACRheum @RheumNow https://t.co/tb5FEmHJDz
Adela Castro AdelaCastro222 ( View Tweet)
“For the secret of the care of the patient is in caring for the patient”
- Francis W Peabody
What a poignant end to a fantastic key note speech by Dr Abraham Verghese!
#ACR22 @RheumNow https://t.co/R6Z1h8em7n
Patricia Harkins DrTrishHarkins ( View Tweet)
"One more thing you need in a story-- Epiphany, where the soul of the commonest object seems radiant" - Dr. Verghese. His #epiphany occurred in the #HIV era helping a dying patient come to terms w/death; he discovered “The doctor can heal without curing.” #ACR22 @rheumnow https://t.co/Yh3SU4AMIZ
TheDaoIndex KDAO2011 ( View Tweet)
GCA with visual symptoms:
do you hit the pulse iv methylpred button? Why?
260 pts from Lund 🇸🇪
no doubt some channelling, but:
IVMP no better and more steroid exposure/toxicity
This adds to existing doubts. Time to seriously question this practice?
ABST0459 #ACR22 @RheumNow https://t.co/nbQlhvoRQP
David Liew drdavidliew ( View Tweet)
Many hoped rituximab would be the panacea for all with IgG4-RD.
Consistent story: it's not.
In this European data:
- only 56% in remission at 12m
- pancreato-hepato-biliary slightly better, RPF mid-range
This story isn't over. We need other options
ABST0147 #ACR22 @RheumNow https://t.co/kyIYLLWM9g
David Liew drdavidliew ( View Tweet)
Interested in this late-breaker, comparative study of secukinumab (IL17) vs adalimumab (TNF) in AxSpa
No difference in radiographic progression at 1 year - in line with my perception of relative equality for these treatments
Need long term data!
#ACR22 @rheumnow abstr#L15 https://t.co/7EdhJsW3bq
Mike Putman EBRheum ( View Tweet)
Only 4 minutes to discuss adherence in #SLE. Implementation of discussion if <80% of meds filled. Academic docs - 20/24 used + reinforcement, validated in 17 Pts, 11/24 asked open ended ?s. Pts thought it was right timing. ?does it change behaviour- ? Abst0063 @RheumNow #ACR22 https://t.co/UQbRgw5Emj
Janet Pope Janetbirdope ( View Tweet)
All monster stories end with an unexpected award: A new order
@cuttingforstone at #ACR22 tells the monster story of #covid
“How will history review our story?”
The science will get an A+, but we failed to learn the lessons of history
All was predictable through history
@RheumNow
Eric Dein ericdeinmd ( View Tweet)
What if a patient is diagnosed with #SLE during #pregnancy?
Abstract #2931 742 women with #lupus
🤰15 women (2%) had onset of lupus during pregnancy
-47% in 2nd trimester, 40% in
3rd
🤰Worse preg. outcomes: fetal demise and preterm delivery (both 13%)
Catherine Sims, MD DrCassySims ( View Tweet)
#ACR22 opening session. Dr.Saag: 50%of rheumatologists expected to retire in the next 10 years reducing our workforce by 25%. Significant concern for access to rheum care lays ahead of us #rheumshortage @RheumNow https://t.co/ECXA2QG0kH
Olga Petryna DrPetryna ( View Tweet)
@KenSaag, ACR president describes the challenges to rheumatologists including physician shortages and need for more diversity at #ACR22 opening session.
"You cannot be what you cannot see"
Room 108 at NOON - find out what @ACRheum and @ACRheumDC will do. @RheumNow @CreakyJoints https://t.co/8KV6vDalNu
Eric Dein ericdeinmd ( View Tweet)
#ACR22 Opening Plenary. Dr Saag championed the importance of funding and support to early career researchers, team science, translational science and public health @RheumNow https://t.co/pgSZ1twgG3
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Kicking things off with South Philly Barbacoa!
#ACR22 #ACRTacoFest #ACRTacoTrot #RheumPix @AliDuarteMD @rheumecraig @BharatKumarMD @maio_danila @SattuiSEMD @RheumNow https://t.co/cxoCuYesDZ
Mike Putman EBRheum ( View Tweet)
Look at these graphs and try and tell me that sex and gender doesn't matter in RA.
We have seen in study after study after study - sex and gender matters.
ABST0241 @erasmusmcintl #ACR22 @RheumNow https://t.co/GQnKrAp0eB https://t.co/MxHRy2kwDN
David Liew drdavidliew ( View Tweet)