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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.
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2022 ACR guide for #vaccinations in RMD pts:
💉Influenza:⬆️dose or adjuvant (CR) >=65 & >18<65 on immunosuppressives
đź’‰Pneumococcal: SR for <65 yrs, on immunosuppressives
đź’‰Rec VZV: SR for >18y on immunosupressives
đź’‰HPV: CR for >26y & <45y on meds & no prev vax
#ACR22 @rheumnow https://t.co/2DlIqNUBct
sheila RHEUMarampa ( View Tweet)
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)
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)
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)
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)
Saturday: ACR 2022 Daily Recap https://t.co/3WGcxsEtOj
Dr. John Cush RheumNow ( View Tweet)
Emerging and exciting treatments in RA: #ACR22 preview
https://t.co/5JtblF9MxE https://t.co/oYSiLguLkJ
Links:
Dr. John Cush RheumNow ( View Tweet)
Are DNA methylation marks the new seronegative RA biomarkers?
Riskedal et al. propose a new model based on whole-blood DNAm profiles
Sens 90%, Spe 88%, Accuracy 89% for classification of RA
Accuracy RA Sero+ 100%, RA Sero- 75%
https://t.co/3occAQPZ1u Abs#0531 #ACR22 @Rheumnow https://t.co/QXhMxyWC8g
Aurelie Najm AurelieRheumo ( View Tweet)
Terrier @TerrierBen . Pooled analysis of MAINRITSAN trials. For major relapse at 84 months RTX>AZA HR 2.5. RTX fixed-dose>tailored HR 3. RTX 18 vs 36 months equal HR 1.2 (although 78% vs 70% relapse free). @RheumNow #ACR22 Abstr#0527 https://t.co/IWQmcGeRiW
Richard Conway RichardPAConway ( View Tweet)
So great to be in person for higher learning in #rheumatology #ACR22 @RheumNow also the onliners are welcomed https://t.co/JIcyV7v1Ws
Janet Pope Janetbirdope ( View Tweet)
Khanna @sclerodermaUM. SLS-III MMF+Pirfenidone vs MMF alone in SSc-ILD. Underpowered due to COVID (51 vs 150). No difference FVC 18 months ?more rapid improvement in combo. Better HRCT, PROs in combination. Need another study! @RheumNow #ACR22 Abstr#0520 https://t.co/K2Ne6PSHkS https://t.co/P6A7OJpzCf
Richard Conway RichardPAConway ( View Tweet)
#Abstr 0542 ASAS EULAR Recommendations for Management of axSpA
'Absence of response to treatment should prompt re-evaluation of the diagnosis and consideration of the presence of comorbidities.'
@RheumNow #ACR22
Akhil Sood MD AkhilSoodMD ( View Tweet)
18mo data of ARIAA study (6mo ABA in pre-RA):
12mo after discontinuation
Progression to RA ABA 35% vs PBO 57% p=0.008
Improvement in synovitis, osteitis & tenosynovitis ABA 57% vs. 29% PBO
Enough to move into clinical application?
https://t.co/2CDN9M31mB
Abs#0530 #ACR22 @Rheumnow https://t.co/R54AokGSiK
Aurelie Najm AurelieRheumo ( View Tweet)
Jayne et al. ADVOCATE avacopan trial sub-analysis looking at patients eGFR<=20. Significantly better reduction albuminuria and increase eGFR. Numerically better recovery, lower GC, less infection @RheumNow #ACR22 Abstr#0525 https://t.co/v4ffiqfsyt https://t.co/9pK0Pn6IOj
Richard Conway RichardPAConway ( View Tweet)
🔎Look! Urinary biomarkers vs. UPCR in tx response of #lupus nephritis by Dr @andreafava et al
🦋A decline in several urinary BMs at 3 mos outperformed UPCR in predicting the 1 yr response.
Urinary BMs as surrogate endpts in trials?🤔#ACR22 @RheumNow ABST0536 https://t.co/kMWmsK8mnO
sheila RHEUMarampa ( View Tweet)
@GuyKatzMD @zach_wallace_md et al. Hypocomplementemia seen in 30% IgG4-RD. More organs involved (mean 4.3 vs 2.9). More likely to have serum IgG4 above ULN (89%vs74%) and 5XULN (52%vs28%) @rheumnow #ACR22 Abstr#0144 https://t.co/bVRTuh3dsU https://t.co/3SHEbg2tbR
Richard Conway RichardPAConway ( View Tweet)
Sanchez-Bilbao et al. IV vs SC tocilizumab in 471 GCA patients. No differences in sustained remission or glucocorticoid-sparing. Numerically more AEs in IV but this due to longer follow up, no difference when corrected @rheumnow #ACR22 Abstr#0146 https://t.co/EB2RMYdzAr https://t.co/4xIMH1PIt3
Richard Conway RichardPAConway ( View Tweet)
Fussner @LynnFussner et al. DAH in PEXIVAS. DAH more freq younger, PR3+, relapsing, higher disease activity, higher creatinine. DAH more likely to die at 30 days and 1 year than those without DAH @RheumNow #ACR22 Abstr#0526 https://t.co/XGYHvDkVeA https://t.co/IEOcQHEQ3e
Richard Conway RichardPAConway ( View Tweet)
Normal weight PsA pts had numerically better PsAID and PGA scores than obese PsA pts when treated with SEC. SEC was effective in all BMI subgroups. Abs 0395 #ACR22 @RheumNow https://t.co/oBSsuJKRem https://t.co/BhybOk76Gr
Dr. Rachel Tate uptoTate ( View Tweet)