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Practical use of JAK inhibitors in select groups in Axial SpA
A new treatment for AxSpA that has come on the scene are JAK inhibitors. In clinic, considerations for JAKi use are body mass index, smoking status, prior use of biologics and patients with high inflammatory states such as high CRP and inflammatory change on MRI scan of the spine and sacroiliac joints. There are further studies at #ACR22 which help answer these questions.
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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)
What's the difference between RA and PsA on hand MRI?
Removing our cognitive biases, here's what a neural network has to say
(not hard to see the power of this work)
ABST0242 @LkasDer @maier_ak #ACR22 @DrCMcMaster @RheumNow https://t.co/TqS6xUZNtl
David Liew drdavidliew ( View Tweet)
Abst0327 #ACR22 SMART-SLE Monitoring
Some SLE patients with +dsDNA have persistent positivity, others have fluctuations
Anti-dsDNA in persistently positive HR 1.56 for flare risk
Change (up or down!) in dsDNA more than 2x prior visit for fluctuating patients: HR 1.43
@RheumNow https://t.co/YwDPTYWPLu
Eric Dein ericdeinmd ( View Tweet)
It's always amazed me adalimumab & abatacept, have very different MOA but similar efficacy in RA - on a population level.
Not for individuals, though. Surely we can pick the winners better?
Lovely biomarker work from a H2H RCT
ABST0244 #ACR22 @RheumNow https://t.co/qVttIZSQtc
David Liew drdavidliew ( View Tweet)
Abst0324 #ACR22
How close are we to measuring Interferon Signature in clinical practice?
NCounter and BioFire assays studied - correlated well we each other
Genes: IFI27, IFI44L, IFIT1, RSAD2
SLE higher than RA or FMS, but does not correlate with SLE activity
@RheumNow https://t.co/izpFtj9Pcd
Eric Dein ericdeinmd ( View Tweet)
Abst0326 #ACR22 Anti-Mitochondrial Ab in SLE
Whole mitochondrial (AwMA), AmtDNA or AmtRNA - higher in SLE compared to controls
AwMA predictive of death, AmtDNA and AmtRNA predictive of nephritis
@Rheumnow https://t.co/d98HSHnJVE
Eric Dein ericdeinmd ( View Tweet)
What if my patient with RA or PsA gets pregnant? @RheumNow #ACR22
Abstract #1786; 34 women
👶 Disease scores improved during #pregnancy and increased #postpartum
👶20-27% of women required a cesarean delivery
👶mean delivery 39-40 weeks gestation
👶 1 NICU admission https://t.co/qYPaB6TcDJ
Catherine Sims, MD DrCassySims ( View Tweet)
JAK inhibitors in RA: does their performance vary in the real world?
@opal_ltd 🇦🇺: n= 5900 JAKi-treated RA pts, 2015-2021
upa is relatively new in Australia, but amazing how bari and tofa are so similar
(same with the data on switching reason too)
ABST0274 #ACR22 @RheumNow https://t.co/63PrRVAzk5
David Liew drdavidliew ( View Tweet)
Abst0328 #ACR22. Predicting UCTD to CTD Meta-Analysis
Factors for SLE transition: younger age, serositis, dsDNA
SSc transition: puffy finger, NFC, or SSc antibodies
No studies wo moderate or high risk of bias
Limited studies on biomarkers for SLE, need more studies
@Rheumnow https://t.co/GofGF8TkCx
Eric Dein ericdeinmd ( View Tweet)
Time check!⌚🦉
This roaming clockface helps me navigate through time zones while attending #ACR22
✈️virtually jetlagged but having fun!🤓
@RheumNow @rheumarhyme @doktora_ging #RheumPix https://t.co/HgTcIyw7ej
sheila RHEUMarampa ( View Tweet)
Infections in JAKi v TNFi in RA
We've seen ORAL Surveillance data
What about East Asian pts, with enriched zoster risk?
National KOR🇰🇷 insurance data:
Bacterial: equal
Opportunistic: TNFi worse
Zoster: JAKi worse
serious zoster a lot more common here!
ABST0302 #ACR22 @RheumNow https://t.co/lxsbY1Nf9N
David Liew drdavidliew ( View Tweet)
“Conflict, crisis and resolution make a story. A good story has drama where there is desire with danger.” @cuttingforstone author, Dr. Verghese noted the COVID19 #pandemic has all of these elements. It is a good story, but we don’t know the resolution. @Rheumnow #ACR22 https://t.co/Tomev2SYcT
TheDaoIndex KDAO2011 ( View Tweet)
RheumNow’s expanded coverage of the #ACR22 Annual meeting is sponsored in part by Novartis. All content chosen by RheumNow & its Faculty.
Dr. John Cush RheumNow ( View Tweet)