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Cognitive Impairment: The Hidden Burden in Lupus Care

Akhil Sood, MD

Suppose you have a patient with lupus returning for follow-up. Their joint symptoms are well controlled. The kidneys—managed with a combination of biologic DMARD and mycophenolate—show no signs of active urinary sediment or protein. Yet, during the routine visit, your patient brings up fatigue and difficulty remembering things. How do you address this? Several studies presented at ACR24 focused on cognitive impairment in lupus.

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Taking AI Out of AutoImmunity: Predicting disease before it develops

Akhil Sood, MD

the predictive value of a positive ANA test—especially in the absence of other clinical symptoms—remains a challenge. A positive test often leads to further testing, yet it does not necessarily indicate whether a patient truly has an underlying autoimmune disease. The development of AI and machine learning algorithms presents an opportunity to interpret autoantibody tests and predict autoimmune diseases. Here are three studies looking at this issue.

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RheumNow’s expanded coverage of the #ACR24 annual meeting is sponsored in part by Novartis. All content is chosen by RheumNow and its faculty.

Dr. John Cush RheumNow ( View Tweet)

Health Literacy: the forgotten social determinant of health? Nine out of ten adults in the USA struggle to understand basic health-related information (1). Across the pond, in the UK, 7.1 million adults read at, or below, the level of a nine-year-old, with 60% unable to… https://t.co/15gvQxZHNN https://t.co/VqCjZY4tYI
Dr. John Cush RheumNow ( View Tweet)
RheumNow’s expanded coverage of the #ACR24 annual meeting is sponsored in part by Novartis. All content is chosen by RheumNow & its faculty

Dr. John Cush RheumNow ( View Tweet)

Assessment and management of axSpA Dr. Antoni Chan reports on abstract 0818, Defining BASDAI Cut-offs for Disease Activity States in Axial Spondylarthritis – Results from the EuroSpA Collaboration, and abstract 0819, The Assessment of SpondyloArthritis International Society… https://t.co/ropQJdElyb https://t.co/IVn5u2l7iP
Dr. John Cush RheumNow ( View Tweet)
RheumNow’s expanded coverage of #ACR24 is sponsored in part by Bristol Myers Squibb and UCB. All content is chosen by RheumNow & its faculty

Dr. John Cush RheumNow ( View Tweet)

RheumNow’s expanded coverage of the #ACR24 meeting is sponsored in part by Novartis. All content is chosen by RheumNow & its Faculty.

Dr. John Cush RheumNow ( View Tweet)

Great project by @kekuchinad to evaluate how PFTs bias our assessment and contribute to disparities @CaoilfhionnMD @jhrheumatology @BayviewMedicine @RheumNow #ACR24 https://t.co/b5pAn3e9AR https://t.co/opzWrZ1NH5

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Eric Dein ericdeinmd ( View Tweet)

A New ACR Dr. Jack Cush highlights a few notable changes to the ACR meeting format this year, and offers pointers on the best way to stay informed and abreast of reporting from the #ACR24 Convergence meeting in Washington, DC. https://t.co/YmI6s1TanV https://t.co/hsByGEBtnz

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Dr. John Cush RheumNow ( View Tweet)
Walsh et al. Direct mailing of PEST questionnaire to psoriasis patients. 13% PEST+, 4% seen by rheum (to date). 75% deemed appropriate for rheum to see - breakdown in picture. @RheumNow #ACR24 Abstr#2635 https://t.co/vlGJ977SV7 https://t.co/dbDUpwDZxy

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Richard Conway RichardPAConway ( View Tweet)
RheumNow’s expanded coverage of the #ACR24 Annual meeting is sponsored in part by Novartis.All content is chosen by RheumNow & its faculty

Dr. John Cush RheumNow ( View Tweet)

How Online Searches Reveal Patient Needs In the digital age, managing health conditions is rapidly evolving as patients increasingly turn to online resources for answers—over 65% search for health-related questions online. #ACR24 https://t.co/AbHGNAsIpH https://t.co/nuoQeigJfE

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Dr. John Cush RheumNow ( View Tweet)
Abstract 1925: Caution w/ ADI as proxy for neighborhood disadvantage - ↑ ADI didn’t correlate with ER visits or hospitalizations, but ↓ Childhood Opportunity Index (COI) did: ER visits: aOR 2.85 (95%CI 1.12-7.26) Hospitalizations: aOR 4.15 (95%CI 1.25-13.81) @RheumNow #ACR24 https://t.co/dVZi8oqBnI

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Akhil Sood MD AkhilSoodMD ( View Tweet)
Abstract 1915: Barriers to repro health discussions in rheumatology clinic - Spanish speaking & IA patients report language differences + OB/GYN deferrals as barriers Appointment time, clinician knowledge, or patient comfort did not make a difference @RheumNow #ACR24

Akhil Sood MD AkhilSoodMD ( View Tweet)

A study evaluating the effectiveness of Direct-to-Patient (D2P) screening for psoriatic arthritis (PsA) in psoriasis patients. Key findings: - 30% response rate from 825 patients; 13% screened positive. - 75% of referrals deemed appropriate, with one-third receiving a new PsA… https://t.co/bcQN6KkC8m https://t.co/zogI2PYvtO

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Overall very reasonable, aligning ACR recs w/other guidance groups & updated data Remember: guidelines are meant to be broken. Some patients can likely avoid pulse, others may need more steroid on the back end, biopsies are not benign #ACR24 @RheumNow

Mike Putman EBRheum ( View Tweet)

Abstract 1912: Time to close the gaps in #PsA care RISE Registry reveals: - higher disease activity in the South - more oral steroids + csDMARDs, fewer bDMARDs, and more comorbidities in the Midwest @RheumNow #ACR24

Akhil Sood MD AkhilSoodMD ( View Tweet)

A#2529 Disparities in JIA Outcome documentation, best practices, access to at-risk pts, agency and access - outcomes initially appeared to worsen - reflection of better documentation Improvement driven by pt global scores Disparity gap closed by 17% #ACR24 @RheumNow https://t.co/oOxs0jIvBK

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Eric Dein ericdeinmd ( View Tweet)
A call for ANA stewardship? Abstract 1931: Educating clinicians on wise ANA ordering via EMR Alert plus removing the comprehensive ANA panel --> - ↓ ANA testing (outpatient 15.9%→7.4%, inpatient 25.5%→6.4%) ↓ costs ($440k→$130k) #ACR24 @RheumNow

Akhil Sood MD AkhilSoodMD ( View Tweet)

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