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Updates on Reproductive Health in Women with SLE
Is patient-administered cervical cancer screening an option for women with SLE? Should I prescribe estrogen containing contraceptives to SLE women with APL antibodies? What complications should I be aware of in pregnant women with SLE? Here are three abstracts that provide insight.
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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How long do we hold meds for live-attenuated #Vaccines? ACR 2022 vax guidelines:
💉Pre-vax:
💊csDMARDs - hold time 4 wks
💊bDMARDs -hold time of one dosing interval
💉Post-vax: hold DMARDs for 4 wks
#ACR22 @rheumnow @rheumarhyme @doktora_ging https://t.co/MGc422EtIC
sheila RHEUMarampa ( View Tweet)
#ACR22 Abs 0408 @philipcrobinson et al, nr-axSpA pts achieving long-term clinical outcomes w/ CZP tx after 1 yr were generally sustained over 3 yrs across MRI+/CRP+, MRI−/CRP+ and MRI+/CRP− subgroups; ASDAS-MI numerically highest in MRI+/CRP+. @RheumNow https://t.co/cjpp2qCN4O https://t.co/G2YjF6ubUf
Dr. Rachel Tate uptoTate ( View Tweet)
Potential disconnect: Objective Inflammatory Response, OIR (MRI/CRP levels) vs Clinical Response,CR (BASDAI/ASDAS). Post hoc analysis AxSpA on Certolizumab. Majority of patients >50% improved OIR, only minority improved CR. Rudwaleit etal https://t.co/WdkmkCWClO #ACR22 @RheumNow https://t.co/qlNUFhnuJQ
Dr. Antoni Chan synovialjoints ( View Tweet)
I've always presumed biopsy-neg GCA just hit skip lesions sections
What does RNA-Seq of temporal artery bx tell us?
positive bx similar to skip lesions
bx neg GCA very different
Sometimes it's not just the sampling
sometimes it's something different...
ABST0486 #ACR22 @RheumNow https://t.co/QITgkZ21sy
David Liew drdavidliew ( View Tweet)
Bimekizumab (IL-17A and IL-17F inhibitor) use in non-radiographic AxSpA resulted in rapid improvement of ASAS40 along with reduction in SPARCC MRI SI joint inflammation
#Abs0544 @RheumNow #ACR22 https://t.co/pOCg0idGsR
Robert B Chao, MD doctorRBC ( View Tweet)
2022 ACR guide for #vaccinations in RMD pts:
💉Influenza:⬆️dose or adjuvant (CR) >=65 & >18<65 on immunosuppressives
💉Pneumococcal: SR for <65 yrs, on immunosuppressives
💉Rec VZV: SR for >18y on immunosupressives
💉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)