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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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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)
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)