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GLP-1 Agonists Show Promise in Slowing Kidney Disease in Lupus Nephritis
A retrospective cohort study presented at #ACR24 explores the benefits of GLP-1Ras in reducing the risk of end-stage renal disease (ESRD) for patients with lupus nephritis. Drawing on data from the TrinetX global research database, the study examines how GLP-1Ras may reduce ESRD progression in a population where 10-20% progress to ESRD within five years, even with immunosuppressive therapies.
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Diagnostic work up for neuropsychiatric SLE. Zahi Touma MD @RheumNow #ACR24 https://t.co/zLX1QHCaSu
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Dr @ZahiTouma discusses the attribution rules for the NPSLE syndromes
Attribute to #SLE if
- onset of NP is near the SLE dx
- absence of concurrent nonSLE factors
- ⬇️ frequency of NP events in the gen pop'n
- diagnostic tools favor NPSLE
@RheumNow #ACR24 https://t.co/e1xBK4Xzsw
sheila RHEUMarampa ( View Tweet)
Very informative slide describing the 2 NPSLE pathogenetic pathways & their differences in mediators, mechanisms and NP events.
@RheumNow #ACR24
@rheumarhyme @theactiverheum https://t.co/D3XFDqxMBq
sheila RHEUMarampa ( View Tweet)
Study on #SLE and ESRD using machine learning:
Developed model to identify patients with SLE and ESRD
Used NIH 'All of Us' dataset
XGBoost outperformed Random Forest
SDOH data improved model precision #ACR24 @rheumnow #MachineLearning abst#1876 https://t.co/PQ7u4Pj5OH
Bella Mehta bella_mehta ( View Tweet)
Disease specific chatbots might be primetime - investigators from NYC made the a #LupusCoach chatbot - patients indicated high levels of satisfaction and were excited about it.
@rheumnow abst#2160 #ACR24
Bella Mehta bella_mehta ( View Tweet)
Abstract 1873: The impact of urbanization on lupus nephritis mortality is complex.
Race/ethnicity + income modify the effects
- Income ≥$50k + living in suburbs associated with lower odds of mortality due to LN in racial/ethnic minorities
@RheumNow #ACR24
Akhil Sood MD AkhilSoodMD ( View Tweet)
Quote of the day. “Time is kidney” Maria Dall’Era MD, UCSF at the ACR SLE guidelines for management of lupus nephritis @RheumNow #ACR24 https://t.co/rz9AhPS2cl
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Important study in SLE: out of 590 pts with pericarditis, 20% had recurrence w/in 1 year
Higher in early dx, younger pts, higher dx activity, & pred exposure
Is prednisone risk confounding by indication? Or causative?
#ACR24 @RheumNow @andreafava Abstr#2372 https://t.co/Seyi4F6weY
Links:
Mike Putman EBRheum ( View Tweet)
Depressing finding re:glucocorticoid discontinuation in SLE
No improvement over decades in rate of GC discontinuation; if anything, we start more GC than ever
@AliDuarteMD help me out here; why haven't we made more progress?
#ACR24 @RheumNow Abstr#2421 https://t.co/uzZATKPWVC
Links:
Mike Putman EBRheum ( View Tweet)
Why is there female predominance in #SLE - the extra X chromosome in females (XX) may not be inactivated properly- usually maintained by the long non-coding RNA #Xist
#ACR24 abst#2599 @RheumNow https://t.co/C9Qj5zSnpN
Bella Mehta bella_mehta ( View Tweet)
Updated ACR guidelines on management of lupus nephritis (LN). Consider early biopsy. Focus on triple therapy in LN. From the panel discussion, Tacrolimus can be an alternative to CNI (Voclosporin) where there is no access to this. Manage comorbidities such as CV risk, bone… https://t.co/4R02YnRXDP https://t.co/3J7YcF5ucQ
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Applying the guidelines to Cases- Dr M Dall’Era for a pt wit extrarenal lupus and active LN. #ACR24 @rheumnow https://t.co/lvOUWjEdEz
Links:
TheDaoIndex KDAO2011 ( View Tweet)
The updated 2024 ACR Guideline for Dx and Tx of #lupus nephritis is here!
Dr. Lisa Samaritano discusses the key recommendations 👇
For all pts: screen for LN, give HCQ and RAAS for pts with ⬆️ proteinuria
GCs in pts w/ LN class III/IV &/or V.
@Rheumnow #ACR24 @rheumarhyme https://t.co/wLVRGktR59
Links:
sheila RHEUMarampa ( View Tweet)
The overview for #lupus nephritis tx.
Triple therapy is preferred as first line due to:
1. RCTs (BLISS-LN & AURORA 1) showing improved outcomes w/ triple txs
2. Nephron loss happens with ongoing LN - time is kidney!
@RheumNow #ACR24 https://t.co/IQo3q3O1pt
Links:
sheila RHEUMarampa ( View Tweet)
Recommend "Triple Therapy" = Glucocorticoids + two other agents
Practically, that means MMF + belimumumab OR CNI for most pts
For the CYC afficionados, the lower-dose EUROLUPUS protocol is preferred
#ACR24 @RheumNow https://t.co/0gRISXSw0c
Mike Putman EBRheum ( View Tweet)
Applying the #ACR24 #LupusNephritis: Case 2 by Dr M Dall’Era @RheumNow https://t.co/A7i103uHZT
Links:
TheDaoIndex KDAO2011 ( View Tweet)
Interesting! Study of pts w/ ANA(-) & dsDNA(+). 1 in 5 dx with APLS! Have others seen that?
I have been disgregarding this pattern, though some of that is related to my in-house assay (seems overly-sensitive) & my bias against overdiagnosis
#ACR24 @RheumNow Abstr#2391 https://t.co/FWgCjEwPDK
Mike Putman EBRheum ( View Tweet)
Abstract 1876: Developed a machine learning model w/ #SDoH covariates to accurately identify patients with SLE and ESRD in NIH All of US dataset
@RheumNow #ACR24 https://t.co/TLDSiBZZPs
Akhil Sood MD AkhilSoodMD ( View Tweet)
Provocative study suggests SLE has changed. Big picture: less physical manifestations, more serologic
@andreafava why isn't this just more-testing & more-sensitive testing shifting the phenotype of who we diagnose?
#ACR24 @RheumNow Abstr#2413 https://t.co/o2e9TFMsUp
Links:
Mike Putman EBRheum ( View Tweet)
