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ACR21 Best Abstracts We Saw - Day 3 (Monday)
The third day of ACR 2021 took a big leap in online content. Here is a compilation (with links) of presentations were the “ACRBest” as seen by our RheumNow faculty.
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Day 2 Report from ACR21
This report highlights the VITAL trial; the ORAL Surveillance Study; and the Microbiome study of monozygotic psoriasis patients.
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I don't know much about antifibrotics in RA-ILD, but these data emphasise that HRCT pattern matters
My simple mind, for any disease:
multiple subtypes with different trajectories➡️likely to be differing responses to Rx
TRAIL1: pirfenidone in RA-ILD
#ACR21 ABSTL10 @RheumNow https://t.co/v7HCO0ZBe1
David Liew drdavidliew ( View Tweet)
Comparative effects of abatacept in RA-ILD with UIP/NSIP. Appears equally effective in stabilising FVC, DLCO, and HRCT findings in both. Abstr#1683 #ACR21 @RheumNow https://t.co/l0Ia1D9c56
Richard Conway RichardPAConway ( View Tweet)
#ACR21 Ab#1683: ABA for RA-ILD
⭐️Stabilization of DLCO, FVC, HRCT in UIP and NSIP in 106 UIP, 84 NSIP patients
⭐️Stabilization or improvement of dyspnea in 91% UIP, 95% NSIP pts
@Rheumnow https://t.co/qfgDmooGOj https://t.co/gz6Jk15nUs
Links:
Eric Dein ericdeinmd ( View Tweet)
☄️Late breakingTRAIL1 RCT Pirfenidone on RA-ILD.
✨Primary outcome on incidence of decline of >10% FVC or death not met 11% PIR vs. 15% PBO OR=0.67 p=0.48
BUT
✨underpowered
✨reduces decline in FVC(ml) over 52wk (-66 vs. -146, p=0.0082)
✨safety ok
#ACR21 #AbstL10
@RheumNow https://t.co/IxYDE3lN1s
Aurelie Najm AurelieRheumo ( View Tweet)
In this study:
💊No correlation bet QTc interval & whole blood HCQ level regardless of dose, CKD or abnormal TTEs in #lupus pts
💊+correlation bet QTci & HCQ levels in pts w/ QTc prolonging drugs but not >456ms
Reassuring, dispels concern on HCQ use
@RheumNow #ACR21 abs1743 https://t.co/kpASRAXJB1
sheila RHEUMarampa ( View Tweet)
#ACR21 L10 TRAIL1: Pirfenidone for RA-ILD
⭐️Low pt enrollment due to pandemic, 1/2 of planned trial size
▶️ Unable to meet primary endpt (composite death+FVC) but met FVC markers. Most pronounced in UIP patterns on HRCT
@Rheumnow https://t.co/HB7N9Wl9Dn https://t.co/muBEguAAja
Links:
Eric Dein ericdeinmd ( View Tweet)
Watch my video discussion of #ACR21 abstract 564 from @KronzerMD @jeffsparks on the association of upper airways disease with incident RA. https://t.co/Nkg9Yl9yYT @RheumNow
Richard Conway RichardPAConway ( View Tweet)
What is the effect of long-term #steroid use on major adverse #cardiovascular events (MACE)?
Find out in my video summary of abstract #1428 which was presented yesterday by @BethIWallace
Read here👉🏼https://t.co/fCM3m04ruS
Watch here👉🏼https://t.co/TLerQT7XnG
#ACR21 @RheumNow
Links:
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR21 #Abstr1541 Any tools to help differentiate MAS vs #COVID inflammatory response? Preliminary criteria showed Sensitivity: 79.6%; Specificity: 81.3% within 6 days admission. No Triglyceride/Fibrinogen compared to 2016 ACR-EULAR & 2004 HLH @RheumNow https://t.co/c7pHaVCr5S https://t.co/6irF64qizI
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Will a FDA black box warning change your JAKi practice?
In May 2019, the EMA put out a warning about VTE with tofacitinib.
In this French cohort, did it change the kind of pts they initiated on JAKi?
no, not it did not😊
A window into the US future?
#ACR21 ABST1245 @RheumNow https://t.co/QI95E1gepg
David Liew drdavidliew ( View Tweet)
Echos in PsA, RA:
🔹Diastolic dysfxn: 52% of PsA and RA (!), controls 5%
🔹Mitral regurge PsA 84%, Ra 53%, controls 10%
🔹Mild pulmonary valve regurge higher in PsA
(Diastolic dysfxn has been seen in prior RA studies)
https://t.co/QCKR5itfYj
#ACR21 Abst1308 @RheumNow
Pedro Castillo _Castillo_Pedro ( View Tweet)
Dr Doliner @zach_wallace_md on ILD in AAV. ILD in 13% - of which 76% fibrotic. UIP most common. Most MPO+, but also rarely seen with PR3+. 47% ⬆️ risk of death. Abstr#0430 #ACR21 @RheumNow https://t.co/6MnxqW92bz
Richard Conway RichardPAConway ( View Tweet)
Dr McDermott @jeffsparks on risk factors for RA-bronchiectasis. Seropositivity, older age at RA onset, and lower BMI⬆️risk. Abstr#0288 #ACR21 @RheumNow https://t.co/7d2ZVWLzn6
Richard Conway RichardPAConway ( View Tweet)
Diabetes puts you at risk of cardiovascular disease, right?
What about RA?
Look at this graph and compare the pair.
"already it was impossible to say which was which” - George Orwell, Animal Farm
#ACR21 ABST0287 @RheumNow https://t.co/r0yaeC530l https://t.co/mKJhoyJ2Cn
David Liew drdavidliew ( View Tweet)
🔥Continued, More Clinically Meaningful data in #SSc #ILD from #Nintedanib in >52 wk SENSCIS & SENSCIS-ON(open-label ext)#ACR21 Dr Distler
✨MMF likely to stay 1st line, then Nintedanib
❓Is it time for MMF + Antifibrotic upfront??
Await SLS-III;Data so far seems supportive https://t.co/JWXMlsJgmc
Ashima Makol MD AshimaMakol ( View Tweet)
Among 6 CV risk algorithms, the best to predict the carotid plaque (CP) in PsA is the ACC/AHA risk score showed an AUC 0.681 (0.551-0.812), p=0.008, a cut-off point ≥4.8, sensitivity of 63.6%, and specificity of 64.4%
⭐️Prevalence CP 42.3%
Abst #1315 #ACR21 @RheumNow https://t.co/hRvyjetYq3
swethaann23 swethaann23 ( View Tweet)
Pulmonary Arterial Hypertension in #AOSD
Rare but severe complication - life threatening
French study of 13 pts - network dataset. ALL FEMALES!
Age 32, mean f/u 34 mths, 5 pts (38.5%) DIED
@RheumNow #ACRBest abst#1100 https://t.co/5LIzHagesP
Bella Mehta bella_mehta ( View Tweet)
Knowledge Bowl at #ACR21
⭐️The first lung fibrosis described in Sjogren's with lung biopsy showing benign polyclonal lymphocytes and plasma cells with a risk for malignant transformation.
➡️Lymphocytic Interstitial Pneumonia
@RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
