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More evidence: persistence of imaging abnormalities is probably NOT an adequate metric of LVV tx failure
Boiardi et al - 87% TAK/LV-GCA pt w persistent dz on imaging despite clinical remission, TAK>GCA
PET avidity more persistent in GCA
@RheumNow #ACR24 Abstract 1617
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Which immunomodulators dampen recombinant zoster vaccine immunogenicity?
In this 🇧🇷 study in autoimmune dx patients, overrepresented in non-responders are:
- rituximab pts
- 'combined therapy'
strategies needed for them
but reassuring for the others!
#ACR24 ABST0248 @RheumNow https://t.co/he1ICa9WZg
David Liew drdavidliew ( View Tweet)
Kerschbaumer et al. Rising placebo rates in PsA RCTs appear linked to changes in global recruitment patterns. Dramatic relationship between GNI and placebo response rate. Crucial information for properly planning future trials @RheumNow #ACR24 Abstr#0772 https://t.co/PtHs2RXe0f https://t.co/OKG6czQrYD
Links:
Richard Conway RichardPAConway ( View Tweet)
#Frailty leads to poor outcomes and occurs earlier in RA patients. Different tools measure frailty as a phenotype vs. deficit accumulation.
Discover the role of frailty in ED from #LancetRheum Ageing Series by Drs. Sarah Lieber and @KWyshamMD !
#ACR24 @RheumNow ABST#1334 https://t.co/25XQBDQMCo
Jiha Lee JihaRheum ( View Tweet)
Location of research matters Ab#0772
Global recruiting patterns impact PBO in PsA
PBO results improve w time - 0.9%/year
More globalization of trials w time
Gross nation index (GNI) neg ass w ACR20 - inclusion of less affluent controls affects higher PBO response
@RheumNow #ACR24
Eric Dein ericdeinmd ( View Tweet)
Poster#0035
🚨Postpartum RA Risk & Mucosal Immunity
👩🍼Elevated anti-CCP-IgG in cervicovaginal fluid of postpartum women (n=25) vs. controls.
🧪Local anti-CCP production despite negative serum
❓Childbirth-associated mucosal inflammation may drive RA onset.
#ACR24 @RheumNow https://t.co/plvtyJDSY1
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
To GLP or not to GLP—is it still even a question in obesity management given pluripotent benefits 👇🏻
Dr. Louis Aronne recommends
➡️ Start low and titrate slow 💊
➡️ Provide pt education on GI side effects, ondansetron effective for nausea
#ACR24 @RheumNow https://t.co/SzVg2dopCo
Links:
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
SELECT-GCA Trial results show UPA 15 mg + 26-week GC taper leads to 46% sustained remission vs. 29% with placebo + 52-week taper (P=.0019).
UPA15 reduced GC use (median 1615mg vs. 2882mg, P<.0001) and improved fatigue scores.
Key finding: UPA15 combined with a 26-week GC… https://t.co/rdHU3GuOwc https://t.co/oMS7x46sIB
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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Mycophenolate isn't great for vaccine immunogenicity, but withholding MMF for one week after both doses of recombinant zoster vaccine boosts Ab titres ++ in this Brazilian RCT.
A week off post-vaccine: definitely worth considering in stable disease
#ACR24 ABST0247 @RheumNow https://t.co/lajS5DzRbD
David Liew drdavidliew ( View Tweet)
CKD keeps a persistent low grade inflammatory state! Implications: CKD ⬆️risk for CV dz through different mech @RheumNow #ACR24 https://t.co/KcCvyTVaav
TheDaoIndex KDAO2011 ( View Tweet)
Safety data reassuring with UPA 15 mg vs PBO
No UPA MACE events, low VTE
Ab#0770
@RheumNow #ACR24 https://t.co/lMf2dCz2RX https://t.co/3DnPIoVOt8
Links:
Eric Dein ericdeinmd ( View Tweet)
Planned to post so much more from #ACR24; my favorite slides from today will have to suffice.
From the #BCRC Dr Monica Guma’s - diet and microbiome.
Dr @NamrataRheum -a reminder that we are all aging.
Dr Connie Weyand’s -metabolic checkpoints in RA T cells and macrophage. https://t.co/MtsheVsUEQ
Links:
Kristen Young kristenyoung ( View Tweet)
Hypophosphatasia:
🦴Inherited disorder of metabolism with low tissue nonspecific alkaline phosphatase (TNSALP)
🦴Impaired bone mineralisation
🦴Accumulation of pyrophosphate
🦴1/100,000-300,000
🦴6 main forms
@RheumNow #ACR24
Mrinalini Dey DrMiniDey ( View Tweet)
Différent patterns of organ involvement in sarcoidosis @RheumNow #ACR24 #Sarcoidosis https://t.co/xigkS3vpUh
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Sarcoid - diagnosis of probability!
Biopsy not required! Can be bx-supported, not confirmed!
Calcium in Sarcoid
10-20% hypercalcemic
30-50% hypercalcuria
Sc: polyuria, dehydration, confusion, depression, fatigue, n/v, anorexia, abd pain, hematuria
@RheumNow
#ACR24 Rev Course https://t.co/B1srD3saij
Eric Dein ericdeinmd ( View Tweet)
Upadacitinib (UPA), a new oral treatment option for GCA? Dr. Peter Merkel discusses SELECT-GCA.
UPA15 + 26-week GC taper >> PBO with a 52-week GC taper for GCA remission.
#ACR24 #ACRBest @RheumNow ABST#0770 https://t.co/UbQLVA8X7r
Jiha Lee JihaRheum ( View Tweet)
Where do SGLT2i have proven benefits for CVD?
👉 Diabetes w/high CV risk
👉Heart failure (all EF)
👉CKD
Dr Weber @rheumnow #ACR24 https://t.co/vFYddrLP1Y
TheDaoIndex KDAO2011 ( View Tweet)
It's been a wild ride over the last 20 years of RA b/tsDMARDs, and fascinating to see how our prescribing habits have changed over that time.
MarketScan data tell a story of fashion and fame. What will the next 20 years be like?
#ACR24 ABST0509 @jeffsparks @RheumNow https://t.co/wCcWgkHrvc
David Liew drdavidliew ( View Tweet)
Major update in tx for GCA beyond Toci
SELECT-GCA showed upadacitinib 15mg daily achieving higher rates of remission with SHORTER (26wk) steroid use compared to placebo (52wk)
No significant adverse safety signal w JAKi including MACE/malignancy
@RheumNow #ACR24 Abstract 0770 https://t.co/45D0Txed2N
Links:
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
TNFi cycling vs. switching to IL-17Ai?
Dr @AlexisOgdie et al from CorEvitas registry:
PsA & axSpA cohort - switchers (TNFi to IL17i) had greater improvements in cDAPSA & BASDAI vs. cyclers (2nd TNF)
Not stat significant but offers alternative Tx options
@RheumNow #ACR24 abs585 https://t.co/8m347BRM75
sheila RHEUMarampa ( View Tweet)