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ACR21 Best Abstracts - Day 2
The RheumNow faculty reporters have been scouring and reporting on the best abstracts from the ACR. Here is a sampling of their choice abstract presentations reported during ACR 2020 Day 2 (#ACRbest).
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#volcosporin good ~lupus nephritis added to #MMF but underbelly - side effects like but ?less than #cyclosporin. #FDA update - ⬆️hypertension and nephrotoxicity, infection #ACR21 @RheumNow https://t.co/w5nLLSTlrB
Janet Pope Janetbirdope ( View Tweet)
Almost like real-life, I've "run across the conference centre" to catch the end of the #InterstitialLungDisease session- some excellent insights from Dr Melissa Griffith on a complex topic, will definitely be reviewing the full talk later.
#ACR21 @RheumNow https://t.co/LdhXI8LLqY
Mrinalini Dey DrMiniDey ( View Tweet)
#ILD in #rheumatic diseases. When to use #glucocorticoids and immune suppressive sand anti fibrotic. V clear but harder in real world! @RheumNow #ACR21 #ACRBest https://t.co/R4V5ZggRsu
Janet Pope Janetbirdope ( View Tweet)
Steroids can cause co-morbidities which increase CV risk, but can PNL directly increase CV event (MACE) risk in RA?
30d PNL➡️15% increase in MACE in next 30d
(independent of underlying CV risk, RA dx activity)
PNL actively confers risk!
@BethIWallace #ACR21 ABST1428 @RheumNow https://t.co/cuL69n7cx3
David Liew drdavidliew ( View Tweet)
Plenary Abs#1428 #ACR21
👉🏼Long-term #steroid use is common in RA incl in pts with high risk of #MACE
👉🏼30days of steroids ➡️ 15% increased odds of MACE
@RheumNow
https://t.co/fCM3m04ruS https://t.co/FWGmAatYu5
Mrinalini Dey DrMiniDey ( View Tweet)
26K Veterans data with RA #ACR21 plenary abst#1428
30 days on glucocorticoids - ⬆️15% odds of Major Adverse Cardiovascular events @RheumNow @BethIWallace https://t.co/BOram4o2rp
Bella Mehta bella_mehta ( View Tweet)
Plenary Abs#1427 #ACR21
👉🏼#Statins assoc w/ reduced #CVD & all-cause mortality, outweighing
modest #T2DM risk increase in RA pts
👉🏼Reduction in all-cause mortality greater in RA than gen population
👉🏼Incr in T2DM risk is NOT greater in RA compared to gen population
@RheumNow https://t.co/WcF11B0C2s
Mrinalini Dey DrMiniDey ( View Tweet)
Statins in RA - plenary at #ACR21 UK Clinical
Practice Research Datalink 1989-2018 @RheumNow
Reduction in CVD risk, All cause mortality
INCREASE in Type 2 DM risk🧐 - need to make sure we look into it for RA patients!
Great work @UNMC_Rheum by Gulsen Ozen! https://t.co/YmTO0xcdjj
Bella Mehta bella_mehta ( View Tweet)
RA and CVD: take your statins!
Obs UK study
Statins ⬇️CVD HR=0.46
⬇️All cause death HR=0.68
w/ mild ⬆️ T2DM risk HR=1.33
(but not more than in general population)
⭐️NNT to prevent CVD 102
⭐️NNT to prevent death 46
⭐️NNH 127
#ACR21 #Abst1427 @RheumNow https://t.co/v6TinuklNv https://t.co/r0rD4jMmuh
Aurelie Najm AurelieRheumo ( View Tweet)
Fautrel describes a series of 13 #AOSD (Stills) pts with Pulmonary arterial HTN (cath confirmed) - seen exclusively with women, 85% and all were on DMARDs - 31% MTX, 69% IL-1i, all on steroids- 5 deaths, 3 yr Survival 74% (same as PAH) #ACR21 Abstract 1100 https://t.co/qR21MdYG3A https://t.co/WN38ifgtT6
Links:
Dr. John Cush RheumNow ( View Tweet)
#ACR21 #Abstr1100 Pulmonary Hypertension is a rare complication of AOSD. What can we learn from case-series of N=13🧐 💠All were female 💠Severe at diagnosis: mean PAP 41mmHg; 85% had NYHA III&IV 💠38.5% mortality rate So, plz be aware of PAH @RheumNow https://t.co/gmXF3AzH2n https://t.co/s5CXrHYUor
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
AS and PsA: Mortality vs Gen Pop (meta-analysis)
AS:
👉⬆️All-cause
👉⬆️CVD
PsA:
👉All-cause not higher
👉⬆️CVD, Respiratory, and Infectious etiologies
Important to consider CVD and other comorbidities.
https://t.co/9K4qNpYvMb
#ACR21 Abst#0569 @RheumNow
Pedro Castillo _Castillo_Pedro ( View Tweet)
Ethnic disparities in pts with RA & CVD - paucity of evidence in published lit
Need to improve study inclusion, diversity to improve quality of care
#ACR21 https://t.co/sWKcHugU9W
Rheum Cat rheum_cat ( View Tweet)
Aware of COPA syndrome?
➡️Rare cause of immune-mediated lung dz
➡️Mimics RA-ILD, SLE, & vasculitis
➡️Adult-onset cases reported
Abst#0529 determined that mutations in the COPA gene underlie some cases of severe pulmonary fibrosis.
#ACR21 @RheumNow https://t.co/mCx3eT7Pv8
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Abst#0572: In US veterans w/ RA followed for 17 yrs, several cytokines+chemokines
⭐️Associated w/ ↑ risk of incident MACE independent of typical CVD RF & RA activity
&
⭐️Predicted MACE even if in LDA/remission
WOW! We need to do better @ CVD risk strat!
#ACRBest @RheumNow https://t.co/J74rRa9EQE
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
*️⃣CT-P13=1st monoclonal biosimilar to infliximab (IFX)
⭐️ReFLECT: 1370 French pts (142 RA, 411 axSpA, 96 PsA)
→2 groups: IFX-naïve starting CT-P vs switching from IFX to CT-P
*️⃣CT-P13 induced improvement in IFX-naïve & maintained dz in pts switched
Abst#0817 #ACR21 @RheumNow https://t.co/bASmGvhuIS
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Great talk by @saadhealth #ACR21 & interesting to compare myocarditis irAEs to inflamm arthritis irAEs:
similar:
- importance of confirming dx well
- cautious adoption steroid-sparing Rx
different:
- clear benefit hard/early Rx
- dx metrics aided by tech
#ACR21 7S404 @RheumNow https://t.co/mFjM3ZlZaP
David Liew drdavidliew ( View Tweet)
#ACR21 #Abstr0871 📢Argument against HCQ<5mg/kg dose from cardiac perspective in #lupus. A retrospective study N=296 pts, 13% developed CV events.⬇️28% in risk of heart failure, arrhythmia/cardiac death per mg/kg of HCQ in non-smokers @RheumNow #ACRBest https://t.co/6ssd2159R1 https://t.co/tllPWLnFFj
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
ORAL Surveillance MACE conclusions:
So this is fair: tofacitinib acts as a CV risk factor, there are many others, we need to address CV risk in RA pts.
Nevertheless, in terms of MI risk, tofa vs TNFi, if I had one CV risk factor, I know what I'd do.
#ACR21 ABST0958 @RheumNow https://t.co/4Z79XtTzl9
David Liew drdavidliew ( View Tweet)
