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ORAL Surveillance - Is Statin Use the Problem/Solution?
The findings from ORAL Surveillance Study have been a dominant conversation at recent ACR Convergence, with the seminal findings and subsequent analyses a target of debate. Subsequent post-hoc analyses, follow-up studies, and claims data analyses have been used to further interpret the data, though a clear answer on safety is not certain. A study presented on Sunday reported on a new post-hoc analysis that provides new insights.
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Improving the Value of Musculoskeletal Ultrasound in Rheumatology Care #ACR24
MSUS has emerged as a powerful asset in rheumatology, providing a real-time, non-invasive, and cost-effective solution for diagnosing and managing inflammatory arthritis conditions such as RA and PsA.… https://t.co/iH9IZmHhSz https://t.co/am5LoBCdpe
Dr. John Cush RheumNow ( View Tweet)
RheumNow’s expanded coverage of #ACR24 is sponsored in part by Bristol Myers Squibb and UCB. All content is chosen by RheumNow & its faculty
Dr. John Cush RheumNow ( View Tweet)
A#2528
Hes1/Piezo1 Pathway - role in osteocyte response to mechanical stimulus
Yoda1 - Piezo1 agonist shown to help fx healing in mice
Piezo1 decrease in GIOP
Basic sci research shows activation of pathway promotes mechanical stress response, decr GIOP
#ACR24 @RheumNow
Eric Dein ericdeinmd ( View Tweet)
Does adding a Clofutriben (HSD-1 inhibitor) w/ prednisone minimize the risks of steroid toxicities in #PMR patients?
VS placebo, PMR patients who received Clofutriben + Prednisone had substantial reductions in bone, lipid, and glycemic control parameters
@RheumNow #ACR24
Akhil Sood MD AkhilSoodMD ( View Tweet)
Late-Breaking Abstract L07
The CLASS Project introduces new global classification criteria for Anti-Synthetase Syndrome (ASSD). Using the gold standard dataset, the key findings were:
✅ Definite ASSD: Sensitivity 94.3%, Specificity 99.7%
✅ Probable ASSD: Sensitivity 97.5%,… https://t.co/PtciIMTSsu https://t.co/jvJv2VNvHx
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
The 🫀is muscle‼️
💥From the maestro herself @JuliePaikMD underscores why cardiac involvement in myositis can't be overlooked.
🔥Crucial insights with major implications for patient care and outcomes
#acr24 @RheumNow @HopkinsMedicine @jhrheumatology
https://t.co/mw6BvkdF2w
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Does vasculitis flare with checkpoint inhibitors?
@MDAndersonNews experience:
17 stable pts
4 pts flared - all able to be controlled
(i.e. 13 didn't flare)
Encouragement that stable vasculitis pts that need ICI should get them!
#ACR24 ABST1986 @RheumNow https://t.co/jO4w3HWBMd
David Liew drdavidliew ( View Tweet)
A#2529
Disparities in JIA
Outcome documentation, best practices, access to at-risk pts, agency and access
- outcomes initially appeared to worsen - reflection of better documentation
Improvement driven by pt global scores
Disparity gap closed by 17%
#ACR24 @RheumNow https://t.co/oOxs0jIvBK
Eric Dein ericdeinmd ( View Tweet)
Here’s my take on A#1743 and 1745 on @RheumNow #ACR24 coverage
https://t.co/PcRn8Hb4PY https://t.co/2vDyyJUp6W
Links:
Eric Dein ericdeinmd ( View Tweet)
Risks for HCQ cardiotoxicity:
👉>5 yrs use
👉>5 mg/kg/d (cumulative dose >500,000 mg)
👉CKD
👉use NSAID
👉preexisting heart dz
👉presence of ocular, derm, SkM toxicity
- Dr M Garschik #ACR24 @rheumnow https://t.co/LFobgls4jm
Links:
TheDaoIndex KDAO2011 ( View Tweet)
A#2530
ANA reactive CD4 cells: elevated B cell help activation in SjD
Unique autoreactive T cell cluster in SSc shows CD4+ TRAIL+ IFN type I - unique to SSc
Leads to decrease activation of APCs, decrease CD4 T effector fxn
@RheumNow #ACR24 https://t.co/4JnA3SpVM8
Eric Dein ericdeinmd ( View Tweet)
#2259 💊 Anti-Obesity Meds in RA 📊 152 RA patients on semaglutide/tirzepatide 🔑 Findings 💥Significant ⬇️weight, BMI, ESR, CRP, lipids, pain VAS 💥Improved CVD risk ⛔ 15% GI side effects, 27% discontinued 🔎Study of impact on RA outcomes needed #ACR24 @RheumNow #ACRBest https://t.co/6LCTZl5173
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Cool study investigating differences in nailfold capillaroscopy, jives w/my clinical experience
Compared to SLE, pts with DM 🔼nailfold changes, 🔼 loop dilation, 🔼hemorrhages
#ACR24 @rheumnow Abstr#2404 https://t.co/8N7KNRZet8
Mike Putman EBRheum ( View Tweet)
Dr. @karen_kc123 discusses the results of the VITAL study.
- Long term use of Vit D3 2000IU was safe and decreased the incidence of all autoimmune dses by 22%.
- It took a while to work but the effect dissipates once discontinued.
@RheumNow #ACR24
@rheumarhyme https://t.co/mnwRsdZ06N
Links:
sheila RHEUMarampa ( View Tweet)
Will be covering some TAK pearls and pitfalls from today’s session!
Renal dz stratified by location of vessel inflammation:
- TAK = proximal (off aorta)
- FMD = mid-section, beading
- PAN = distal arterial branches
@RheumNow #ACR24 https://t.co/zu6qJ6DXcF
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
A call for ANA stewardship?
Abstract 1931: Educating clinicians on wise ANA ordering via EMR Alert plus removing the comprehensive ANA panel -->
- ↓ ANA testing (outpatient 15.9%→7.4%, inpatient 25.5%→6.4%)
↓ costs ($440k→$130k)
#ACR24 @RheumNow
Akhil Sood MD AkhilSoodMD ( View Tweet)
Study of 25K+ patients using TrinetX on immune checkpoint inhibitors shows no significant mortality difference between those with pre-existing autoimmune disease (AID) and those without.
Mortality rates:
AID: 39.8%
Non-AID: 40.2%
Large-scale evidence supports ICIs in AID… https://t.co/BI5jK9jsoM
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
A#2531 @AlisaMueller
CRISPR deletion of fibroblasts, gave cytokine activation to mimic inflamm
Are there gene depletions that affect inflamm pathways?
👉SIX1 reduces inflamm potentiation
👉NFIL3 deletion promotes inflamm, degradation
@RheumNow #ACR24 https://t.co/Nqghb5UaBR
Links:
Eric Dein ericdeinmd ( View Tweet)
A#2532
Pre-existing AID for immunoRx?
Excluded from trials
4 prior studies showed no diff in mortality w AID
Propensity-matched cohort study
Followed median 250 days
Hazard ratio: 1.07 (unmatched), 0.97 (matched) - no diff. Mortality about 40% in grps
@RheumNow #ACR24 https://t.co/zyVCPts6s6
Links:
Eric Dein ericdeinmd ( View Tweet)