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ACR24: Rheumatology Roundup

Jack Cush, MD

Join Drs. Jack Cush and Artie Kavanaugh as they review 15+ presentations and abstracts from the 2024 ACR Convergence meeting in Washington, DC.

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Shedding Weight and Pain: The Promise of Anti-Obesity Medications in RA

Caoilfhionn Marie Connolly, MD

With the advent of FDA-approved anti-obesity medications such as semaglutide and tirzepatide, a new avenue for managing this challenging patient population has emerged. But how might these drugs impact the trajectory of RA, and are we on the cusp of a paradigm shift?

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back, LBP, spine, AS

Difficult to Manage Axial Spondyloarthritis

Adela Castro, MD

Studies show that patients with difficult-to-manage axSpA have a higher disease activity; however, the lack of a consensus definition led researchers and clinicians to utilize their own proposed definition, resulting in variability of the characteristics of non-responders.

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No Increase in Cardiovascular Events with JAK Inhibitors in IBD Patients

Jack Cush, MD

UMKC researchers have compared the use of JAK inhibitors versus tumor necrosis factor (TNF) blockers in inflammatory bowel disease (IBD) patients, but failed to see an increase in major adverse cardiovascular events (MACE) in JAKi vs TNFi use in IBD.

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ANA+ and no Autoimmune Disease? Check the liver Dr. Janet Pope discusses abstract 0627, presented at #ACR24. https://t.co/4HV2kqjibL https://t.co/kmVcvUZtRQ

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Dr. John Cush RheumNow ( View Tweet)
Differential diagnosis of ACA+ 1. SSc 2. Sjogren Syndrome 3. PBC 4. Overalp syndrome https://t.co/JmqDaaZerJ

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Dr. Dinesh Khanna sclerodermaUM ( View Tweet)
A#2647 DADA2 cohort 101 pts in India Median delay dx 5 years - 5 pts of >20 yr - 39 pts w GI involvement- bad outcomes Skin most common - largely livedo, then ulcers/nodules CNS common w ischemia Many Rx before dx 12 deaths (11.8%) - 8 GI, 3 CVA, 1 suicide #ACR24 @RheumNow https://t.co/Q8kiVbJq8I

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Eric Dein ericdeinmd ( View Tweet)
The precise mechanism of action of GIOP is not known. Decrease in osteocyte LCN is observed. Abstr#2528 @RheumNow #ACR24 https://t.co/fazUUy03fQ

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Abstract 1686: Urinary proteomics reveals potential markers (MMP-13, M-CSF receptor, CD163, ALCAM, FOLR2) and pathways (neutrophil degranulation, ECM, tissue remodeling) involved in lupus nephritis Class II. @RheumNow #ACR24 https://t.co/kufd2zl9yc

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Akhil Sood MD AkhilSoodMD ( View Tweet)
#1330 🔬F-Calprotectin in Early RA ➡️ New-onset RA pts(n=104) had ⬆️ F-calprotectin vs controls(n=50)(71 v. 17µg/g; p<0.001) 🔑Higher F-calprotectin linked to ⬆️ DAS28 & NSAID use ⬇️levels @ 6 months Rx ❓Role of subclinical gut inflammation in early RA #ACR24 @RheumNow

Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)

If high +ANA and NO #rheumatic #disease LOOK 👀 at #LIVER #Autoimmune #hepatitis And #alcoholic #liver #dx #ACRBest #ACR24 @rheumnow abst#0627 https://t.co/EVLUyvpBfD

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Janet Pope Janetbirdope ( View Tweet)
Yokose et al. Population study using NHANES. Gout patients had 1.6 higher fold risk of gallstone disease. What? Why do we care? Well, GLP-1s associated with higher risk gallstones also... @RheumNow #ACR24 Abstr#0133 https://t.co/nf4R0hQe50 https://t.co/wDrEDeNbpT

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Richard Conway RichardPAConway ( View Tweet)
Pharmacologics: Cannabis absorption and metabolism is variable Inhaled absorption 10-35% THC is 97% protein bound, lipophilic and deposits in fat and spleen Liver function is critical for THC metabolism 16S18 @BharatKumarMD #ACR24 @RheumNow

Eric Dein ericdeinmd ( View Tweet)

The METEOR study reveals distinct clinical features in spondyloarthritis (SpA) patients with vs. without IBD. Key features of those with IBD: - Lower male prevalence - Higher uveitis rates - Lower psoriasis rates - More structural damage in SI joints Mirroring gut… https://t.co/EyBZQ91DDn

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)

Data from the EISER study show that IBD was significantly more prevalent in pts with r-axSpA than nr-axSpA. Makes sense in a way since longer dse duration may play a role. 🔶️THM - screen SpA pts for IBD; ask for GI symptoms @RheumNow #ACR24 abs554 https://t.co/Q6jeDUFa8Z

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sheila RHEUMarampa ( View Tweet)
Différent patterns of organ involvement in sarcoidosis @RheumNow #ACR24 #Sarcoidosis https://t.co/xigkS3vpUh

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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

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Eric Dein ericdeinmd ( View Tweet)
No Increase in Cardiovascular Events with JAK Inhibitors in IBD Patients UMKC researchers have compared the use of JAK inhibitors versus tumor necrosis factor (TNF) blockers in inflammatory bowel disease (IBD) patients, but failed to see an increase in major adverse… https://t.co/XY0UVDTAI6 https://t.co/b09FB3niNP
Dr. John Cush RheumNow ( View Tweet)
Gut microbiome changes linked to onset of RA Changes in the make-up of the gut microbiome are linked to the onset of clinically evident rheumatoid arthritis in those at risk of the disease because of genetic, environmental, or immunological factors, suggests research published… https://t.co/gUgYLOKrI0 https://t.co/d75NmKup2U
Dr. John Cush RheumNow ( View Tweet)
Peptic ulcer disease is still assoc w/ signif. hospitalization & mortality (10K deaths in USA/Yr). PUD affects 10% of outpts w/ Upper GI pain. 42% are due to H.pylori, 36% from ASA NSAIDs. Complications bleeding (73%), perforation (9%), pyloric obstruction (3%)- JAMA review… https://t.co/1bgagFVlYN https://t.co/8i2j3r1puf
Dr. John Cush RheumNow ( View Tweet)
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