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Day 2 Report - ACR Plenaries: Changing the Practice of Rheumatology

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Nov 14, 2023

Over the years of navigating the annual meeting, I found the sessions with the most impact to my practice were the Plenary Sessions. During these sessions, the latest research is presented, new ideas are floated, and old myths debunked. Here are the top ACR2023 Plenary abstracts I found impactful for my practice.

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The Fallacy of Biologic Treatment to Prevent RA It is time to stop fooling ourselves that we can prevent RA with our existing biologic agents. #ACR23 https://t.co/qHMW4HGkk2 https://t.co/l2Tn7hGtY3

Links:

The Fallacy of Biologic Treatment to Prevent Rheumatoid Arthritis | RheumNow

Dr. John Cush RheumNow ( View Tweet)

Nov 14, 2023

Summary of diet effects in RA and SLE patients 👇 Dr. Sarah Patterson also shared nutrition resources for pts and clinicians https://t.co/ae6nLrLXca #ACR23 @Rheumnow @rheumarhyme @GerRheumDoc @doktora_ging https://t.co/8HhCHCTGLh

sheila ( View Tweet)

Nov 14, 2023

Great summary of the big takeaways yesterday at #ACR23. Always love talking to @KDAO2011 @EBRheum @RheumNow We get into the use of MTX, the safety on TNFs and what is in the purview of rheumatology practice https://t.co/jm0a8ndrsi

Eric Dein ( View Tweet)

Nov 14, 2023

Excellent pragmatic RCT, TNF withdrawal in RA Almost 2/3 flared by 1 yr; at 3 years up to 3 in 4 Supports my practice of generally continuing TNFs long term Also highlights importance of pt preferences; 1 in 4 may do well if they wish to discontinue @RheumNow #ACR23 #ACRBest https://t.co/G4l0DgBP2Z

Mike Putman EBRheum ( View Tweet)

Nov 14, 2023

In case you missed it! Watch our ACR Monday Recap of the meeting with me, @RheumNow @EBRheum and @ericdeinmd. #ACR23 @uptoTate https://t.co/GpMdev0Yk7

TheDaoIndex KDAO2011 ( View Tweet)

Nov 14, 2023

#irAE Baseline immune suppression does NOT protect against worsening synovitis flares when using check point inhibitors in Pts with established #inflammatory #arthritis #ACRbest #ACR23 @ACRheum @RheumNow abst1075 Data from #CanRIO database https://t.co/lOCf8Tbgta

Janet Pope ( View Tweet)

Nov 14, 2023

#ACR23 highlights from PlenaryII 🙉#RA #ILD seems that #TNFi is equal to other bDMARDs - was thought to worsen /cause it. 🙉Septra should be given with #rituximab and #steroids in #GCA to prevent #infections not just #PJP #ACR23 @RheumNow @ACRheum #ACRbest

Janet Pope ( View Tweet)

Nov 14, 2023

Cancer and TNF inhibitors

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d Richard Conway, MBBChBAO, PhD

Nov 13, 2023

Cancer risk minimisation is a high priority for people with rheumatic diseases, as it is for the general population. Tumor necrosis factor inhibitors (TNFi) have a long history of association with cancer risk discussions. An oral presentation by Suarez-Almazor et al provided more supportive data on using TNFi in this population.

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#ACRbest Abstracts – Day 2

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d Jack Cush, MD

Nov 13, 2023

Our reporters have been prolific in finding the hot abstracts, those that were most attended or those that are getting the most buzz on social media. Here are RheumNow's #ACRbest abstract reports from Monday, November 13, 2023 at #ACR23, covering The Great Debate, SGLPT2 inhibitors in SLE, the SMART Study of MTX, TMP/SMX Prophylaxis, RA-ILD & TNF Inhibitors, cancer research and more.

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Methotrexate: shall we split up?

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d Aurelie Najm, MD, PhD

Nov 13, 2023

Methotrexate is widely used in rheumatic diseases yet poses common tolerance issues, especially for the oral form; and bioavailability is known to be limited for doses over 15mg. In the SMART study, Prasad et al. present the first RCT comparing either single dose (25 mg) or split-dose (10 mg morning, 15 mg evening, same day) once weekly MTX for 24 weeks.

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Large observational study of TNF use among patients with RA & cancer Overall encouraging, no negative impact on survival I'm kind of a TNF-truther on this; I don't think they cause ANY increased risk of malignancy @RheumNow #ACR23 Abstr 1675 https://t.co/KRVlIFxhl8

Mike Putman EBRheum ( View Tweet)

Nov 13, 2023

Does TNFi use in pts with RA and early breast cancer affect survival? TNFi did not affect overall survival or breast cancer specific survival compared to cDMARDs Steroids did increase mortality @RheumNow #ACR23 Abs#1675

Robert B Chao, MD ( View Tweet)

Nov 13, 2023

No significant difference in overall survival in early stage breast cancer (BC) patients treated with TNFi (alone -/+ cDMARDs, in 1st year of BC) and cDMARDs in RA. Those on glucocorticoids had worse survival. Suarez-Almazor M, Abst#1675 #ACR23 @RheumNow https://t.co/lnZx3OpuN5

Dr. Antoni Chan ( View Tweet)

Nov 13, 2023

Insights into pathogenesis venous & arterial thrombosis in RA + JAKi Significant dysregulation of clotting pathways in myeloid & increased clot formation in context of microbial challenge (TLR4) Observed across all JAKI, but selective JAK3i @RheumNow #ACR23 ABST1676 https://t.co/nboy0znfAW

Aurelie Najm ( View Tweet)

Nov 13, 2023

Hand movement video: more promising than photos as a computer vision concept for remote monitoring of RA disease activity. Of course: validation, training, clinical evaluation all must happen before it is ready for your clinic https://t.co/HyN6ElKF0F #ACR23 ABST1293 @RheumNow https://t.co/DltI9HFiFE

David Liew drdavidliew ( View Tweet)

Nov 13, 2023

Fatigue 😴 in RA & synovial biology In DAS LDA pts Fatigue asso w/ -female sex -synovial lymphocytic inflammation In DAS moderate DA: -female sex -synovial lining layer -Anxiety Limitations: arthroplasty tissue, small sample size, no Immunohisto @RheumNow #ACR23 ABST1630 https://t.co/4vhzvdPgyd

Aurelie Najm ( View Tweet)

Nov 13, 2023

Fisher et al. In high disease activity, fatigue associates anxiety and synovial lining hyperplasia, 1.57[1.01,2.5]; p=0.047) In LDA, fatigue associates chronic lymphocytic synovial inflammation, 1.92[1.09,3.57]; p=0.024) Abstr#1630 #ACR23 @RheumNow https://t.co/Gev6pU3srq https://t.co/Ys8etP36ir

Richard Conway ( View Tweet)

Nov 13, 2023

Do we miss RA activity in obese pts? Pre-clinical trial entry MSK USS: similar DAS28 but lower SJC/US scores in obese Is it because, in obese RA patients: we underdetect on exam? we undertreat? higher risk, so lower penetrance of severe dx endotypes? #ACR23 ABST1287 @RheumNow https://t.co/3FFPdBJOpz

David Liew drdavidliew ( View Tweet)

Nov 13, 2023

Multimorbidity in #RA - VARA registry data- looking at 61 different biomarkers and 44 comorbidities Chronic pain in 44% Specific biomarkers seen in different morbidities @rheumnow #ACR23 session#13M148 https://t.co/l6FU1ELKD3

Bella Mehta bella_mehta ( View Tweet)

Nov 13, 2023

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