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ACR/Vasculitis Foundation 2021 Guidelines for ANCA–Associated Vasculitis
Chung et al have published the 2021 treatment guielines for the management of antineutrophil cytoplasmic antibody–associated vasculitis, including granulomatosis with polyangiitis, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis. These guidelines are put forth by the ACR and the Vasculitis Foundation as benchmark guidance to assist health care professionals in managing AAV.
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RheumNow Podcast – Modern Treatment of RA Pregnancy (6.25.2021)
Dr. Jack Cush reviews this week’s news and journal reports featured on RheumNow.com.
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RheumNow Podcast - Best of EULAR 2021
Dr. Jack Cush reviews and highlights his favorite abstracts and presentations from last week's virtual EULAR 2021 meeting.
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Plasmapheresis Indications : TTP, HUS, Cryoglobulinemia, Hyperviscosity, Myasthenia gravis, Goodpastures, Catastrophic APL Syn, Chr inflamm demyelinating polyneuropathy, Removal of drugs/toxins, Alveolar hemorrhage, ANCA vasculitis (questionable)
https://t.co/uph9Eprlvc https://t.co/FPLOgzZpfB
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Dr. John Cush RheumNow ( View Tweet)
Textbooks say fever is common in lupus ("36%–86%") BUT IT IS NOT! Lupus is cause of FUO in 5%; Fever is seen in a minority of SLE onsets; Fever occurs w/ SLE complications - vasculitis, pneumonitis/serositis/alveolar hem, CNS, & INFECTION!
https://t.co/KvZeo6Q1WY
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Dr. John Cush RheumNow ( View Tweet)
WATCH: Is blindness with Tocilizumab in GCA a worry?
Dr. David Liew ( @drdavidliew) weighs in. #EULAR2021
https://t.co/eFrmbkW9Gy https://t.co/imMaEIczb8
Links:
Dr. John Cush RheumNow ( View Tweet)
Blindness with Tocilizumab in GCA: Is it a Worry?
https://t.co/PJYap294jm https://t.co/q1izGlH68j
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Dr. John Cush RheumNow ( View Tweet)
Danish population study shows that all cause mortality in GCA is increased 49%,(RR 1.49; CI1.36-1.64) after 1 year but less so at 10 years (RR 1.03: 1.00-1.05). Deaths usually due to infectious, endocrine, cardiovascular, GI diseases https://t.co/p36zDskf6y
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Dr. John Cush RheumNow ( View Tweet)
French Vasculitis registry studied 354 GPA patients- 25% had hypereosinophilia (HE) ≥ 500; mostly male (73%) w/ most skin dz (49%) peripheral neuropathy (32%) & higher BVAS (21 vs 18, p= 0.01): severe HE had more baseline renal dysfunction https://t.co/G4s3CEavL9
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Dr. John Cush RheumNow ( View Tweet)
Rituximab in PMR. Intriguing
proof of concept (SB?) RCT
(1:1, total n=47 (recent dx 38/relapsing 9))
17w rapid PNL taper
ritux 1g x1
21w:
steroid-free remission: 48% v 21%
PNL ≤5mg/d: 100% v 54%
effect mainly from recent dx pts
We do need options!
POS0343 #EULAR2021 @RheumNow https://t.co/g6xJekY92O
David Liew drdavidliew ( View Tweet)
Dr Schapp on nasal Staph Aureus eradication in ANCA vasculitis. Neither the presence or eradication of Staph Aureus appeared to influence the vasculitis @RheumNow #EULAR2021 Abstr#POS0249 https://t.co/bxtaznejNk
Richard Conway RichardPAConway ( View Tweet)
Dr Marsman presents positive RCT of Rituximab in PMR. GC-free remission 48% vs 21% (p=0.049) GC<=5mg 100% vs 47% (p=0.005) @RheumNow #EULAR2021 Abstr#POS0343 https://t.co/tjkKTS6DMN
Richard Conway RichardPAConway ( View Tweet)
Blindness with Tocilizumab in GCA: Is it a Worry? Dr. David Liew ( @drdavidliew )
#EULAR2021
https://t.co/xokPqGMEyA https://t.co/NJ3PrFR6nF
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Dr. John Cush RheumNow ( View Tweet)
Rheum alliance trainee survey (n=302):
87-96% report negative impact of COVID19 on Rheumatology training:
-outpatient clinics (79%)
-inpatient consultations (59%)
-formal teaching (55%)
-procedures (53%) and
-ultrasonography (36%)
#POS0051 @RheumNow #EULAR2021 @kristenyoung
Aurelie Najm AurelieRheumo ( View Tweet)
So it comes down to the grand question: how on earth do we actually monitor disease activity??
"We still don't have a failsafe algorithm... relapse is both underdiagnosed & overdiagnosed" - @Sarah_L_Mackie
The challenge lots of good people are working on!
#EULAR2021 @RheumNow https://t.co/PUa6Ly1DQw
David Liew drdavidliew ( View Tweet)
Drug-induced ANCA-associated vasculitis:
here are the ones to look for👇
- hydralazine
- PTU
- penicillamine
- thiamazole
- sofosbuvir
- minocycline
- carbimazole
(but then a few others floating about!)
VigiBase data POS0118 #EULAR2021 @RheumNow https://t.co/ujgJAJQeKY
David Liew drdavidliew ( View Tweet)
Fascinating talk by Dr Tombetti on the potential use of arterial wall derived microvesicles collected from plasma as a means of non-invasive liquid biopsy in vasculitis @RheumNow #EULAR2021 Abstr#OP0056 https://t.co/Y6UO2mpjV0
Richard Conway RichardPAConway ( View Tweet)
Do look out for Abst #OP0057 today 2/6/21 1645 CEST #EULAR2021. We propose a data-driven algorithm for #rituximab maintenance in #ANCA #vasculitis to avoid excessive retreatment and low IgG @RheumJArn @edvital P. Emery @LeedsMedHealth @LTHTResearch @LeedsHospitals @LeedsBRC https://t.co/XRR0NFnpMu
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Dr Sanchez-Bilbao presents surprising data that tocilizumab may improve even permanent vision loss in GCA @RheumNow #EULAR2021 Abstr#OP0065 https://t.co/oFGNZ04oKr
Richard Conway RichardPAConway ( View Tweet)
Some interesting abstracts at #EULAR2021 today on monitoring GCA with:
- ultrasound
OP0055 https://t.co/0fqLIK5IPV
- PET/CT
OP0069 https://t.co/WQl9VaHR9E
OP0064 https://t.co/w7biFT6qy0
What do you believe is the most accurate measure of true disease activity in GCA? @RheumNow
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David Liew drdavidliew ( View Tweet)
