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Who declines most with #scleroderma #ILD - early dcSSc, ⬆️CRP, ⬆️mRSS all w more ⤵️FVC. Results verified in SENSIS trial of SSc ILD where #nintedanib was superior to placebo abst#1846 #ACR21 @RheumNow https://t.co/eckUj0qwch
Janet Pope Janetbirdope ( View Tweet)
Hospitalisation for heart failure ⬆️ in inflammatory diseases. RA>PsA>AS>PsO . HRs 1.1-1.6 compared to general population. Abstr#1925 #ACR21 @RheumNow https://t.co/kKlGQM5Tcg
Richard Conway RichardPAConway ( View Tweet)
#ACR21 Ab#1939: Tofa CV Outcome (STAR-RA)
▶️Pooled data does not show ⬆️ risk of CVD
▶️Trend in pts w prior CVD -HR 1.27 (0.95-1.7), cannot r/o CVD risk in pts w risk factors
Less clear than oral surveillance data, but concerns in those w risks
https://t.co/JOKNyYVZfX @Rheumnow https://t.co/GGYJfxcqhc
Links:
Eric Dein ericdeinmd ( View Tweet)
STAR-RA, CV risk
large insurance datax3
tofa vs TNFi
all comers: HR 1.01 (0.83-1.23)
one CV RF + any MTX: HR 1.24 (0.90-1.69)
prev CVD: HR 1.27 (0.95-1.70)
not sig
but surely okay to say baseline CV risk + tofa makes me a little nervous?
@SeoyoungCKim #ACR21 ABST1939 @RheumNow https://t.co/LmmL5zgv9u
David Liew drdavidliew ( View Tweet)
Elevated CRP levels (>3) in PsA associated with ⬆️risk of cardiovascular events
⭐️NSAID use significantly REDUCED risk of CV events
Abs#1920
#ACR21 @RheumNow
https://t.co/gIz9f4SlWo https://t.co/V4uDeO3Iuz
Links:
Robert B Chao, MD doctorRBC ( View Tweet)
Another study linking long term GC and CV risk in RA!
Medicare data >65yo 130000+ pts
1-year incidence CV ⬆️ as follows:
📍Dose ≤5mg 1.4%
📍Dose 5-10mg 1.7%
📍Dose >10mg 1.9%
Not replicated in younger pts (Optum data)
#ACR21 #Abst1915 @RheumNow https://t.co/DLXdfvfiBW
Aurelie Najm AurelieRheumo ( View Tweet)
Can we predict who will develop #RA-ILD?
Perhaps anti-MAA is the answer!
#ACR21 Abs#1916
👉🏼⬆️anti-MAA antibody assoc with incident ILD risk
👉🏼Associations are antigen &
isotype dependent
👉🏼Antibody measurement may be useful to risk stratify for RA-ILD
@RheumNow https://t.co/nC0OkuWtGU
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR21 Abs#1915
👉🏼Chronic steroid use in older adults on stable DMARD therapy
assoc w/ ⬆️CV risk
👉🏼Risk even present among older adults receiving low dose ≤5mg/day
👉🏼Larger studies needed in younger healthier adults
@RheumNow https://t.co/Lsj5YBz7IG
Mrinalini Dey DrMiniDey ( View Tweet)
OK is this a swan or a swan song? Graph looks like a swan 🦢 but message is NO #MACE differences in PsA on csDMARDs v #biologics #ACR21 abst#1833 @RheumNow https://t.co/TM91z5wiFY
Janet Pope Janetbirdope ( View Tweet)
Composite MACE outcomes no different among PsA pts treated w/ biologics and DMARDs. Abs 1833 #ACR21 #RheumNow #ACRbest @RheumNow https://t.co/TxyE4Uqttq https://t.co/Eykxwmcc44
Dr. Rachel Tate uptoTate ( View Tweet)
Post hoc analysis of pooled data from 19 clin trials on SEC & CV risk & systemic #inflammation in PsO, PsA, AS
📌Traditional CV parameters remained stable on all SEC treated grps
📌SEC sig. ⬇hsCRP & NLR
@RheumNow #ACR21 abs1835 https://t.co/iCaGFbXNXn
sheila RHEUMarampa ( View Tweet)
Advantages of treat to target (of serum urate) beyond less gout flares? Maybe equal to ⬇️MACE events - I hope in long term less MACE due to less ⬆️CRP w flares. Modelling observational study abst#L06 #ACR21 #ACRBest @RheumNow below is comparative safety T2T better than usual care https://t.co/95M6lNX416
Janet Pope Janetbirdope ( View Tweet)
I don't know much about antifibrotics in RA-ILD, but these data emphasise that HRCT pattern matters
My simple mind, for any disease:
multiple subtypes with different trajectories➡️likely to be differing responses to Rx
TRAIL1: pirfenidone in RA-ILD
#ACR21 ABSTL10 @RheumNow https://t.co/v7HCO0ZBe1
David Liew drdavidliew ( View Tweet)
Comparative effects of abatacept in RA-ILD with UIP/NSIP. Appears equally effective in stabilising FVC, DLCO, and HRCT findings in both. Abstr#1683 #ACR21 @RheumNow https://t.co/l0Ia1D9c56
Richard Conway RichardPAConway ( View Tweet)
#ACR21 Ab#1683: ABA for RA-ILD
⭐️Stabilization of DLCO, FVC, HRCT in UIP and NSIP in 106 UIP, 84 NSIP patients
⭐️Stabilization or improvement of dyspnea in 91% UIP, 95% NSIP pts
@Rheumnow https://t.co/qfgDmooGOj https://t.co/gz6Jk15nUs
Links:
Eric Dein ericdeinmd ( View Tweet)
☄️Late breakingTRAIL1 RCT Pirfenidone on RA-ILD.
✨Primary outcome on incidence of decline of >10% FVC or death not met 11% PIR vs. 15% PBO OR=0.67 p=0.48
BUT
✨underpowered
✨reduces decline in FVC(ml) over 52wk (-66 vs. -146, p=0.0082)
✨safety ok
#ACR21 #AbstL10
@RheumNow https://t.co/IxYDE3lN1s
Aurelie Najm AurelieRheumo ( View Tweet)
In this study:
💊No correlation bet QTc interval & whole blood HCQ level regardless of dose, CKD or abnormal TTEs in #lupus pts
💊+correlation bet QTci & HCQ levels in pts w/ QTc prolonging drugs but not >456ms
Reassuring, dispels concern on HCQ use
@RheumNow #ACR21 abs1743 https://t.co/kpASRAXJB1
sheila RHEUMarampa ( View Tweet)
#ACR21 L10 TRAIL1: Pirfenidone for RA-ILD
⭐️Low pt enrollment due to pandemic, 1/2 of planned trial size
▶️ Unable to meet primary endpt (composite death+FVC) but met FVC markers. Most pronounced in UIP patterns on HRCT
@Rheumnow https://t.co/HB7N9Wl9Dn https://t.co/muBEguAAja
Links:
Eric Dein ericdeinmd ( View Tweet)
Watch my video discussion of #ACR21 abstract 564 from @KronzerMD @jeffsparks on the association of upper airways disease with incident RA. https://t.co/Nkg9Yl9yYT @RheumNow
Richard Conway RichardPAConway ( View Tweet)
What is the effect of long-term #steroid use on major adverse #cardiovascular events (MACE)?
Find out in my video summary of abstract #1428 which was presented yesterday by @BethIWallace
Read here👉🏼https://t.co/fCM3m04ruS
Watch here👉🏼https://t.co/TLerQT7XnG
#ACR21 @RheumNow
Links:
Mrinalini Dey DrMiniDey ( View Tweet)
