All News

Article

Methotrexate: shall we split up?

Aurelie Najm, MD, PhD

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.

Eric Dein Tweet
A#1403 #ACR23 @RheumNow 17% of 1st degree relatives of AS pts have MRI-defined sacroiliitis Study of 100 subjects w FHx AS - 13/100: new dx of AxSpA, 7 w radiographic changes - 4/100: Sacroiliitis without back pain - 1 periph SpA - 12 met clinical ASAS classification but not dx https://t.co/V7LCbaDXBe
Eric Dein Tweet
GCs Major Driver of Depression in SLE Ab#1446 #ACR23 @RheumNow 1463 pts with SLE, prospective longitudinal study GC use: 49-57% of pts Prevalence of depression at any time: 89.8%, most of time 35%!! Risk factors: - Fibromyalgia OR 2.9 - GC OR 1.85
David Liew Tweet
drdavidliew
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
Aurelie Najm Tweet
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
Eric Dein Tweet
PRES in SLE A#1478 @RheumNow #ACR23 303 cases of Posterior Reversible Encephalopathy Syndrome in SLE - Mean age 28, 91% F - 42% HTN, HLD 15%, DM 10% - 83% lupus nephritis. 80% dsDNA, 41% Sm, 38% aPL - 78% seizures - 3% mortality - Transient in 45%, persistent in 19%, 8% sequelae
Md Yuzaiful Md Yusof Tweet
#ACR23 Abstr#1636 Phase 2 crossover RCT of Dazodalibep, Anti-CD40L-i in #Sjogren pts with high disease activity showed primary endpoint, change in ESSDAI was met in DAZ vs PBO. More COVID in DAZ in Stage 1 but trial was at the start of pandemic. Phase 3 is starting soon @RheumNow https://t.co/hZcpOHumB3
Richard Conway Tweet
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
David Liew Tweet
drdavidliew
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
Eric Dein Tweet
Vasculitis in SLE A#1443 @RheumNow #ACR23 804 SLE pts, 74% black, 9.5% h/o vasculitis 45% visceral vasculitis, 43% cutanous, 8% both Pts w vasculitis: younger age of SLE dx- 27 v 31y Risks: other SARD, renal dx, neuro dx, low compl Trend to higher mortality 21 to 14% (no signif)
Bella Mehta Tweet
bella_mehta
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
Aurelie Najm Tweet
Peyton et al.: 4 multimorbidity patterns in RA -Mental health and subst abuse -Metabolic -CV -Chronic pain All associated with different sets of biomarkers. Some are very specific of one profile while others are widespread across profiles. @RheumNow #ACR23 ABST1631 https://t.co/VqCrLI3oyy
David Liew Tweet
drdavidliew
Ultrasound (and specifically intima-media thickness) might not just be for diagnosis in GCA - it might be a GCA disease activity measure for monitoring: - improves over time - increases with flares Valentin Schaefer #ACR23 ABST1649 @RheumNow https://t.co/QWdIVGrHbn
Richard Conway Tweet
Ross et al. Ultrasound assessed Optic nerve sheath measurement in GCA. Previously shown increased in GCA. Here decreases with treatment shown in 9 patients Abstr#1650 #ACR23 @RheumNow https://t.co/fcrS4tT6U0 https://t.co/ylnPKzdUe0
Dr. Antoni Chan Tweet
In PS-matched study, no significant difference in respiratory hospitalisation or death between RA-ILD patients on non-TNFi/JAKi vs. TNFi. This finding does not support systematic avoidance of TNFi in RA-ILD, England B Abst#1582 #ACR23 #ACRBest @RheumNow https://t.co/1zVjMWNZZS https://t.co/d8TRIvGaIe
Eric Dein Tweet
Fate of ANA+/UCTD A#1449 #ACR23 @RheumNow 207 asymptomatic ANA+ or UCTD followed - <10% progress to SARD, 90% did not Progression to SLE (11 pt), Sjo (5), SSc (3), RA (1) Progressors to SLE: arthritis (91%), low compl (45%), alopecia (36%), ulcers (27%) - milder manifestations
TheDaoIndex Tweet
KDAO2011
Abst#1583 SMART study: Split dose qwk MTX (10 mg QAM, 15 mg QPM) may have better efficacy compared to 25 mg single dose qwk MTX. RCT 253 RA patients: split dose had better DAS score, less likely to add other DMARDS, but slight⬆️in LFTs. #Plenary #ACR23 @rheumnow #ACRbest
Richard Conway Tweet
Evidence of window of opportunity concept in PsA. Certainly >52 weeks delay associates with worse outcomes. <12 weeks and 12-52 weeks similar. Abstr#1641 #ACR23 @RheumNow https://t.co/fMb3D9zl8B https://t.co/rHu29Eflo0
How well do you know this week's rheumatology news?
Take the rheumIQ quiz
Take the RheumIQ Quiz

×