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Addressing CV Risk in RA: Are we doing enough?
ORAL surveillance was a post-authorisation safety study of tofacitinib 5mg and 10mg versus TNF inhibitors, focusing on rates of adverse events, including MACE. A higher incidence of MACE was observed with the use of tofacitinib. Statins are recommended in patients with a history of atherosclerotic disease or 10 year predicted risk of MACE. But, how many patients with rheumatoid arthritis, at risk of MACE, are actually taking a statin?
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Happening now, new guidelines for mgmt. A few highlights:
Recommend prompt GC therapy, pulse x1-3d followed by oral pred (<0.5mg/kg/d) w/taper to <5mg by 6 months
Aligns with EULAR recs for a much-lower dose than most clinicians currently doing
#ACR24 @RheumNow https://t.co/B71i7FBYlQ
Mike Putman EBRheum ( View Tweet)
Biosimilar switching in practice
Hyrich: UK experience
Switching to biosimilar has no immediate benefit to patients but saves NHS money
Allows for gain share that can be re-invested in pt care
Transparency in switching in explaining to pts and offering resource
@RheumNow #ACR24
Eric Dein ericdeinmd ( View Tweet)
If you’re starting with DMARD (according to ACR/VF guidelines) tx in TAK - MTX and AZA are probably equivalent options… MMF not so much
@RheumNow #ACR24 https://t.co/jn52ujtspo
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Hyrich:
ETN originator vs biosimilar initiation
- DAS28 - no signif change at B/L, 6mo, 12 mo.
Switch?
Matched pts in ETN switch v cont originator - good b/l control on Rx
-DAS28 maintained w switch
10% did go back to originator, felt less good tho similar DAS
#ACR24 @RheumNow https://t.co/RHRit5CtUu
Links:
Eric Dein ericdeinmd ( View Tweet)
Older adults with late-onset RA (LORA) with more erosive changes, even with DMARD use
But is T2T met?
LORA with higher DAS on diagnosis and yet 10% on bDMARD vs 26% of young-onset RA
#ACR24 @RheumNow ABST#2224 https://t.co/dYs1JwcJeq
Jiha Lee JihaRheum ( View Tweet)
#2222
📊 New data on #RA-ILD:
🔴In early RA, ILD prevalence hits 21.4% after 10 years, with 8.2% cumulative incidence at 5 years (IR 14.9/1000 PY).
🔴ILD often precedes or coincides with RA onset.
🔴NSIP > UIP
🔴airway involvement less common than expected.
#acr24 @RheumNow
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
RA patients affected by frailty at a younger age
in @VARA frailty associated with lower BMD
But frailty is modifiable!
#GeriRheum
#ACR24 @RheumNow ABST#2140 https://t.co/BoTGoESB43
Jiha Lee JihaRheum ( View Tweet)
Improving the Value of Musculoskeletal Ultrasound in Rheumatology Care #ACR24
MSUS has emerged as a powerful asset in rheumatology, providing a real-time, non-invasive, and cost-effective solution for diagnosing and managing inflammatory arthritis conditions such as RA and PsA.… https://t.co/iH9IZmHhSz https://t.co/am5LoBCdpe
Dr. John Cush RheumNow ( View Tweet)
Here’s my take on A#1743 and 1745 on @RheumNow #ACR24 coverage
https://t.co/PcRn8Hb4PY https://t.co/2vDyyJUp6W
Links:
Eric Dein ericdeinmd ( View Tweet)
#2259 💊 Anti-Obesity Meds in RA 📊 152 RA patients on semaglutide/tirzepatide 🔑 Findings 💥Significant ⬇️weight, BMI, ESR, CRP, lipids, pain VAS 💥Improved CVD risk ⛔ 15% GI side effects, 27% discontinued 🔎Study of impact on RA outcomes needed #ACR24 @RheumNow #ACRBest https://t.co/6LCTZl5173
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
In earlier studies of Vit D, there were conflicting evidence as to whether it reduced or increased the risk of RA and #SLE
@RheumNow #ACR24 @rheumarhyme https://t.co/PvjjmhHaOd
sheila RHEUMarampa ( View Tweet)
A Bayesian Network Meta-analysis Phase II/III/IV, placebo-controlled, randomised clinical trials and long-term extension studies of JAKi and TNFi, in adults with RA, PsO, PsA, axial
spondyloarthritis axSpA and IBD showed the following:
- TNFi was associated with a significantly… https://t.co/FWHgemEAvG https://t.co/3D0nldwmwA
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
📢 Late breaking #2002
➡️In ICI-induced arthritis, patients (n=100) report worsened pain, fatigue, & physical function vs population norms.
➡️High disease activity worsens symptoms
#acr24 @RheumNow @jhrheumatology
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Fertility in RA. Improved outcomes in the T2T group. Abstr#1647 @RheumNow #ACR24 https://t.co/gLpY8enaEb
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Shifting Trends in Initial RA Treatment Approaches
A recent study by Sparks et al (Abstract #0509) reveals evolving trends in disease-modifying antirheumatic drug (DMARD) usage for rheumatoid arthritis (RA) over two decades in the U.S.
https://t.co/6FN0WayZZR #ACR24 https://t.co/dc3CiNpKmx
Dr. John Cush RheumNow ( View Tweet)
Nice data from the OTIS Autoimmune Disease in Pregnancy Project re: certolizumab-exposed pregnancies:
- spontaneous loss rate comparable to non-disease controls
- no stillbirths
- preterm similar to disease controls
Plenty positive for CZP in pregnancy!
#ACR24 ABST0805 @RheumNow https://t.co/XCRYsioxC0
David Liew drdavidliew ( View Tweet)
A study exploring the benefits of treating RA patients to remission after achieving low disease activity (LDA).
Key findings:
- Among patients initially at LDA, achieving remission (CDAI ≤2.8) led to significantly better functional outcomes and reduced durable medical equipment… https://t.co/SNPKlRieur https://t.co/YIQNMf3Oap
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
I have no doubt many of our RA patients will take GLP-1 agonists in the future.
Here's some data @UCLA showing significant differences in not just body weight and HbA1c, but pain.
Will be fascinating to see what it does for grumbling disease activity!
#ACR24 ABST2259 @RheumNow https://t.co/HdOPACEo3A
David Liew drdavidliew ( View Tweet)
What is #healthliteracy? Why is it important for our patients with #RMDs?
Come to poster 1913 today at #ACR24 to find out about health literacy & outcomes in #InflammatoryArthritis
For more information on this important topic, read my article @RheumNow
https://t.co/llWs5aYtpK
Mrinalini Dey DrMiniDey ( View Tweet)
