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Reproductive Issues in axSpA: Fertility and Pregnancy
Axial spondyloarthritis (axSpA) affects young patients with symptom onset occurring in early adulthood. Apart from pain and quality of life, reproductive issues also arise because patients who are diagnosed with the disease are also in their reproductive age. Two interesting abstracts about reproductive issues in axSpA will be presented during the poster sessions on Saturday, November 16, 2024.
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Synovial fibroblast gene expression
Neutron-4 - plays role in axonal outgrowth, affects pain-sensitive neurons
May help explain pain in RA, possible targets
Year in Review #ACR24 Bridges
@RheumNow https://t.co/kpDVKh0C9O
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Eric Dein ericdeinmd ( View Tweet)
Role of X chromosome in autoimmune disease?
SLE increased in Klinefelter (XXY), decreased in Turner’s (XO)
X chromosome inactivation with Xist
Inductively transgenic expression of Xist in male mice induces autoantibodies
Year in Review #ACR24 Bridges
@RheumNow https://t.co/M88f0v0kpe
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Eric Dein ericdeinmd ( View Tweet)
Amazing review @NamrataRheum on the important role the rheumatologist can play to improve the care of our older patients!
Don’t forget the 5Ms!
🧠Mind (cog/mood)
💊Medication (PIM)
🏃♀️Mobility
👉Multi-complexity
💪🏻Matters most (pt priority)
@RheumNow #ACR24 #gerirheum https://t.co/0Iv4TdS8AX
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Patricia Harkins DrTrishHarkins ( View Tweet)
CV risk factors in rheumatic dz patients start in childhood. Patients with PMH of Kawasaki disease are at risk for rca/lmca aneurysms, thrombosis and stroke. Important to consider this with our history taking when pediatric patients transition to adult care! @RheumNow #ACR24 https://t.co/CIp8PjW4vD
Gabriela Martinez Zayas, MD MartinezZayasMd ( View Tweet)
EGPA: To RTX or not to RTX?
French MAINRITSEG trial underway to determine utility of RTX vs. AZA maintenance therapy
Huge anticipation for these results, hopefully next year!
#ACR24 @RheumNow https://t.co/POelLpirrI
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
SCN9A:
Mutations associated with primary erythromelalgia, loss of fxn in congenital inability to experience pain
Target for OA?
Nav1.7 expressed in human OA chondrocytes
Blocking in mice- decr structural jt damage, incr mouse movement
Bridges Year in Review #ACR24
@RheumNow https://t.co/AKViXGfDa6
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Eric Dein ericdeinmd ( View Tweet)
Hot off the racks:
The MITIGATE trial is the 1st RCT for IgG4-RD showing that Inebilizumab significantly reduced flare rates vs PbO by depleting CD19-targeted B cells
Game changer?
Year in review.
@RheumNow #ACR24 @rheumarhyme @marklagacmd @idatan @ljdado https://t.co/CZvdrymIyr
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sheila RHEUMarampa ( View Tweet)
Treatment alert for Sjogrens
TWINSS study:
Iscalimab CD40/CD40L monoclonal Ab:
Improves disease activity
Also helps fatigue and sicca, not pain
Dazodalibep - CD40L antagonist also reduce symptoms/disease activity
Year in Review #ACR24 Pillinger
@RheumNow https://t.co/WjHuEpm9XW
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Eric Dein ericdeinmd ( View Tweet)
Year in review:
The MANDARA trial showed benralizumab was non-inferior to mepolizumab for #EGPA
@RheumNow #ACR24 @rheumarhyme @doktora_ging https://t.co/k5azGQOECB
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sheila RHEUMarampa ( View Tweet)
Looking forward to this Plenary - upadacitinib vs plbo in GCA
Similar to GiACTA, 26wk taper w/UPA better than 52wk taper w/PLBO. Too small for safety, but no new rsks
Strong argument for DMARDs upfront in GCA... but doesn't help with which 😉
#ACR24 @RheumNow Abstr#0770 https://t.co/MZY4QUazhI
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Mike Putman EBRheum ( View Tweet)
MANDARA
Mepolizumab v benralizumab for EGPA
BEN is non-inferior
Secondary outcomes- less eosinophils and more pts completely off GCs
Now approved for EGPA
Year in Review #ACR24 Pillinger
@RheumNow https://t.co/ThLziABvzu
Eric Dein ericdeinmd ( View Tweet)
With increased use of smartphones and wearables there is the opportunity to promote increased physical activity. Christine Pellegrini @RheumNow #ACR24 https://t.co/wSX3EbhVJG
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Rheumatic diseases are highly affected by environmental impacts
Appreciate the ACR for creating a Climate Change Task Force to proactively and reactively respond to the issues this creates for rheumatologist
@ACRheum @dddesir
#ACR24 @RheumNow https://t.co/h4jCMa9Fyg
Eric Dein ericdeinmd ( View Tweet)
CV risk after gout attack
1.75x increase risk of acute CV risk in first 30 days after gout flare (significant) possibly up to 120 days (didn’t reach significance)
@RheumNow
#ACR24 year in review Pillinger https://t.co/a2zS8mIw3L
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Eric Dein ericdeinmd ( View Tweet)
Year in review: Can #gout flares increase CV risk?
Cipoletta et al - pts with gout may be at inc risk of CV events for at least 30-120 days after flares.
Emphasize CV risk mgt in all patients w/ gout.
@RheumNow #ACR24 https://t.co/p1aXVgqkuR
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sheila RHEUMarampa ( View Tweet)
Knee OA
Krill oil - No benefit in randomized PBO control study
MTX (25 mg) for pain - modest diff in pain (numerical, not WOMAC), lost by 12 mo
STEP-9: GLP1 agonist for BMI>30 w knee OA. 60% better than PBO. Wt or other benefits?
@RheumNow
Michael Pillinger
#ACR24 year in review https://t.co/dMw4T0tWLX
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Eric Dein ericdeinmd ( View Tweet)
Year in review:
Semaglutide reduced knee pain over 68 weeks in patients with high BMI and moderate knee #osteoarthritis pain
But mechanism of knee pain improvement not yet known if due to wgt loss or other mechanisms.
@Rheumnow #ACR24 @rheumarhyme @theactiverheum https://t.co/PkrcIMbgPl
sheila RHEUMarampa ( View Tweet)
Abatacept for GPA?
Tx with Abacept did NOT significantly reduce rates of treatment failure compared to GC + PBO (background DMARD allowed) in non-severe, relapsing GPA
Continued need for tx options in non-severe relapsing dz
@RheumNow #ACR24 Abstract #0823 https://t.co/7GfprUzoL7
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
RheumNow’s expanded coverage of the #ACR24 annual meeting is sponsored in part by Novartis. All content is chosen by RheumNow & its faculty.
Dr. John Cush RheumNow ( View Tweet)