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Say Goodbye to Methotrexate in PMR?
For decades, glucocorticoids (GCs) have formed the backbone of polymyalgia rheumatica (PMR) management.
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A#1743
Are there benefits of getting LDA to remission?
Remission CDAI <2.8, VLDA 2.8-6, LDA 6-10
After 1 yr f/u of LDA, 45% Rem, 40 VLDA, 16 LDA
Not in remiss - higher BMI, longer duration, higher resource utilization, worse PRO
No clear diff bw remission & VLDA
#ACR24 @RheumNow https://t.co/ut7c52JVDr
Links:
Eric Dein ericdeinmd ( View Tweet)
Frideres et al. Target trial emulation in RA-ILD. Primar outcome death or respiratory hospitialization. Abatacept (aHR 0.90), tocizilumab (aHR 0.93), tofacitinib (aHR 0.69) vs rituximab. @RheumNow #ACR24 Abstr#1713 https://t.co/fbE8xAnzQ2 https://t.co/uwzH8oAyAT
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Richard Conway RichardPAConway ( View Tweet)
A#1694
To get one or two lungs for lung transplant? 🫁
Autoimmune related ILD transplant outcomes?
145 single (SLT), 461 double (DLT)
Similar 1 yr mortality - HR SLT 1.19 unadjusted, 1.49 adj - not statistically significance
@RheumNow #ACR24 https://t.co/uo8WbrNFAm
Links:
Eric Dein ericdeinmd ( View Tweet)
BE MOBILE 1 & 2: Bimekizumab resulted in improvement of SIJ MRI inflammation & structural lesions particularly after 16 wks of treatment and continued on until wk. 52.
Supports addtl evidence of BKZ's winning streak in #axSpA
@RheumNow #ACR24 abs1757 https://t.co/EUntQIuQC8
sheila RHEUMarampa ( View Tweet)
A picture is worth a thousand words—and so are the four abstracts behind it! At #ACR24, I highlight the benefits and risks of apremilast in #PsA.
@RheumNow
https://t.co/ospR0qEIsd
Akhil Sood MD AkhilSoodMD ( View Tweet)
Chevet et al. What happens when you withdraw tocilizumab after 6 months in PMR? Follow up of SEMAPHORE study. 80.8% relapsed! Median time to relapse 15 weeks. @RheumNow #ACR24 Abstr#1698 https://t.co/9pJ88C05V2
Richard Conway RichardPAConway ( View Tweet)
Choose Rheum!
Hart & Kumar interviewed trainees about picking rheumatology... major themes:
▶️ exposure prior to medical training
▶️ mentorship/sponsorship
▶️ long-term self-reflection
▶️ chance!
How can we optimize first 3 to build our workforce?
@RheumNow #ACR24 Abst 1738
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Is 6M TCZ treatment enough to induce lasting remission in PMR?
➡️cohort of pts in SEMAPHORE trial
➡️among pts in remission after 6M TCZ, 1/4 were relapse-free after TCZ discontinuation
⏩6M treatment not enough to withdraw TCZ
Ab1698 #ACR24 @RheumNow https://t.co/wTRTfX1fWq
Mrinalini Dey DrMiniDey ( View Tweet)
Is #IL1 inhibition for 4 months a winner in #GCA —NOPE
Anakinra daily 100mg sc 4/12
Underpowered but equal relapses and d/c #steroids not different
#relapses esp after d/c #anakinra
N=30 d/c due to #COVIDpandemic
#1699 #ACR24 @RheumNow @ACRheum https://t.co/1TgloS5x8O
Janet Pope Janetbirdope ( View Tweet)
#Gout attack is assoc w 1.5 X MI, MACE in next 30 days
@ACRheum @RheumNow #ACR24 https://t.co/7IeFbW6xW8
Janet Pope Janetbirdope ( View Tweet)
#HRT is not much of a risk of
Breast cancer
Compared to
A drink a day of #ETOH
#ACR24 @RheumNow @ACRheum https://t.co/LFgqbFocpb
Janet Pope Janetbirdope ( View Tweet)
A#1693
Change in FVC @ W12 or 24 has progn value @ w52 in AI-ILD
Study SENSCIS (SSc) & INBUILD (SARD) trial PBO gps
SENSCIS: OR for ILD progression 1.9 @ w12, 2.5 @ w24
INBUILD: OR 2.2 @ w12 & w24
Early PFTs predict outcomes @ 1 yr, short trials may be feasible
#ACR24 @RheumNow https://t.co/8cICAeG0nr
Links:
Eric Dein ericdeinmd ( View Tweet)
How do you manage skin in Sscl?
-RNA pol III + high risk for skin progression.
-Limited+ low risk + stable Sscl no need for immunesuppresors.
-Look for EF in pts with generalized morphea.
-Ttnt of skin depending on other organ involvements.
-If no Raynaud’s/hands spared think of… https://t.co/HBjO5eQfjT https://t.co/oS1ZmkanGA
Links:
Adela Castro AdelaCastro222 ( View Tweet)
de Boysson et al. RCT anakinra in GCA. 30 patients. Week 52 relapse 53% in anakinra vs 46% in placebo. @RheumNow #ACR24 Abstr#1699 https://t.co/sqDWUlkXAX
Richard Conway RichardPAConway ( View Tweet)
Sarilumab is better than #MTX in #PMR
Reminder #RCT of #MTX in #PMR was a NEGATIVE #trial #1697
60 % #sarilumab in #RWE could d/c
#Prednisone after failure of initial #pred #Rx >1yr pred prior vs 40% MTX
Comparative effectiveness sari v MTX
#1700 #ACR24 @ACRheum @RheumNow https://t.co/4YXIBz0OK7
Links:
Janet Pope Janetbirdope ( View Tweet)
RheumNow’s expanded coverage of #ACR24 is sponsored in part by Novartis. All content is chosen by RheumNow & its faculty.
Dr. John Cush RheumNow ( View Tweet)
A retrospective analysis by Dr. ERayens et al showed that RA pts >/=50y given 2 RZV doses were less likely to develop HZ vs. unvaxxed grp
Incidence of PHN was also lower in the vaccinated group (0.2py vs.1.9py)
RZV is effective in preventing HZ & PhN
@Rheumnow #ACR25 abs0977 https://t.co/JhYBYnLmhl
sheila RHEUMarampa ( View Tweet)
2023 @ACRheum guidance recommends #MediterraneanDiet in RA
What are barriers/facilitators to following the diet?
Many pts are willing to try but don't follow it
Barriers➡️ food insecurity & aversions
Many are unaware
Do you talk to your pts about diet?
Ab1673 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
Bolhuis et al. PMR MODE study. MTX 25mg/week in recently diagnosed PMR. 52 weeks. 56 patients. Nada, zip, no effect. GC free remission 67% vs 68%. No difference in any secondary outcome. @RheumNow #ACR24 Abstr#1697 #ACRbest https://t.co/Mb909u1zFT https://t.co/dShyBF4WST
Links:
Richard Conway RichardPAConway ( View Tweet)