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Once again, high BMI and smoking associated with substantial decrease in TNFi response for treatment of axSpA.
Easier said than done however. How are you helping pts lose weight or stop smoking?
Abs#1510 @RheumNow #ACR22 https://t.co/ircLkuXhCs
Robert B Chao, MD doctorRBC ( View Tweet)
Gut microbiota of axSpA pts who underwent bDMARD tx for one year more closely resembled controls. Unique enrichment of Collinsella in axSpA patients remained stable across time & tx, suggesting it may be a disease biomarker. Abs 1162 #ACR22 @RheumNow https://t.co/SjwORWp6IU https://t.co/rLlu4jGCfd
Dr. Rachel Tate uptoTate ( View Tweet)
GM-CSF inc'd in active AS pts, particularly in younger ages, and strongly correlates with disease activity, but not with disease duration. TNFi tx does not affect GM-SCF levels, despite improving disease activity. Abs 1156 #ACR22 @RheumNow https://t.co/ndhBGbPsCw
Dr. Rachel Tate uptoTate ( View Tweet)
Nice study on referral strategies for #axSpA in pts w/ chronic LBP by Dr @Nellziade
🔸MASTER strategy-optimal reference strategy: IBP, ✅NSAID response, HLA-B27+ & +SpA family hx
🔸Clinical predictive factors: uveitis, IBP, Pso, enthesitis &🚹
#ACR22 @RheumNow ABST#1512 #ACRBest https://t.co/l6AleXX7Kt
sheila RHEUMarampa ( View Tweet)
Decreased colonic mucus production in HLA-B27 + healthy individuals and axSpA and IBD pts. Abs 1151 #ACR22 @RheumNow https://t.co/CwX4n6PJFy https://t.co/4f1Za0Qhpj
Dr. Rachel Tate uptoTate ( View Tweet)
Biologics to treat gut microbiome dysbiosis??
In axSpA pts treated with bDMARDs for one year, gut microbiome resembled those of controls.
Collinsella remained stable - possible biomarker?
Abs#1162 @RheumNow #ACR22
#ACRBest https://t.co/vmQFJMpNPP
Robert B Chao, MD doctorRBC ( View Tweet)
Abs 1153 at #ACR22 males may have a higher levels of Th17-associated transcription factors. Radiographic progression in men may be mediated by S100 proteins and prostaglandins. @RheumNow https://t.co/mWbsaB8kK8 https://t.co/IkTBZcaqa6
Dr. Rachel Tate uptoTate ( View Tweet)
Inflammation causing HTN in AS?
Abstract #0384 #ACR22 @RheumNow
🫀413 patients followed for median 12 years
🫀14% developed HTN
🫀Baseline disease duration was an independent RF for HTN
🫀ESR > 20 sig. associated with HTN
Catherine Sims, MD DrCassySims ( View Tweet)
Ab1011 #ACR22
@SMerjanah: Fracture rates among vets with AS
Increasing fx incidence for AS and comparator groups over time
There was increase in fractures during TNFi era 2004-2021 compared to pre-TNFi, does not show fx sparing effect
@RheumNow https://t.co/fTSYbFcxqo
Eric Dein ericdeinmd ( View Tweet)
Abs 1011 examined fracture incidence rates in AS patients over time in VA cohort
- Rate of fractures in AS pts 2.1 per 1000 PY --> 22.8 (1999 --> 2021) vs Comparators 0.4 --> 8.3
- Post TNF era fracture rates increased AS > comparators
@RheumNow #ACR22 https://t.co/eUxoTavHGV
Akhil Sood MD AkhilSoodMD ( View Tweet)
What delays diagnosis of AS? #ACR22 @RheumNow
Abstract #0328
Diagnosed faster if:
👨🦳Older age at back pain onset
🧬HLA-B27+
✋🦶peripheral arthritis
📍Higher socioeconomic vulnerability had diagnostic delay
👁 uveitis more common in patients with > 4 years dx delay
Catherine Sims, MD DrCassySims ( View Tweet)
Analysis from Abs 0954 shows that mainly fatigue and back pain have an impact on the mean BASDAI during pregnancy. #ACR22 @RheumNow https://t.co/l5VGKqF2ar https://t.co/fpkl8VRRJP
Dr. Rachel Tate uptoTate ( View Tweet)
Dr PMease et al looked into impact of TNFi cycling in their #axSpA cohort:
💠After 6mos on 2nd TNFi, only 15% had ASDAS-LDA, 7% MCID in ASDAS, 8% >50% improvement
💠Cycling to 2nd TNFi limited benefits
⬇️sample size, worth further investigation
#ACR22 @RheumNow ABST#1499 https://t.co/OVJxezdipW
sheila RHEUMarampa ( View Tweet)
Post hoc analysis of 3 PsA/SPA trials: no effect of tobacco 🚬 on TOFA efficacy But numerically higher TEAEs
Contrasting w/ data from real world TNF
Interesting data but small sample size & events N
https://t.co/gv8uvcThMD
Abs#1036 #ACR22 @Rheumnow https://t.co/HCJT0XF1tg
Aurelie Najm AurelieRheumo ( View Tweet)
DANBIO registry: 1600+ pts RA, AxSpA, PsA
Infiximab biosimilar to biosimilar switch (CT-P13 -> GP1111)
Maintenance at 1yr:
>80%
> withdrawal in original IFX naive, but higher BL DA
Do second time switchers do better because of past switch experience?
Abs#1112 #ACR22 @RheumNow https://t.co/IgjhGLVESz
Aurelie Najm AurelieRheumo ( View Tweet)
Biosimilar to biosimilar effective in treatment of RA/PsA/AxSpA.
Large study looking at infliximab biosimilar switching - resulted in high retention rates and virtually no change in disease activity.
@RheumNow #ACR22 Abs#1112 https://t.co/uNRXLewo4M
Robert B Chao, MD doctorRBC ( View Tweet)
Abstr #1494 determinants of clinically important worsening (CIW) of early axSpA
- CIW = ASDAS ↑ > 0.9 b/w 2 visits
- Tender Joint count and ASAS-NSAID score associated w/ CIW
- MRI SI Jt inflammation & structural damage predictive of CIW
@RheumNow #ACR22 https://t.co/Dgeh25BaWM
Akhil Sood MD AkhilSoodMD ( View Tweet)
BASDAI and ASDAS performed similarly in axPsA pts, both demonstrating weak correlations w/ peripheral arthritis and moderate/strong correlations w/ pt fatigue and pain. Abs 1037 #ACR22 @RheumNow https://t.co/WRQx1hkIll https://t.co/kJVIWyVv2w
Dr. Rachel Tate uptoTate ( View Tweet)
Osteoporotic fx in AS
Abstract #0388 #ACR22 @RheumNow
🦴2k adults in RISE, mean age 68y, 44% female, 76% white
🦴Higher risk with: older age, increased comorbidity index, OP history, chronic use of opioids, low BMI
🦴Men and women were equally likely to fracture
Catherine Sims, MD DrCassySims ( View Tweet)
Early TNFi use and cardiovascular events in AS
Abstract #0415 #ACR22 @RheumNow
📍17.6k patients, 91% male, 80% white
📍TNFi initiators were younger with lower prev. of HTN and DM
📍TNFi was associated with higher risk of incident CVD, CVA, and MACE https://t.co/7bCkfk7EYY
Catherine Sims, MD DrCassySims ( View Tweet)
