All News
Taking AI Out of AutoImmunity: Predicting disease before it develops
the predictive value of a positive ANA test—especially in the absence of other clinical symptoms—remains a challenge. A positive test often leads to further testing, yet it does not necessarily indicate whether a patient truly has an underlying autoimmune disease. The development of AI and machine learning algorithms presents an opportunity to interpret autoantibody tests and predict autoimmune diseases. Here are three studies looking at this issue.
Read Article
ACR 2024 - Day 2 Report
Plenary sessions began the day, followed by thousands on the abstract floor. Here are a few of my favorite presentations from day 2 at ACR 2024.
Read Article
Abstract 1912: Time to close the gaps in #PsA care
RISE Registry reveals:
- higher disease activity in the South
- more oral steroids + csDMARDs, fewer bDMARDs, and more comorbidities in the Midwest
@RheumNow #ACR24
Akhil Sood MD AkhilSoodMD ( View Tweet)
A#2529
Disparities in JIA
Outcome documentation, best practices, access to at-risk pts, agency and access
- outcomes initially appeared to worsen - reflection of better documentation
Improvement driven by pt global scores
Disparity gap closed by 17%
#ACR24 @RheumNow https://t.co/oOxs0jIvBK
Eric Dein ericdeinmd ( View Tweet)
A call for ANA stewardship?
Abstract 1931: Educating clinicians on wise ANA ordering via EMR Alert plus removing the comprehensive ANA panel -->
- ↓ ANA testing (outpatient 15.9%→7.4%, inpatient 25.5%→6.4%)
↓ costs ($440k→$130k)
#ACR24 @RheumNow
Akhil Sood MD AkhilSoodMD ( View Tweet)
RheumNow’s expanded coverage of the #ACR24 meeting is sponsored in part by Novartis. All content is chosen by RheumNow & its faculty.
Dr. John Cush RheumNow ( View Tweet)
Can you build systems that stop that ANA neg ENA pos anxiety? Plus $$?
Lehigh Valley, Allentown, PA:
lab would run ENA+dsDNA automatically, but only when ANA >1:80
(i.e. leave the ENA order to the lab)
first voluntary, then compulsory
it's possible!
#ACR24 ABST1931 @RheumNow https://t.co/UQjWwve7DV
David Liew drdavidliew ( View Tweet)
Probably no surprise, but if you can navigate the digital world, it portends work for your rheum disease.
all @MedUni_Wien rheum clinic pts did an eHealth survey
high eHealth literacy did much better
We can't leave digital stragglers behind!
#ACR24 ABST1942 @Stiddyo @RheumNow https://t.co/c9IyPz6ujJ
David Liew drdavidliew ( View Tweet)
My ramblings on the SELECT-GCA study and predictions of the place of upadacitinib in clinical practice in GCA are up now on RheumNow #ACR24 @RheumNow https://t.co/DR5VgVmdse
Richard Conway RichardPAConway ( View Tweet)
Older RA patients in RISE with high disease activity show a higher incidence of hip and major osteoporotic fractures. Practice T2T and monitor bone health closely!
#ACR24 @RheumNow ABST#1748 https://t.co/7MCAIrfXhp
Jiha Lee JihaRheum ( View Tweet)
A#1748
Fracture incidence in RA - RISE registry
Incidence rate of MOF, hip Fx by disease activity
50% did not have CDAI available
IR 12 per 1000py hip, 43 for MOF
High activity worst, low/mod similar, remission is best
Supports remission is better than LDA
@RheumNow #ACR24 https://t.co/78FCLemfZD
Eric Dein ericdeinmd ( View Tweet)
A#1746 companion for RA
Like plenary for PsA, PBO response incr w time 1%/yr
More trials in less affluent countries may be related to increasing PBO response in trials
Possible reason: access to health care improves PBO in less affluent areas
@RheumNow #ACR24 https://t.co/S3LffF8vPH
Eric Dein ericdeinmd ( View Tweet)
A#1744 AI for RA to improve scheduling in UK
39% pts meet quality metric for early intervention
Input: RF, CRP, CCP, gender, age -> 51% accuracy (compare to first appt clinical accur 46%)
Focusing on highest risk -> 88% accuracy -> 50% wait time for high-risk pts
#ACR24 @RheumNow
Eric Dein ericdeinmd ( View Tweet)
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)
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)
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)
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)
The Joint Project is a community-based, barangay health worker-led screening program that aims to increase MSK dse awareness, timely referral & treatment or rehab.
The figure below illustrates the conceptual framework for the program
@RheumNow #ACR24 abs0979 https://t.co/yxXsASl2GJ
sheila RHEUMarampa ( View Tweet)
Ultrasound guided injections on cadavers improve rheumatology trainees ability to do
#joint #injections
17 trainees -a couple of hrs of cadaver inj
▶️ joint injection confidence improved esp uncommon / difficult areas
Elbow
Ankle
Wrist
@RheumNow #ACR24 @ACRheum abst#1310 https://t.co/ZcER4s8QcR
Janet Pope Janetbirdope ( View Tweet)
The idea of patient-initiated follow-up for RA is enticing:
patient & physician time is already stretched
minimize unnecessary visits/improve access
but what actually needs to go into the design, to make it safe/workable?
A: plenty.
🇨🇦 pilot underway
#ACR24 ABST1041 @RheumNow https://t.co/03u4bhnQ0v
David Liew drdavidliew ( View Tweet)
