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Who gives a ‘JAK’ why and how they work, as long as they do!
Several abstracts have studied the mechanism of action of JAK inhibitors (JAKi) in various diseases. JAKi alter many other mediators affected by the JAK STAT pathway. For instance, T cell signature in blood that is proliferative was associated with a response in RA.
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Ross et al. Fascinating study of infusion of etanercept into lymphatics in RA in inadequate responders to s/c etanercept. DAS28(CRP) reduced 5.40±0.16 to 3.55±0.21, PGA of Disease Activity and Pain decreased by 66% and 77%. Abstr#0838 #ACR23 @RheumNow https://t.co/RIMCS3nmy6 https://t.co/U2689atvmj
Richard Conway ( View Tweet)
APIPPRA trial of abatacept to prevent RA in sero+ arthralgia. Picture paints a thousand words - big difference at week 52 (on abatacept) and watch those lines converge Abstr#0835 #ACR23 #ACRbest @RheumNow https://t.co/cwX389TUZN https://t.co/2CQHYlW0nq
Richard Conway ( View Tweet)
Baker et al. Danish registry study. Truncal vagotomy increases risk RA (but not OA), HR 2.62 (95% CI 1.47-4.67). Support for vagus nerve stimulation in RA? Abstr#0836 #ACR23 @RheumNow https://t.co/SbphSMLHc7 https://t.co/93SfyGizLt
Richard Conway ( View Tweet)
Inflammatory reflex suggests role of vagal nerve in inflammation regulation
Danish database
Truncal vagotomy
2000+ pts matched w/ 22000+ = Increase risk for RA HR 2.6
Not the case for supras elective vagotomy (HR 1)
No influence on OA
@RheumNow #ACR23 ABST0836 https://t.co/3ThYP1nKTe
Aurelie Najm ( View Tweet)
Here's the counterpoint to the previous positive tweet on vagal nerve stimulation in RA. The previously promising data on auricular vagus stimulation falls flat on further study Abstr#0837 #ACR23 @RheumNow https://t.co/APnrPhWA9q https://t.co/adA0H1VETt
Richard Conway ( View Tweet)
This is particularly interesting considering this 👇🏼👇🏼
First RCT of NI auricular vagal nerve stimulation did not meaningfully improve RA disease activity or outcomes.
No SAEs
Is this supporting the need for other VNS modalities?
@RheumNow #ACR23 ABST0837 https://t.co/yFcMPoSc31 https://t.co/G069XwUyAz
Aurelie Najm ( View Tweet)
What is D2T PsA?
A proposal of definition in ABST0777
Thoughts:
A lot of features are extrapolated from the EULAR RA definition
RA & PsA population are hardly comparable
Lack of emphasis more problematic domains ie. dactylitis
Further work is required
@RheumNow #ACR23 https://t.co/A28e6XBME3
Aurelie Najm ( View Tweet)
Fascinating how upadacitinib may well have an effect on pain in RA, beyond inflammation.
Now seen similar for bari in RA & guselkumab in PsA. And, if real, for some people could be a massive get. Love to see dedicated studies
SELECT-COMPARE post-hoc #ACR23 ABST0429 @RheumNow https://t.co/Tk278mGJYY
David Liew drdavidliew ( View Tweet)
Klein et al. 205 RA-ILD. MUC5B not significantly associated survival, although wide CIs, aHR 0.75 (0.45, 1.24). Abstr#0772 #ACR23 @RheumNow https://t.co/ZfIIr2BbbR https://t.co/47DPYWNpL9
Richard Conway ( View Tweet)
FAPα possible therapeutic biomarker target of pathogenic fibroblasts. #ACR23 Abs 0802 demonstrates potential therapeutic efficacy of fibroblast-targeted immunotherapy as a novel treatment in inflammatory disease. https://t.co/ZGUfC6PZxa @rheumnow https://t.co/jj9BeuvTuc
Dr. Rachel Tate ( View Tweet)
Plasma MMPs and RA-ILD. Strong association MMPs 7 & 9 with prevalent RA-ILD. Abstr#0770 #ACR23 @RheumNow https://t.co/5qWeK3lAly https://t.co/SyZY2OhcbH
Richard Conway ( View Tweet)
Always great to see UCSD represent at #ACR23!
Pregnant women with rheumatic diseases and antiphospholipid syndrome higher a HIGHER risk for acute cardiovascular events
30% of events occurred postpartum
@RheumNow Abs#0722 https://t.co/CqZedfOlBC
Robert B Chao, MD ( View Tweet)
Are anti CCP3 the new anti CCP2 antibodies?
Not yet!
Anti-CCP3 associated w/ diagnosis of RA in a population of patients w/ MSK symptoms
But… very strong overlap between CCP2 and 3 with only 3.4% positive for CCP3 negative for CCP2
@RheumNow #ACR23 ABST 0389 https://t.co/BHRqCbqEYw
Aurelie Najm ( View Tweet)
Detectable hs-cTnT at baseline was associated with future MACE HR 5.6, in the hsCRP high→low cohort with high inflammation at baseline, not vice versa. hs-cTnT may provide additional info for assessing CV risk, Weber et al, Abst#0387 https://t.co/M4zyz2tzIO #ACR23 @RheumNow https://t.co/omMgpRzBA5
Dr. Antoni Chan ( View Tweet)
Non invasive screening for pulmonary involvement in early RA
Combination of PFT and Lung 🫁 US:
-50% with interstitial or focal changes or pleural effusion on US
-58% with abnormal DLCO
Correlation w/ higher disease activity.
Pathological meaning?
@RheumNow ABST 0393 #ACR23 https://t.co/BBcOEgcJK2
Aurelie Najm ( View Tweet)
WEAR study: adherence to wearable activity trackers in RA
Something that is consistent across all wearable studies is low adherence
Here under 50% for PRO + tracking
In an already selected population!
To implement, we need to make this better?
ABSTRACT 0344 @RheumNow #ACR23 https://t.co/csVZlzABGt
Aurelie Najm ( View Tweet)
Year in Review: Dr. P Seo
⭐️Does Pizza consumption favor improved dz activity in RA?
If in Italy
➡️ 365 pts w/RA in Milan: 18-65 yo w/ >3 mo dz
➡️Ate 1/2 a pizza > 1x/wk w/ decr in dz activity (SDAI⬇️: -3.6)
➡️Mozzarella & olive oil showed beneficial effects
#ACR23 @RheumNow https://t.co/qZTzThI39e
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Towards more personalised care in rheumatoid arthritis #ACR23 @RheumNow https://t.co/roxtcX8QHI
Dr. Antoni Chan ( View Tweet)
RA as a young woman used to mean kids were only a distant thought.
Japanese RA pts n=280 asked whether RA onset meant wanting fewer children & why.
Confidence improving across the board over time.
We want to give our RA pts choices to live their life!
#ACR23 ABST0473 @RheumNow https://t.co/OHZM2J5qxS
David Liew drdavidliew ( View Tweet)