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#ACR21 Abst#0293:
Lung involvement in 67 sero+ RA pts assoc w/:
⭐︎ SSc-specific ab
➡️ RP155, Th/To, fibrillarin, NOR90 in ILD group
➡️ Ku, Pm/Scl100, CENP-A/B in non-ILD group
⭐︎ older age, ⚦ sex, heavy 🚬
⭐︎ ↑ WBC, CRP, RF
#ACRBest @Rheumnow
https://t.co/Yo4jRKqvfV https://t.co/l5gbKoZBkm
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
What increases risk of RA-assoc #bronchiectasis, separate from #RA-ILD?
Results from @BrighamResearch find seropositivity (esp high +ve RF/CCP), older age, disease duration, & low BMI incr. risk of isolated bronchiectasis in RA.
#ACR21 Abs#0288 @RheumNow
https://t.co/jvvRucqTjL https://t.co/aFCfxrbUdV
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR21 Abst#0290:
Ever wonder about other predictors of mortality in pts w/ RA-Lung Disease besides ILD (OR 2.3) or older age?
⭐︎ ↑ mortality associated w/ pleural effusions (OR 3.3)
AND, notably...
⭐︎MTX use was protective (OR 0.4)!!!
@RheumNow
https://t.co/KKRkQVY2pf https://t.co/JsU2Rqzi6R
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
This study looked into the prevalence of subclinical atherosclerosis in #rheumatoidarthritis pts w/n 5 yrs of dx using carotid US.
📌vs. controls, RA pts had ⬆ CPs, cIMT
❗Screen RA pts for CV risk early on in their diagnosis
@RheumNow #ACR21 abs0271 https://t.co/btU6IcM3xb
sheila RHEUMarampa ( View Tweet)
#ACR21 Abst#0293
RA patients with lung disease have increased rates of SSc-specific autoantibodies compared to RA w/o lung disease.
▶️ Suggests we may need to investigate further into overlap phenotype in RA-ILD
@Rheumnow https://t.co/04FFuBUKmA https://t.co/A83kaie2gr
Links:
Eric Dein ericdeinmd ( View Tweet)
Dr Doliner @zach_wallace_md on ILD in AAV. ILD in 13% - of which 76% fibrotic. UIP most common. Most MPO+, but also rarely seen with PR3+. 47% ⬆️ risk of death. Abstr#0430 #ACR21 @RheumNow https://t.co/6MnxqW92bz
Richard Conway RichardPAConway ( View Tweet)
#ACR21 Abst#0289: Predictive score for preclinical RA-ILD based on 4 identified RF:
⭐︎ ⚦ sex (OR 3.9)
⭐︎ MUC5B T-risk allele (OR 3.7)
⭐︎ mean DAS-28 (OR 2.0)
⭐︎ older age at RA onset (1.1)
Obtain HRCT if w/ above (Se ~87%)!
#ACRBest @Rheumnow https://t.co/KKRkQVY2pf https://t.co/wifiTi6vPq
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
@jhrheumatology Dr. Petri at #ACR21 Great Debate.
Safety issues with Voclosporin:
1) Nephrotoxicity
2) Infection
3) CV Risk Factors
4) Malignancy
5) Neurologic toxicity
6) Osteoporosis
7) Drug interactions
8) Deaths
9) Pregnancy contraindication
@RheumNow https://t.co/wjluivmKNt
Eric Dein ericdeinmd ( View Tweet)
#ACR21 Abst#0170:
↑ epicardial adipose tissue volume predicts new coronary plaque development in the following RA patients:
⋆ <10 yrs dz (OR 5.75)
⋆ 1 cardiac risk (OR 3.4)
⋆ statin < 1 yr (OR 3.3)
⋆ w/o calcification at b/l (OR 2.65)
@Rheumnow
https://t.co/tnyWRVSger https://t.co/uhak4kdbll
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Interesting study on 5yr CV event risk in early #rheumatoidarthritis pts who received T2T mgt shows no difference in CVE risk in ERA grp vs control
ERA cohort:
> Longer remission = protective for CVE
> ⬆ HAQ = predictive of CVE
Tighter control, ⬇ CVEs
@RheumNow #ACR21 abs0282 https://t.co/GG7HPvWd0r
sheila RHEUMarampa ( View Tweet)
Abst#271 #ACR21. RA activity predicts left ventricular mass change in pts without CVD
⭐️35% had abnormal LV geometry at baseline TTE
⭐️55% at f/u TTE 3-6 years later
⭐️Increase in concentric remodeling on LV
@Rheumnow https://t.co/uHnqITcTy9 https://t.co/KmV8volVwd
Links:
Eric Dein ericdeinmd ( View Tweet)
#ACR21 Abst#0276:
Pulse pressure (PP) = Systolic BP - Diastolic BP, measures arterial compliance
⭐️RA: higher PP than controls
⭐️PP was independent risk factor for subclinical atherosclerosis
▶️ Look at the vitals, we have this at every pt visit!
@Rheumnow https://t.co/KZaf1AwO6Q https://t.co/kN4xGxWiV9
Links:
Eric Dein ericdeinmd ( View Tweet)
It's what's below the surface that's most scary.
see: RA & the heart
- why do RA pts without cardiovasc dx/Sx get LV remodelling over time
- why is it worse with worse RA control?
RA goes deeper than the joints & our pts need to hear that!
@Columbia #ACR21 ABST0272 @RheumNow https://t.co/NDHLZwoEjy
David Liew drdavidliew ( View Tweet)
Despite >20y of bDMARDs, our patients still have a 50% greater risk of cardiovascular issues
(similar to family history or abdominal obesity)
Cardiovascular disease in RA is not historic, it's today's reality we too often ignore.
2020 data @VUamsterdam #ACR21 ABST0286 @RheumNow https://t.co/Az4wHNUOGe
David Liew drdavidliew ( View Tweet)
Diabetes puts you at risk of cardiovascular disease, right?
What about RA?
Look at this graph and compare the pair.
"already it was impossible to say which was which” - George Orwell, Animal Farm
#ACR21 ABST0287 @RheumNow https://t.co/r0yaeC530l https://t.co/mKJhoyJ2Cn
David Liew drdavidliew ( View Tweet)
#ACR21 Abst#0271. ⬆️ Risk of carotid atherosclerosis in first few years of RA diagnosis. Authors recommend routine carotid screening in pts at time of diagnosis.
Q: would you routinely screen all patients at time of diagnosis?
@Rheumnow
https://t.co/A9akqyVRGF https://t.co/SYGkJHQzWf
Links:
Eric Dein ericdeinmd ( View Tweet)
Abst#0276:
Pulse Pressure (PP) can predict carotid plaque in RA!
➡️PP (SBP – DBP) assoc w/ subclinical CVD in gen populat. How about in RA?
⭐︎ RA pts had higher PP than controls
⭐︎ PP = only independent RF for subclinical athero
#ACR21 @Rheumnow https://t.co/esLDW8iggf https://t.co/6d2D9hXC1i
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Nintedanib open-label extension study in PF-ILD (progressive fibrosing)
- active arm continuing: similar rate of change as RCT (78 v 77)
- placebo arm initiating: similar as well
Missing data (COVID-19) but effect appears related to exposure
INBUILD-ON #ACR21 ABST0186 @RheumNow https://t.co/hWe7ypbex6
David Liew drdavidliew ( View Tweet)
Abst#0269: Autoabs confer risk of incident CVD in US ⚦ veterans w/ RA
⭐︎ MACE risk: ↑ concentrations of RF (HR 1.15) & malondialdehyde acetaldehyde (anti-MAA) (HR 1.2)
⭐︎ CVD Death: ↑ concentrations of CCP (HR 1.27) & anti-MAA
#ACR21 @Rheumnow
https://t.co/UeOz91Bh3P https://t.co/PJwP1H4eNk
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
#ACR21 Abst#0269
⭐️TCZ: ⬆️cholesterol, LDL, TG. ⬇️ hsCRP compared to TNFi. No ⬆️ risk of Reynold risk score (RRS)
Take-away: good data on TCZ effect on lipids, but I wouldn't use RRS to calculate CVD risk on med that ⬇️ CRP @Rheumnow https://t.co/zMltktfHkS https://t.co/bwKXiGIi8a
Links:
Eric Dein ericdeinmd ( View Tweet)
