All News
#ACR BEST Abstracts from San Diego – Day 1
The RheumNow faculty reporters have been scouring the meeting for what they believe to be the best presentations from the first day at ACR 2023 in San Diego. From hundreds of online presentations, the poster floor and the plenary podium, here are some of the best abstracts from Sunday Nov. 12th. You can spot these on Twitter by looking for the (#ACRbest) hashtag.
Read Article
Frailty in PMR @DrTrishHarkins >1/3 are frail or pre-frail. Frailty correlates with PROs - worse mood, pain, fatigue, and QoL. Abstr#1201 #ACR23 @RheumNow https://t.co/pH5yG4AscU https://t.co/QuHmOgpLbi
Richard Conway ( View Tweet)
The Great Debate #ACR23 - and it’s a cracker.
Is early steroid-sparing therapy justified in GCA/PMR? I don’t know, but Rob Spiera and @philseo will battle it out to tell us.
(and ably moderated by the always eloquent @SattuiSEMD)
I’ll put some highlights here ⬇️🧵
@RheumNow https://t.co/ASpuglyENv
David Liew drdavidliew ( View Tweet)
Baseline vascular ultrasound predicts clinical outcomes @ 3 months. Subclinical GCA = relapse 37% vs 15%. Higher cumulative steroid dose. @sharoncowley01 @DrTrishHarkins Abstr#1565 #ACR23 @RheumNow https://t.co/b35CkFS0lz https://t.co/suBGR1ByDK
Richard Conway ( View Tweet)
So firstly the no case, and Rob Spiera takes up the case, dictated by the electronic coin toss.
No-one disagrees that we need steroid-sparing options, or that IL-6Ri work in PMR and GCA. But it’s the strategy questions which remain in play:
#ACR23 @RheumNow https://t.co/I2QDU7l6DE
David Liew drdavidliew ( View Tweet)
@RheumNow #ACR23 #GreatDebate
Use Advanced Rx for GCA 1st line?
Spiera: No
No ev for disease modification with early Rx
Lose only reliable biomark of dis activity w IL-6 inhib
No evid of reduced major GC AEs
$$
GCA: treat by GC alone, taper off by 6 m, low threshold to escal https://t.co/QxgAlVKitd
Eric Dein ( View Tweet)
@RheumNow So what might early steroid-sparing therapy in PMR/GCA achieve?
Cure? Superior disease activity control? Minimize damage? Improve QoL/function?
Well, sadly we have a long way to go in defining a lot of this:
#ACR23 @RheumNow https://t.co/QeidAHHm8x
David Liew drdavidliew ( View Tweet)
@RheumNow So in GCA, we don’t know if therapies can truly disease modify at all. There’s a lot of grumbling disease, and it’s unclear whether we can stop long-term vascular issues. And in PMR, we have very little data on early therapy at all.
So what’s the justification?
#ACR23 @RheumNow https://t.co/spAMqfSOy2
David Liew drdavidliew ( View Tweet)
#ACR23 @RheumNow #GreatDebate
Treatment for PMR by Spiera
- Plan rapid GC taper. It is OK to flare, prepare pt!
- Low threshold to introduce anti-IL-6 for GC intolerance or AEs
No need for initial biologic treatment for PMR/GCA
@philseo rebuttal upcoming... https://t.co/A0f3b0fMOr
Eric Dein ( View Tweet)
Should IL-6i be first line in GCA/PMR? Dr. Spiera says steroids work, are cheap; no evidence of using IL6i early in disease. there had been cases where pts still had active vasculitis while on IL-6i. He starts with steroids first then add IL6i #GreatDebate #ACR23 @rheumnow https://t.co/Oq5Q9HFtW3
TheDaoIndex KDAO2011 ( View Tweet)
Cognitive function in PMR @DrTrishHarkins 71% cognitively impaired! Markedly higher than population level #ACR23 @RheumNow https://t.co/0KTnssktKz https://t.co/XyjFzioiqB
Richard Conway ( View Tweet)
Great work @sharoncowley01 https://t.co/llUF6REOFR https://t.co/Ej8fQlTNH0
Barry O'Shea ( View Tweet)
Fantastic presentation by @sharoncowley01 🚀
~1/5 patients with PMR have US evidence of Vasculitis at time of diagnosis without clinical signs of GCA
⬆️role of US in these patients https://t.co/wSs3IB8SU7 https://t.co/mAhFDVJJ8T
Caoilfhionn Connolly ( View Tweet)
PMR in the #ACR23 @US_FDA new approval update - not something you see every day!!
@RheumNow https://t.co/yll3d4AicK
David Liew drdavidliew ( View Tweet)
#ACR23 tidbits from Sunday @ACRheum @RheumNow
1 Less steroids better w other #Rx in #GCA, #PMR, #SLE #nephritis, #nonrenal #lupus BUT NOT in Severe GCA
2 Trend for combined immune modulators in #lupus GN or w a #CNI
3 #HCQ is better than sliced bread in #SLE aim for drug level
Janet Pope ( View Tweet)
Cowley et al @sharoncowley01 Subclinical GCA in 17.5% with new PMR. Males with higher ESR more likely to have subclinical GCA. Subclinical GCA more axillary artery. Abstr#0747 #ACR23 #ACRbest @RheumNow https://t.co/CghmX1TKpf https://t.co/MJawtslLud
Richard Conway ( View Tweet)
Sarilumab for relapsing of PMR. Any thing to to taper off prednisone quickly.
#ACR23 , year in review.
Lost of good studies and smart discussions @RheumNow at Make rheum for PMR month. https://t.co/VyRP8ls3OC
Nouf Al hemmadi ( View Tweet)
@RheumNow PMR Mythbusters:
we polled Aussie🇦🇺 rheumatologists
How did those motivated enough to answer a PMR/GCA survey fare?
Myth: PMR is only proximal
- not bad
Myth: PMR needs ⬆️ESR/CRP
- a bit of work
Time to #MakeRheumForPMR
@victor_yang1 @CatherineL_Hill #ACR23 ABST0267 https://t.co/Z4ZkDHljOf https://t.co/ssHxOBJFxR
David Liew drdavidliew ( View Tweet)
YR in Review: Dr. P Seo
⭐️Sarilumab for relapse of PMR during GC taper:
➡️ab against IL6R
➡️118 pts:
⏺️pred 15 mg/d
⏺️Sari 200 mg/d q2wk/14wk
⏺️52wk pred taper
➡️At wk 52:
⏺️sustained remission: 28% vs 10%
⏺️mean total GC: 777 vs 2044 mg
#ACR23 @RheumNow https://t.co/ETVpyuBlZ7
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
These US Medicare data show us what we've all suspected:
PMR patients stuck on steroid get the fractures, heart attacks, & infections that land them in hospital.
And it costs $$$
Hopefully PMR steroid-sparing Rx can change this!
@RADoctor @SattuiSEMD #ACR23 ABST0718 @RheumNow https://t.co/XAWmf2qZAU
David Liew drdavidliew ( View Tweet)
