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Infection or Disease Flare: What Tools Can Help Differentiate?

Olga Petryna, MD Nov 08, 2021

Differentiation between a flare of disease and infection in patients with autoinflammatory (AI) conditions, where fever is the hallmark, can be extremely difficult. Few studies have evaluated potential differentiators; and having such tools would meet a huge unmet need.

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Opening Day Report

Jack Cush, MD Nov 06, 2021

The opening of ACR2 Convergence was a hit for all who signed up and viewed in. The day included the presidential address by outgoing president Dr. David Karp (UT Southwestern) and a keynote talk and interview with Dr. Seema Yasmin (Stanford).

Knowledge Bowl at #ACR21 ⭐️In a suspected PAN case, you order a peripheral smear to look for this potential etiology, ➡️Hairy cells @RheumNow

Dr Stewart @TonyMerriman2 report in 16,000 patients that repeat serum urate testing not superior to single measure in predicting incident gout over 9 years. Makes sense in general, maybe different in those with medication changes etc? Abstr#1449 #ACR21 @RheumNow https://t.co/69NofMNuB8

Guselkumab treatment of PsA improved Hgb levels and ⬇️ incidence of anemia ⭐️Anemia resolution associated with improved clinical status #ACR21 #ACRBest Abs#1331 @RheumNow https://t.co/nbG7DpMDaR https://t.co/rxWsVfNqed

Guselkumab (TREMFYA®) Improves Anemia in Patients with Active Psoriatic Arthrit…

Knowledge Bowl at #ACR21 ⭐️Which HLA allele confers an increased risk for anterior uveitis and inflammatory sacroillitis? ➡️HLA-B27 @RheumNow

Knowledge Bowl at #ACR21 ⭐️This HLA allele can be seen in a certain vasculitis where panuveitis is a possibility and has a venulitis predilection ➡️HLA B51 @RheumNow

Peripheral and axSpA pts with low Vitamin D levels (<30) had worse disease activity and functional impairment (BASDAI, ASDAS, BASFI) compared to pts with normal Vit D levels. Abs#1316 #ACR21 @RheumNow https://t.co/ulIqOAnWtp https://t.co/aMQaTpduJK

Vitamin D Deficiency and Disease Activity in Patients with Spondyloarthritis - …

#ACR21 Abs#1225: B/L Extracell Matrix Biomarkers predict ABA response in MTX-naive, +ACPA early RA ⭐️ECM biomarkers predict SDAI remission or DAS28 w ABA+MTX vs PBO+MTX. ⭐️⬆️CTX1 biomarker predicts efficacy endpts for ABA+MTX https://t.co/7wHQefb5D4 @Rheumnow

https://bit.ly/31wNLV2

#ACR21 #Abstr1011 Can we differentiate NEMO-deleted exon 5 autoinflammatory syndrome (NEMO-NDAS) vs CANDLE? Bioinformatics to mask the IKBKG pseudogene is promising and identified IL-6, 8,18, IFN-I and TNF-induced cell death as future targets @RheumNow https://t.co/tR2PNymMVn https://t.co/yCKHQx6R3E

Validation of Bioinformatics Pipeline to Detect NEMO-Deleted Exon 5 Autoinflamm…

Abst 0789 Baker & colleagues examined adipokine levels in association with disease activity in RA patients - Patients with high levels of adipokines less likely to achieve low disease activity & remission - These patients more likely to escalate to b/tsDMARDs #ACR21 @RheumNow https://t.co/1xlO4W9q9v

#ACR21 #pedsrheum juvenile localized scleroderma Polypositive profile 3 or more autos correlated with more severe skin score, more activity https://t.co/vVXV4jjLvG

TOFA Post hoc analysis on 2000pts: ⬆️ Paraoxonase PON1 activity associated w/ ⬇ risk of malignancies (not NMSC) in RA pts treated w/ TOFA, Adj on RA duration, age, and smoking. A promising biomarker! #Abst980 @RheumNow #ACR21 https://t.co/fOILnAyDN9

Awesome presentation today from Dr. Cristina Ruiz-Romero on lipidomic profiles in RA vs PsA. Using mass spectrometry, found differences in both synovial bx and fluid. Potentially useful lipid markers, more studies to follow. #ACR21 #ACRBest Abst#0946 @RheumNow https://t.co/KmWCPKijSx

Getting closer to personalised medicine in AS, ECM-mediated biomarkers may help predict response to Adalimumab in AS. The biomarkers C1M, C6M and PRO-C4 were lower in responders to adalimumab treatment after 24 weeks @RheumNow #ACR21 Abst#0915 https://t.co/K2YxPvUAwu https://t.co/w9kcBSFeG9

Biomarkers of Extracellular Matrix Turnover Reflect Treatment Response and Phar…

Soluble urinary ALCAM previously shown as potential biomarker for LN. Further study showing urinary ALCAM trended with changes in renal-SLEDAI and UPCr. #ACR21 Abst#3053 @RheumNow https://t.co/IqVJej7yda

https://bit.ly/3qa2Eae

Abst#0788 #ACR21. Forgot to measure vitamin D? ▶️ Red cell distribution width (RDW) inversely correlates w vit D 25(OH) levels prior to MTX ⭐️ RDW ⬆️ after starting MTX, no longer correlates https://t.co/b5EPDmGE18 @Rheumnow https://t.co/cNN14ErOmF

https://bit.ly/3BPL5hL

#ACR21 Abst#0449: Ever wish you had a tool to help you predict which PsA pts will progress to radiographic damage? ➡️Proteomic approaches identified 103 candidate biomarker peptides related to 69 proteins that can potentially do so! @Rheumnow @uptoTate https://t.co/uUsZlBLTWC

https://bit.ly/31DjDaJf

Are we getting closer to personalised medicine in #psoriaticarthritis Predicting progressors vs non-progressors using proteomics identified 103 candidate biomarker peptides that will discriminate the two groups @RheumNow #ACR21 #ACRBest Abst#0449 https://t.co/obDXTz3i5N

Identification of Serum Protein Biomarkers at Baseline to Distinguish Radiograp…

Can we predict who which PsA pts will be radiographic progressors? Abs#449 identified 103 candidate biomarker peptides corresponding to 69 proteins that could ID progressors More data needed #ACR21 @RheumNow https://t.co/OLfPRNjTKV https://t.co/6UTn1J7nJH

Identification of Serum Protein Biomarkers at Baseline to Distinguish Radiograp…

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