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ACR21 – Day 3 Report
Hitting the home stretch, day 3 presentations were big! Here are a few of my favorites: secukinumab efficacy in juvenile PsA; VEXAS - predicting poor outcomes; and the FDA Safety Update session.
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Monitoring Infliximab Drug Levels Improves Efficacy
Should we start considering therapeutic drug monitoring when prescribing TNFi for treatment of our rheumatologic conditions?
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#ACR21 Ab#1941: ORAL Surveillance VTE risk
▶️Tofa 10 BID risk > 5 BID > TNFi for VTE, DVT, PE
▶️Age, male, obesity, HTN, h/o VTE, oral contraception/HRT, steroids, antidepressants were risk factors
@RheumNow
https://t.co/JOKNyYVZfX https://t.co/mTkgkwPIT6
Links:
Eric Dein ericdeinmd ( View Tweet)
Comparative risks of skin SCC and BCC with different DMARDs. Abatacept appeared worst, HR 2.18, but may be residual confounding due to burden disease/comorbidities. Abstr#1942 #ACR21 @RheumNow https://t.co/UzOwuKKFmX
Richard Conway RichardPAConway ( View Tweet)
Therapeutic drug monitoring ⬆️ infliximab efficacy in RCT. 17.6% improvement in sustained disease control. Consistent across all rheumatic and non-rheumatic diseases. Abstr#1946 #ACR21 @RheumNow https://t.co/D1Ppb58fB8
Richard Conway RichardPAConway ( View Tweet)
Who declines most with #scleroderma #ILD - early dcSSc, ⬆️CRP, ⬆️mRSS all w more ⤵️FVC. Results verified in SENSIS trial of SSc ILD where #nintedanib was superior to placebo abst#1846 #ACR21 @RheumNow https://t.co/eckUj0qwch
Janet Pope Janetbirdope ( View Tweet)
Thank you @AhmadSherbini for discussing his #ACR21 research on @RheumNow on Abs#1444 - Can we predict which patients are most likely to have nausea or alopecia intolerance to MTX?
https://t.co/I5WmCECq7v
Eric Dein ericdeinmd ( View Tweet)
GRA @rheum_covid data presented by @mugartegil. African-American and Hispanic individuals with SLE have MUCH worse COVID-19 outcomes. Likely related socioeconomic and health disparities. Abstr#1933 #ACR21 @RheumNow https://t.co/YUoOeIxN7O
Richard Conway RichardPAConway ( View Tweet)
Hospitalisation for heart failure ⬆️ in inflammatory diseases. RA>PsA>AS>PsO . HRs 1.1-1.6 compared to general population. Abstr#1925 #ACR21 @RheumNow https://t.co/kKlGQM5Tcg
Richard Conway RichardPAConway ( View Tweet)
#ACR21 Ab#1939: Tofa CV Outcome (STAR-RA)
▶️Pooled data does not show ⬆️ risk of CVD
▶️Trend in pts w prior CVD -HR 1.27 (0.95-1.7), cannot r/o CVD risk in pts w risk factors
Less clear than oral surveillance data, but concerns in those w risks
https://t.co/JOKNyYVZfX @Rheumnow https://t.co/GGYJfxcqhc
Links:
Eric Dein ericdeinmd ( View Tweet)
ORAL Surveillance malignancy risk @RADoctor . Numerically higher at both doses tofacitinib compared to TNFi . Abstr#1940 #ACR21 @RheumNow https://t.co/uc2k5EaiRq
Richard Conway RichardPAConway ( View Tweet)
STAR-RA, CV risk
large insurance datax3
tofa vs TNFi
all comers: HR 1.01 (0.83-1.23)
one CV RF + any MTX: HR 1.24 (0.90-1.69)
prev CVD: HR 1.27 (0.95-1.70)
not sig
but surely okay to say baseline CV risk + tofa makes me a little nervous?
@SeoyoungCKim #ACR21 ABST1939 @RheumNow https://t.co/LmmL5zgv9u
David Liew drdavidliew ( View Tweet)
So time for ORAL Surveillance, malignancy and VTE risk.
I'll go through some of the key points in this thread
#ACR21 ABST1940, ABST1941 @RheumNow https://t.co/pbjM2sFAXz
David Liew drdavidliew ( View Tweet)
Why is there more CHF in #RheumatoidArthritis ? Also dose response between highest inflammation RA the PsA then axSpA then PsO. ?Cytokine profile varying with disease and maybe CRP. Who knows. Abst#1925 #ACR21 @RheumNow https://t.co/JIH3qwkLpx
Janet Pope Janetbirdope ( View Tweet)
#ACR21 Ab#1940. ORAL Surveillance - Malignancy
▶️Remember: pts had ⬆️ CVD risks incl older, smoker, etc so higher risk group for cancer
⭐️Lung cancer most common
⭐️# to harm ~ 300
⭐️Older age, current/past smoking were independent risk factors
https://t.co/JOKNyYVZfX @RheumNow https://t.co/WeX5uZAubd
Links:
Eric Dein ericdeinmd ( View Tweet)
ORAL Surveillance VTE risk. Significant increase in VTE/PE only at 10mg bd dose. Abstr#1941 #ACR21 @RheumNow https://t.co/WW71syiINE
Richard Conway RichardPAConway ( View Tweet)
Sick Leave in axSpA: Who takes more?
Dr. Rachel Tate ( @uptoTate) reviews abstract 0380 presented at #ACR21.
https://t.co/e8cU9rIVB1 https://t.co/ImSjjLK15m
Links:
Dr. John Cush RheumNow ( View Tweet)
@drhalafadhil @ACRheum @nighat @DrDavidKarp (ACR President) who can we contact at ACR who can help mentor her? I believe there is session #GlobalRheumatologySummit that addresses this. @rheumnow #ACR21 #RheumatologyforAll
TheDaoIndex KDAO2011 ( View Tweet)
Nature or nurture or both? Genesis #scleroderma US cohort showed Hispanic pts had more RNP, more #SLE overlap & younger but ⬆️mortality vs whites but less mortality vs blacks. Health disparities? Abst#1839 #ACR21 @RheumNow https://t.co/pgYJEXP1fN
Janet Pope Janetbirdope ( View Tweet)
#ACR21 #Abstr1913 What do our patients think about #Telemedicine?GRA Registry (N=596; 50% RA and #lupus):
💠Most found => effective than In-Person
💠25% dissatisfied and not keen to continue post-COVID
💠Poor predictors: Age, 🇬🇧🇨🇦🇦🇺🇳🇿, Graduates @RheumNow
https://t.co/55UmppwF9P https://t.co/9AyYB4hI3V
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)