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Applying the guidelines to Cases- Dr M Dall’Era for a pt wit extrarenal lupus and active LN. #ACR24 @rheumnow https://t.co/lvOUWjEdEz
Links:
TheDaoIndex KDAO2011 ( View Tweet)
The updated 2024 ACR Guideline for Dx and Tx of #lupus nephritis is here!
Dr. Lisa Samaritano discusses the key recommendations 👇
For all pts: screen for LN, give HCQ and RAAS for pts with ⬆️ proteinuria
GCs in pts w/ LN class III/IV &/or V.
@Rheumnow #ACR24 @rheumarhyme https://t.co/wLVRGktR59
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sheila RHEUMarampa ( View Tweet)
The overview for #lupus nephritis tx.
Triple therapy is preferred as first line due to:
1. RCTs (BLISS-LN & AURORA 1) showing improved outcomes w/ triple txs
2. Nephron loss happens with ongoing LN - time is kidney!
@RheumNow #ACR24 https://t.co/IQo3q3O1pt
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sheila RHEUMarampa ( View Tweet)
Overall very reasonable, aligning ACR recs w/other guidance groups & updated data
Remember: guidelines are meant to be broken. Some patients can likely avoid pulse, others may need more steroid on the back end, biopsies are not benign
#ACR24 @RheumNow
Mike Putman EBRheum ( View Tweet)
Happening now, new guidelines for mgmt. A few highlights:
Recommend prompt GC therapy, pulse x1-3d followed by oral pred (<0.5mg/kg/d) w/taper to <5mg by 6 months
Aligns with EULAR recs for a much-lower dose than most clinicians currently doing
#ACR24 @RheumNow https://t.co/B71i7FBYlQ
Mike Putman EBRheum ( View Tweet)
Applying the #ACR24 #LupusNephritis: Case 2 by Dr M Dall’Era @RheumNow https://t.co/A7i103uHZT
Links:
TheDaoIndex KDAO2011 ( View Tweet)
Biosimilar switching in practice
Hyrich: UK experience
Switching to biosimilar has no immediate benefit to patients but saves NHS money
Allows for gain share that can be re-invested in pt care
Transparency in switching in explaining to pts and offering resource
@RheumNow #ACR24
Eric Dein ericdeinmd ( View Tweet)
If you’re starting with DMARD (according to ACR/VF guidelines) tx in TAK - MTX and AZA are probably equivalent options… MMF not so much
@RheumNow #ACR24 https://t.co/jn52ujtspo
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Older adults with late-onset RA (LORA) with more erosive changes, even with DMARD use
But is T2T met?
LORA with higher DAS on diagnosis and yet 10% on bDMARD vs 26% of young-onset RA
#ACR24 @RheumNow ABST#2224 https://t.co/dYs1JwcJeq
Jiha Lee JihaRheum ( View Tweet)
Abstract 1912: Time to close the gaps in #PsA care
RISE Registry reveals:
- higher disease activity in the South
- more oral steroids + csDMARDs, fewer bDMARDs, and more comorbidities in the Midwest
@RheumNow #ACR24
Akhil Sood MD AkhilSoodMD ( View Tweet)
Provocative study suggests SLE has changed. Big picture: less physical manifestations, more serologic
@andreafava why isn't this just more-testing & more-sensitive testing shifting the phenotype of who we diagnose?
#ACR24 @RheumNow Abstr#2413 https://t.co/o2e9TFMsUp
Links:
Mike Putman EBRheum ( View Tweet)
Class V #Lupus Nephritis usually takes longer to treat. Stay the course if no contraindications and taper steroids! - Dr A Askanase #ACR24 LN Guidelines @RheumNow https://t.co/4BBuAWi2da
Links:
TheDaoIndex KDAO2011 ( View Tweet)
Improving the Value of Musculoskeletal Ultrasound in Rheumatology Care #ACR24
MSUS has emerged as a powerful asset in rheumatology, providing a real-time, non-invasive, and cost-effective solution for diagnosing and managing inflammatory arthritis conditions such as RA and PsA.… https://t.co/iH9IZmHhSz https://t.co/am5LoBCdpe
Dr. John Cush RheumNow ( View Tweet)
RheumNow’s expanded coverage of #ACR24 is sponsored in part by Bristol Myers Squibb and UCB. All content is chosen by RheumNow & its faculty
Dr. John Cush RheumNow ( View Tweet)
Late-Breaking Abstract L07
The CLASS Project introduces new global classification criteria for Anti-Synthetase Syndrome (ASSD). Using the gold standard dataset, the key findings were:
✅ Definite ASSD: Sensitivity 94.3%, Specificity 99.7%
✅ Probable ASSD: Sensitivity 97.5%,… https://t.co/PtciIMTSsu https://t.co/jvJv2VNvHx
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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
The 🫀is muscle‼️
💥From the maestro herself @JuliePaikMD underscores why cardiac involvement in myositis can't be overlooked.
🔥Crucial insights with major implications for patient care and outcomes
#acr24 @RheumNow @HopkinsMedicine @jhrheumatology
https://t.co/mw6BvkdF2w
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
A#2529
Disparities in JIA
Outcome documentation, best practices, access to at-risk pts, agency and access
- outcomes initially appeared to worsen - reflection of better documentation
Improvement driven by pt global scores
Disparity gap closed by 17%
#ACR24 @RheumNow https://t.co/oOxs0jIvBK
Eric Dein ericdeinmd ( View Tweet)
Here’s my take on A#1743 and 1745 on @RheumNow #ACR24 coverage
https://t.co/PcRn8Hb4PY https://t.co/2vDyyJUp6W
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Eric Dein ericdeinmd ( View Tweet)
Will be covering some TAK pearls and pitfalls from today’s session!
Renal dz stratified by location of vessel inflammation:
- TAK = proximal (off aorta)
- FMD = mid-section, beading
- PAN = distal arterial branches
@RheumNow #ACR24 https://t.co/zu6qJ6DXcF
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
A call for ANA stewardship?
Abstract 1931: Educating clinicians on wise ANA ordering via EMR Alert plus removing the comprehensive ANA panel -->
- ↓ ANA testing (outpatient 15.9%→7.4%, inpatient 25.5%→6.4%)
↓ costs ($440k→$130k)
#ACR24 @RheumNow
Akhil Sood MD AkhilSoodMD ( View Tweet)
