All News
Why would higher active dose of #methotrexate with sc admin & more metabolites polyglutamates which can give side effects have LESS AEs? Never understood it! #ACR21 abst#1695 @RheumNow https://t.co/qrEKofX1cl
Janet Pope Janetbirdope ( View Tweet)
Abst1810 #acr21 @RheumNow survey of pt preferred meds for PsA points out ⬆️ interest in IL17 & PDE4 since 2018 guideline update: anti-IL17 compared to 2018 or earlier (30% vs 3.5% p< 0.001);anti-PDE4 (40% vs 11.5% p< 0.012). Meds SEs& prevention of joint damage important for pts
Olga Petryna DrPetryna ( View Tweet)
#ACR21 L16 - Breakthrough #COVID19 in rheum pts
⭐️Breakthrough ifn ~4%, compared to 3% wo rheum disease. Statistically signif ⬆️ risk in RA, gout, polymyositis, vasculitis, multiple rheum disease
⭐️bDMARD, multiple AIRD risks
@Rheumnow https://t.co/cuM9LcEr4u https://t.co/Los2n7BoIn
Links:
Eric Dein ericdeinmd ( View Tweet)
After 2018 ACR Guidelines, significant increase in IL-17i and PDE4i use in PsA pts
⭐️TNFi most common tx
⭐️28% pts not on any tx⭐️
#ACR21 @RheumNow Abs#1810
https://t.co/7Rmirfm3nK https://t.co/0Ui9pq5uyo
Links:
Robert B Chao, MD doctorRBC ( View Tweet)
RHEKISS registry: SpA pts on bDMARDs at conception are NOT at inc. risk for adverse pregnancy outcomes. Discontinuation of bDMARDs after conception is assoc'd w/ inc. dz activity during/after pregnancy & flare risk. Abs 1730 #ACR21 #RheumNow @RheumNow https://t.co/b2wI9GZios https://t.co/wsuvv3hF0v
Dr. Rachel Tate uptoTate ( View Tweet)
The plague protection genetically can lead to Pyrin induced inflammasome activation. Theory of more FMF in Mediterranean / Turkey. So high protection gene in population Dan Kastner - a genetic detective 9T119 #ACR21 #ACRBest @RheumNow https://t.co/qzdc12fT0j
Janet Pope Janetbirdope ( View Tweet)
In Phase 2 trial of Tildrakizumab in active PsA efficacy tended to be lower among patients with comorbid MetS, with improvements from baseline across efficacy measures generally larger in patients without MetS vs those with MetS @RheumNow #ACR21 Abst#1819 https://t.co/ATxaFz9X2O https://t.co/2iJMNmfUzg
Dr. Antoni Chan synovialjoints ( View Tweet)
Post hoc analysis of pooled data from 19 clin trials on SEC & CV risk & systemic #inflammation in PsO, PsA, AS
📌Traditional CV parameters remained stable on all SEC treated grps
📌SEC sig. ⬇hsCRP & NLR
@RheumNow #ACR21 abs1835 https://t.co/iCaGFbXNXn
sheila RHEUMarampa ( View Tweet)
French study shows more than 75% of RA/SpA pregnancies resulted in a live-birth, BUT 50% of pts had at least one unfavorable pregnancy outcome! However, miscarriage prevalence lower than in reported literature. Abs 1724 #ACR21 #RheumNow @RheumNow https://t.co/64PspIKPTu https://t.co/LyfHVARAgd
Dr. Rachel Tate uptoTate ( View Tweet)
IVIG can passively transfer donor Ab including 'clinically significant' e.g. HBcAb
@OchsnerHospMed 123 pts HBcAb+ post-IVIG
37 had HBcAb- captured pre-IVIG
of those, 22 received prob unnecessary antiviral Rx
Be smart: pre-IVIG, anticipate - test HBV
#ACR21 ABST1528 @RheumNow
David Liew drdavidliew ( View Tweet)
2 year study shows low rates of radiographic progression in PsA pts on guselkumab
#ACR21 @RheumNow Abs#1805
https://t.co/dobg3cEXXG https://t.co/m1P24qPAhy
Links:
Robert B Chao, MD doctorRBC ( View Tweet)
SERENA interim analysis on interruption of secukinumab in AS and PsA
🔹>=16 wks of Rx before interruption of >= 3 mo.
🔹75-80% of pts reinitiated w/o loading phase
🔹AS: BASDAI, PGA stable
🔹PsA: SJC, TJC returned to Rx baseline
https://t.co/3G6rVW8TPv
#ACR21 Abst#1361 @RheumNow
Pedro Castillo _Castillo_Pedro ( View Tweet)
Have you heard of pSpA? (Peripheral) pSpA: distinct clinical phenotype w/ intermediate features between pure PsA & pure axSpA but w/ a higher disease burden compared to both diseases, & lower use of b-DMARDs. Abs 1787 #ACR21 #ACRbest #RheumNow @RheumNow https://t.co/Wsysm7A0Y3 https://t.co/rwQ8ukBEDq
Dr. Rachel Tate uptoTate ( View Tweet)
Genes for oral aphthous ulcers common in gen pop’n, Behcets and w auto inflammatory PFAPA - kids w fevers ⬆️IL12 Kastner practical gene stories @RheumNow #ACR21 9T119. Have a listen. Bench to bedside & back https://t.co/UkPzoYbBNb
Janet Pope Janetbirdope ( View Tweet)
ARIAA Study - Abatacept Reverses ACPA+ Subclinical Arthritis: Dr. Jack Cush discusses abstract #0455, a preclinical RA intervention trial - abatacept or placebo given to at risk individuals (arthralgias, CCP+, MRI+) for 6 months, presented at #ACR21.
https://t.co/fz1hPTleMn https://t.co/V4PsPZ0ZwF
Links:
Dr. John Cush RheumNow ( View Tweet)
5 yr multinational PROOF study - enrolled 1612 axSpA pts enrolled (65% xray+ axSpA; 35% nr-axSpA) nraxSpA had more enthesitis, PSO IBD. Over time, more TNFi use (less NSAIDs) w/ less disease activity #ACR21 Abst #0363 https://t.co/5DdDlCjq9h (Graph: NSAID use over time) https://t.co/5JE69vTIy9
Links:
Dr. John Cush RheumNow ( View Tweet)
Quick plug:
not all joint pain in ICI-treated pts needs reflex steroids
eg OA can get exacerbated by ICI Rx
(ICI-aOA)
call rheum, hold the PNL & save tumor response
@ReidMDMPH @got_rheum @lovetolearn27 +me
#ACR21 ABST1518 @RheumNow
our paper @jitcancer https://t.co/InespbOn6m https://t.co/HSjtGrwePE
David Liew drdavidliew ( View Tweet)
Glory to GLORIA trial? Low dose prednisone 2mg in active RA>65yrs, N=451 All Standard care. in 2yrs, ~40% drop out- same in each grp Better RA control but NNH 9.5 w steroids, mostly non severe infections. So, prednisone debate in RA continues #ACR21 @RheumNow #ACRBest abst#1678 https://t.co/emOaYSjYAa
Janet Pope Janetbirdope ( View Tweet)
Pregnant pts w/ PsA, but not AxSpA, at increased risk of pre-eclampsia. In RA pregnancies, pre-eclampsia risk increases w/ dz severity prior/during pregnancy. We need to discuss potential risks w/ pts and OB team. Abs 1722 #ACR21 #RheumNow @RheumNow https://t.co/yeQmNAZ1jV https://t.co/cBfeVKQHfr
Dr. Rachel Tate uptoTate ( View Tweet)
Just worthwhile remembering:
in terms of TNFi anti-drug immunogenicity in autoimmune disease:
RA is top of the pops
(although dose spacing is worse)
data from NOR-DRUM A, TDM in infliximab #ACR21 ABST1525 @RheumNow https://t.co/wfcA72wcLP https://t.co/mHppH6qYdY
David Liew drdavidliew ( View Tweet)