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For patients with inflammatory irAEs, what's your preference of bDMARD/tsDMARD?
(keeping in mind both irAE response and tumor response)
#ACR21 irAE Study Group run by @CCalabreseDO @NAbdelwahabMD @ReidMDMPH
@RheumNow
David Liew drdavidliew ( View Tweet)
☄️Late breakingTRAIL1 RCT Pirfenidone on RA-ILD.
✨Primary outcome on incidence of decline of >10% FVC or death not met 11% PIR vs. 15% PBO OR=0.67 p=0.48
BUT
✨underpowered
✨reduces decline in FVC(ml) over 52wk (-66 vs. -146, p=0.0082)
✨safety ok
#ACR21 #AbstL10
@RheumNow https://t.co/IxYDE3lN1s
Aurelie Najm AurelieRheumo ( View Tweet)
Safety update for #filgotinib in #RA over ~2.2yrs treatment
👉🏼Well-tolerated with no ne safety concerns since 2020
👉🏼AE incidence rates decreased or remained stable
👉🏼Slight incr rates of NMSC & non-NMSC malignancies
Abs#1698 #ACR21 @RheumNow
https://t.co/0jbZFVgiyN https://t.co/yOlntLwQlU
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR21 Ab#1655. Respiratory Ifn in RA on bDMARD
▶️1 group was initiated into vaccination program vs usual care
⭐️Vaccinated group had ⬇️ admissions from respiratory ifns. 44% ⬇️ severe resp ifn
💉programs work!
@Rheumnow https://t.co/pljR6DbAtU https://t.co/goSHGID8qG
Links:
Eric Dein ericdeinmd ( View Tweet)
Isolated axial involvement exists in 2-5% of PsA patients. In 576 patients 495 (31.4%) had axial disease, of which 32 (2.0%) had isolated axial disease. HLA-B*27+ and lower HAQ scores were associated with isolated axial disease @RheumNow #ACR21 Abst#1775 https://t.co/Y1EAJlA0mT https://t.co/8oZhN3mT30
Dr. Antoni Chan synovialjoints ( View Tweet)
In this study:
💊No correlation bet QTc interval & whole blood HCQ level regardless of dose, CKD or abnormal TTEs in #lupus pts
💊+correlation bet QTci & HCQ levels in pts w/ QTc prolonging drugs but not >456ms
Reassuring, dispels concern on HCQ use
@RheumNow #ACR21 abs1743 https://t.co/kpASRAXJB1
sheila RHEUMarampa ( View Tweet)
#Multimorbidity in women with #rheumatoidarthritis is increased compared to men with RA. However, women and men without RA have similar levels of multimorbidity.
Abs#1656 #ACR21 @RheumNow
https://t.co/iXhXOldTy0 https://t.co/CsOM7odE69
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR21 Ab#1658 - Autoimmune Risks in Relatives of RA pts. 1st degree relatives have risk of:
▶️ AI thyroid (OR 1.3)
▶️ Celiac (1.5)
▶️ SLE (1.3)
▶️ IBD - no ⬆️ risk
⭐️1st, 2nd, 3rd degree relativ: ⬆️ risk of RA
⭐️2nd degree: ⬆️ risk SLE
https://t.co/ATHdemoF45 @Rheumnow #ACRbest https://t.co/JcuZmg9L8E
Links:
Eric Dein ericdeinmd ( View Tweet)
GLORIA RCT: 400+ pts. Low dose Pred in RA >65yo on top of other treatments 2yrs.
Authors conclude benefit/risk balance in favour of GCs 🧐
2 thoughts:
1️⃣ CV risk linked to GCs ⬆️ over time and cumulative dose: Follow up= short!
2️⃣ Small # for CV events
#ACR21 #Abst 1678 @RheumNow https://t.co/QECJR68ZJu
Aurelie Najm AurelieRheumo ( View Tweet)
Dr Deike on prevalence and incidence of PsA in Germany. Prevalence 5-6/1000. Incidence 30-40/100000. Marked age variations that don't really make sense for prevalence. Abstr#1785 #ACR21 @RheumNow https://t.co/uW0ruW2Jda
Richard Conway RichardPAConway ( View Tweet)
What is the likelihood of developing an #autoimmunedisease in first-degree relatives of pts with #RA?
Genealogical & phenotypic data suggests lower threshold for screening for autoimmune thyroiditis, #coeliac & #SLE in FDRs.
Abs#1658 #ACR21 @RheumNow
https://t.co/PdSZ05elsf https://t.co/AkIXDkWCM8
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR21 Ab#L02 - #COVID19 vax in rheumatic pts:
❌No ⬆️ in disease activity scores post-vaccination
❌No serious adverse event
▶️Vax response 88% in RA, 78% in SLE, 87% other rheum diseases after 2 shots vs 100% controls
⭐️RTX and MMF ⬇️ responses
@Rheumnow https://t.co/BChhmW0jpy https://t.co/2q8IKRoYqW
Links:
Eric Dein ericdeinmd ( View Tweet)
Dr Hebing on s/c vs oral methotrexate. erythrocyte methotrexate polyglutamates significantly higher with s/c administration. s/c consistently seems to be the better option, better efficacy, less side effects. Abstr#1695 #ACR21 @RheumNow https://t.co/kLGr6pVnxQ
Richard Conway RichardPAConway ( View Tweet)
Can we predict which PsO pts will develop PsA?
Machine learning and phenotyping of blood immune cell subsets identified an immune profile to discriminate PsO from PsA.
Abs#1774
#ACR21
@RheumNow
https://t.co/PERx86jjkJ https://t.co/oEpbMZ0nnK
Links:
Robert B Chao, MD doctorRBC ( View Tweet)
Congrats to Dr. Debaditya Roy, Dr. Chinenye Osuorji and Dr. Vaneet Sandhu on the leaderboard for engaged learning during #ACR21 @rheumnow
My points are pathetic compared to theirs and the top 10 https://t.co/yYppc029DM
TheDaoIndex KDAO2011 ( View Tweet)
#ACR21 Ab#L03: B cell depletors and #COVID19 vax:
⭐️B cell count <40 around vax had lower response to vax, than 40+ B-cell, independent of RTX or BEL
▶️ Timing of vax around B cell return can improve response
@Rheumnow https://t.co/1B7Bnb1QQu https://t.co/bKnfw6gD8O
Links:
Eric Dein ericdeinmd ( View Tweet)
#ACR21 #Abstr1491 What’s new in skin #lupus aetiology? Paired skin & blood using scRNA-seq:
💠Nonlesional skin in CLE/SLE is IFN-I-riched
💠Lupus-enriched CD16+ DCs undergo robust IFN education in the skin & gained pro-inflammatory phenotypes @RheumNow https://t.co/70zrC4T7SB https://t.co/75HjvGmNTa
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
In this study by Prof MAringer et al, majority of #lupus pts enrolled in TULIP 1/2 met the the EULAR/ACR 2019 #SLE criteria
🦋Of few pts not meeting new criteria, most were ANA- w/detectable anti-dsDNA/Smith Ab
Better outcomes for criteria+ in TULIP1/2?
@RheumNow #ACR21 abs1733 https://t.co/XpfMZQLGUv
sheila RHEUMarampa ( View Tweet)
Dr Coras on "ITIS" anti-inflammatory diet in RA. Improves fatigue after 2 weeks. Fatigue response dissociated from disease activity response. Open label, but promising. Fatigue remains one of our biggest challenges in RA. Abstr#1699 #ACR21 @RheumNow @ElenaNikiUK https://t.co/tBMqmWAy8m
Richard Conway RichardPAConway ( View Tweet)
Breakthrough COVID-19 in rheum pts: great data @rheum_covid
B-cell depleting agents overrepresented, esp in hospitalization in fully vaccinated - but plenty of others
Booster (& booster booster) vaccine doses + other mitigation badly needed!
@rheum_cat #ACR21 ABSTL04 @RheumNow https://t.co/92Sn3mCwAi
David Liew drdavidliew ( View Tweet)