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Well done 👏@DrCMcMaster @victor_yang1 on this great work - using machine learning to pick apart GCA from its mimics.
Predicting mimics improves prediction, especially in the quagmire of biopsy-negative GCA
(also excellent memes in this Twitter thread)
#ACR21 ABST1417 @RheumNow https://t.co/cS3fMLwem4
David Liew drdavidliew ( View Tweet)
@RheumNow Janet Zeide @Wharton - if the purpose = persuade:
e.g. persuading an audience, persuading pts to change
- ethos/logos/pathos
- remove barriers to action (cost of not changing, incremental change)
- state & refute counter-arguments
- know & engage your audience
#ACR21 @RheumNow https://t.co/JU2WeNYDvz
David Liew drdavidliew ( View Tweet)
So how do we treat this long COVID thing?
Some sensible hints here, but sadly I can't really say that we've got this under control. I feel helpless with the long COVID patients I've cared for.
#ACR21 8M406 @RheumNow @galbamd @CCalabreseDO @philipcrobinson https://t.co/Vaw0QlUx50
David Liew drdavidliew ( View Tweet)
Given the choice, you want me to risk long COVID?
No thanks. #GetVaccinated
#ACR21 8M406 @RheumNow @galbamd @CCalabreseDO @philipcrobinson https://t.co/TCao34vWK8
David Liew drdavidliew ( View Tweet)
This is priceless:
“Learning from our patients is a key highlight of #ACR21.” — Dr. S. Bhana
I could not agree more: a patient’s insight is invaluable, irreplaceable, and essential.
@RheumNow https://t.co/kS0NWVIpiG
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Knowledge Bowl at #ACR21
⭐️AMBITION trial data suggested combination of these meds might be more effective than either alone in patients with pulmonary arterial HTN.
➡️Ambrisentan + tadalafil
@RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Knowledge Bowl at #ACR21
⭐️This type of vasculitis is most likely to cause proptosis
➡️GPA
@RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Knowledge Bowl at #ACR21
⭐️This protean tumefactive disease can rarely present with orbital myositis.
➡️IgG4-related Disease
@RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Knowledge Bowl at #ACR21
⭐️This is the most common chest imaging finding in a patient with relapsing chondritis
➡️ Tracheal Stenosis
@RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Dr. K Costenbader #ACR21 #YearinReview will cover important studies for #ClinicalPractice:
👉add on Therapies
👉 the JAK evolution
👉improving clinical care
👉disparities in care
@RheumNow https://t.co/dp1oeYMh8n
TheDaoIndex KDAO2011 ( View Tweet)
👉Voclosporin for SLE: rapid control of proteinuria (50% reduction over 29 days in UPCR w/o high side effects) @rheumnow #YearInReview #ACR21
Are you all starting to use this drug now? It has helped my patients; pretty well tolerated. https://t.co/zqJRsjnV4n
TheDaoIndex KDAO2011 ( View Tweet)
Dr. K Costenbader #ACR21 #YearinReview add-ons Rx:
👉Avacopan for AAV: new oral C5a inh allowed for remission & prevention of relapse, aggressive pred taper https://t.co/39V3LLOYKZ
TheDaoIndex KDAO2011 ( View Tweet)
Experts (Drs. M Clowse, Sammaratino) limit mAb TNFi 1 month b/f delivery or extend dosing. But, they do dose again for flares. Risk for infection is low based on the PIANO registry. Postpartum, they restart the meds w/in 1 week (vag delivery), 2 weeks C/S @rheumnow #pregnancy
TheDaoIndex KDAO2011 ( View Tweet)
Which of the following would you d/c in the 3rd trimester of pregnancy? #ACR21 #Pregnancy @rheumnow
TheDaoIndex KDAO2011 ( View Tweet)
Dr. M Clowse (on HCQ during pregnancy):
👉All pregnant women get HCQ 400 mg/day regardless of how big they are (she does not dose based on mg/kg/d)
👉with maternal metabolism/volume distrib, levels are low.
#ACR21 @rheumnow #pregnancy @drbags71 https://t.co/dZtFLdKOvk
TheDaoIndex KDAO2011 ( View Tweet)
Is holding MTX during breastfeeding overblown?
@MotherToBaby data showed that infants get 0.4% of mom’s dose 24 hrs post-MTX dose. Skip breastfeeding 1 day post-MTX may be safe. Consider monitoring infant CBC. Studies needed to follow infants longitudinally #ACR21 @rheumnow https://t.co/ikJvkk5BjI
TheDaoIndex KDAO2011 ( View Tweet)
Dr. Chambers review @MotherToBaby prospective data on HCQ use in pregnancy (n=279):
👉no major defects (regardless of dose)
👉no oral clefts
👉SGA slightly lower in exposed group b/c of underlying dz
👉no case of retinopathy in babies after 1 year f/u @rheumnow #Pregnancy https://t.co/vw2eryFgro
TheDaoIndex KDAO2011 ( View Tweet)
Dr. Chambers reviewed @MotherToBaby data of pregnant rheum women during the pandemic noted:
⬆️EtOH use in pregnancy,
⬆️stress, anxiety, depression
⬆️obesity
⬇️likelihood to get prenatal care
#ACR21 @rheumnow #RheumPregnancy https://t.co/GCYCIuiunS
TheDaoIndex KDAO2011 ( View Tweet)
#GreatDebate: add on BLMB vs. VCS to MMF for LN
Dr. Petri argues for BLMB b/c:
👉cost is less
👉better adherance
👉not good for class V
👉voclosporin had greater nephrotoxicity
👉insuff data in pregnancy, but not contraindicated like VSC #ACR21 @rheumnow https://t.co/mk2eXwkxcG
TheDaoIndex KDAO2011 ( View Tweet)
#ACR21 #GreatDebate: Dr. Rovin argues for VCS add to MMF b/c:
👉fewer side effects than legacy CNI
👉elevated in creatinine related hemodynamic reversible effect
👉did increase BP (but controllable)
@rheumnow (2/2) https://t.co/mmWp0sBveT
TheDaoIndex KDAO2011 ( View Tweet)