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TNF inhibitors and radiographic progression in axSpA
A remaining challenge for clinicians is the ability to delay, if not completely stop, structural progression in patients with axSpA, whether they are diagnosed with radiographic (r-axSpa) or non-radiographic (nr-axSpA) disease.
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Bridging the gap in the delayed diagnosis of axSpA
Delay in the diagnosis of axial spondyloarthritis (axSpA) has been a huge challenge and is associated with poor outcomes.
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My summary article on some of the many abstracts at #ACR21 on #WorkParticipation in #axSpA.
Featured abstracts in this article:
#0358 https://t.co/LrZYWqCuOm
#0362 https://t.co/flL5MiqDL8
@RheumNow
https://t.co/tu5L0yIVIV
Links:
Mrinalini Dey DrMiniDey ( View Tweet)
Dr Elliott presenting on US assessment of enthesitis with TNFi vs secukinumab. Surprisingly TNFi showed a more marked decrease in US enthesitis. Abstr#1356 #ACR21 @RheumNow https://t.co/XXgYMgkMyP
Richard Conway RichardPAConway ( View Tweet)
Waist:Hip ratio may be better than BMI in screening for obesity in #axSpA accdg to this study by @Sineadm15 & colleagues
👉⬆ prevalence of abdominal obesity in axSpA esp among ♀️
@RheumNow #ACR21 abs1322 https://t.co/UB3K7xR9kG
sheila RHEUMarampa ( View Tweet)
Psoriasis can be diagnosed at any time of axSpA follow up.
Incidence of PsO ⬆️from 16.8% to 26.8% after 6 years
Patients with PsO had more peripheral arthritis and higher BMI
Abs#1311
@RheumNow
https://t.co/IrvHiFqr2m https://t.co/lqCVcF81zA
Robert B Chao, MD doctorRBC ( View Tweet)
Peripheral and axSpA pts with low Vitamin D levels (<30) had worse disease activity and functional impairment (BASDAI, ASDAS, BASFI) compared to pts with normal Vit D levels.
Abs#1316
#ACR21 @RheumNow
https://t.co/ulIqOAnWtp https://t.co/aMQaTpduJK
Robert B Chao, MD doctorRBC ( View Tweet)
@Sineadm15 @bososhea on undiagnosed depression in axSpA. Common, and associated with worse disease activity and quality of life. Abstr#1305 #ACR21 @RheumNow https://t.co/PBH1F3XEGv
Richard Conway RichardPAConway ( View Tweet)
We need to be better at identifying and managing #depression in patients with #axspa.
In a group of 70 pts, many had high HADs-D & PHQ-9, with worse disease activity & #QoL compared to those with normal scores.
Abs#1305 #ACR21 @RheumNow
https://t.co/lNoo0HfMcC https://t.co/n7Vyl9L5FR
Mrinalini Dey DrMiniDey ( View Tweet)
Females axSpA pts presented w/ higher disease burden (fatigue/tiredness, & spinal pain at night.) Female axSpA pts achieved sign/symptom improvement with IXE later than male axSpA pts. Abs 0934 #ACR21 #RheumNow@RheumNow https://t.co/EGXnfeF6KQ https://t.co/TDF5zxtca7
Dr. Rachel Tate uptoTate ( View Tweet)
@RheumNow From Abst#3053 noted above, here we see the trend of urinary ALCAM with UPCr and renal-SLEDAI https://t.co/3Ujo8WTslO
Pedro Castillo _Castillo_Pedro ( View Tweet)
AS and PsA: Mortality vs Gen Pop (meta-analysis)
AS:
👉⬆️All-cause
👉⬆️CVD
PsA:
👉All-cause not higher
👉⬆️CVD, Respiratory, and Infectious etiologies
Important to consider CVD and other comorbidities.
https://t.co/9K4qNpYvMb
#ACR21 Abst#0569 @RheumNow
Pedro Castillo _Castillo_Pedro ( View Tweet)
MRI Imaging in RA and SpA: Dr. Sheila Reyes (@RHEUMarampa )
Dr. Sheila Reyes discusses abstracts #0468 and #0469, presented at the #ACR21 annual meeting.
https://t.co/KUoO88dEhQ https://t.co/10R4jC5p0y
Links:
Dr. John Cush RheumNow ( View Tweet)
⭐️C-OPTIMISE:
Early, active AxSpA on certilozumab (CZP) 200mg q2w x 48w. Then, if remission, randomized to CZP q2w vs q4w vs PBO x 48w
➡️No flare in PBO BUT w/ ↑:
*️⃣ASDAS + BASDAI
*️⃣CRP + fecal calprotectin
Thus, keep some dose of CZP on!
Abst#0916 #ACR21 @RheumNow https://t.co/DT8FKHAhr0
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
⭐️Imaging of the SIJ in psoriatic axSpA is similar to axSpA associated with iritis or colitis!
Abst#0902 (https://t.co/f55Vfi1LSS)
#ACR21 @RheumNow https://t.co/UCXrwPiyhh
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Real-world data shows no difference between genders in effectiveness of secukinumab in #AnkylosingSpondylitis, for disease activity, global functioning and severity of depression.
#Abs0909 #ACR21 @RheumNow
https://t.co/2n6Y5ZB1Ot https://t.co/zIMEzHBUrh
Mrinalini Dey DrMiniDey ( View Tweet)
Predictors of clinical remission in AS patients Rx with TNFi
⭐️Age and 3-mo BASDAI improvement➡️ predictor of clinical remission criteria
⭐️Normalized ESR and CRP at month 3 were predictors of achievement of BASDAI-CRP
Abst#0931 #ACR21 @RheumNow https://t.co/Ot1ypgNg3A
swethaann23 swethaann23 ( View Tweet)
Baseline/ Clinical /Imaging predictors of flare when tapering TNFI in axSpA in remission:
⭐️🔼Baseline physician global VAS 🔼flare in 16 weeks after tapering to 2/3 of standard dose.
⭐️🔼Age 🔼flare within 16 weeks after tapering to 1/2 dose
Abst #0929 #ACR21 @RheumNow https://t.co/EFiwKA8z99
swethaann23 swethaann23 ( View Tweet)
AxSpA pts who achieve ASDAS low disease activity (LDA) 6 mo after bDMARD initiation
⭐️ 25% achieved ASDAS LDA
⭐️ASDAS LDA achievers were ♂️ + naïve to c/b DMARDs + with PROM / Clinical improvement
⭐️ASDAS LDA non-achievers=depression, uveitis, IBD
Abst# 0925 #ACR21 @RheumNow
swethaann23 swethaann23 ( View Tweet)
Turkish study finds that ETN may be negatively associated w/ the development of ADA in AS pts. Abs 0936 #ACR21 #RheumNow @RheumNow https://t.co/z3pYDpp1NN https://t.co/MR1R41rCHV
Dr. Rachel Tate uptoTate ( View Tweet)
