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#ACRbest Largest to date cohort study of pregnancies in women w/ ILD showed no maternal deaths suggesting that women w/ ILD may not need to avoid conception or terminate pregnancies, but pts w/ severe ILD were at higher risk for poor pregnancy outcomes. #Abst1446 @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Poll results are in! 75% of those that responded plan to only screen for cardiac manifestations of myositis if a pt develops concerning symptoms. 20% screen for involvement annually w/ a TTE, troponin, BNP, and EKG! @RheumNow #ACR20 https://t.co/crUhFR6Hzf
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
@RheumNow #ACR20 abs1151 screening for inflammatory hyperferritinemia may be feasible but requires additional info: inflammatory huperferritinemia more likely to correlate with ⬆️IL18, AST&thrombocytosis while high CRP+ferritin more often seen in infectious etiology https://t.co/wiFPXepxpz
Olga Petryna DrPetryna ( View Tweet)
Can hs-troponin and hsCRP predict future major cardiovascular events? Certainly appears so in RA pts (n=636).
To what extent do subclinical dx and inflammation combine to cause future RA CV pain?
PRECISION trial subgroup @ElaineHusniMD @DanielHSolomon #ACR20 ABST1189 @RheumNow https://t.co/ZYTpodatVI
David Liew drdavidliew ( View Tweet)
The lung-joint axis in RA just keeps on getting stronger
Lung ACPA present in early untreated RA/CSA:
crossreact acetylated/carbamylated antigens
differ in effects on cell types (neut activation, fibroblasts, osteoclasts)
Isn't lung ACPA fascinating?
#ACR20 ABST1445 @RheumNow https://t.co/9VKSRYlndT
David Liew drdavidliew ( View Tweet)
National Inpatient Sample claims: ANCA Assoc vasculitis pts hospitalized with acute MI (AMI) had a no increase in mortality rate (5.3% vs. 4.7%) during 2016-2017, suggesting potentially better control w/ new meds (RTX), less steroids #ACR20 Abstr#1424 https://t.co/TYELUAjm9d
Dr. John Cush RheumNow ( View Tweet)
821 SLE pts from Hopkins lupus clinic showed that LAC was best predictor of venous + arterial thromboses. β2glycoproteinI IgA (+) also important! #ACR20 #Abstr#1261 https://t.co/H0hz9Gp5Hy https://t.co/Vpiih4LyuZ
Dr. John Cush RheumNow ( View Tweet)
In our quest to reduce delays to diagnosis in axSpA, this paper in patients with psoriasis, AAU and IBD, the ASAS-modification of the Berlin algorithm was superior to the original algorithm, with enhanced sensitivity @RheumNow #ACR20 Abstr#1303
Dr. Antoni Chan synovialjoints ( View Tweet)
NT-proBNP and TnI predicted cardiovascular events in patients with PsO or PsA. Abs#1328
Do you measure/monitor for cardiovascular disease in your psoriatic patients?
@RheumNow #ACR20
Robert B Chao, MD doctorRBC ( View Tweet)
Nintedanib in rheum ILD (RA/SSc/CTD)
I appreciate the volumes might not seem like much, but:
- in first 1y Rx 20% more are spared a FVC decline>10%
- biggest diff in UIP-like pattern
With the right patient selection, nintedanib does have its place!
#ACR20 ABST1048/1049 @RheumNow https://t.co/jGZdR84bBU
David Liew drdavidliew ( View Tweet)
So much more work to be done- the traditional tools for estimating CVD in rheumatic patients are likely not accurate especially patients with SLE- abstract 1286 @RheumNow #acr20 https://t.co/L6Z1fsO2he
alexa meara lexmeara ( View Tweet)
#sjogren #syndrome poster session #ACR20 @RheumNow Clinical characteristics: lung, pregnancy,smoking, cervical lesions, anti La, childhood. https://t.co/QN4FVvQrYN
Sole RetamozoSole ( View Tweet)
Do you obtain baseline and/or serial TTE, EKG, BNP, and TROPONIN* on follow-up visits of your patients with myositis? #ACR20 @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Do you obtain baseline and/or serial TTE, EKG, and BNP on follow-up visits of your patients with myositis? #ACR20 @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
@RichardPAConway @DrDDRheum @DrErickZamora1 @hoffmann_vold @RheumNow YES! Why? 'Normal' echo in 1/3 of patients with early PAH. Screening# Diagnosis. Below is data where echo and RHC was done at the same time. in those with eRVSP < 36, 36% had RHC- derived PAH. https://t.co/W2YiyZnwwV
Dr. Dinesh Khanna sclerodermaUM ( View Tweet)
Dr Cai presents risk of CVD in gout in study 450,000 patients. Gout was independently associated with an increased risk of CVD events HR = 1.24 for women; 1.21 for men. @rheumnow #ACR20 Abstr#950 #ACRbest https://t.co/089aKtN5a7
Richard Conway RichardPAConway ( View Tweet)
Rheumatoid arthritis and lung disease in the spotlight at #ACR20 by @jeffsparks
https://t.co/0Dth0k6uve https://t.co/pGfGtq8Sz7
Links:
Dr. John Cush RheumNow ( View Tweet)
Nice insights into RA-ILD from @jeffsparks:
- assoc (in Medicare): male, smoker, asthma/COPD, b/tsDMARDs, steroids
- mortality risk? Yes, esp resp (sdHR 4.4), cancer
- ACPA/lung inflamm related to RA-ILD? Yes, esp anti-filaggrin (aOR 3.08/log unit)
#ACR20 ABST0489/0490 @RheumNow https://t.co/DGkNNPOcbd
David Liew drdavidliew ( View Tweet)
Dr Sammy Zakaria said we need close communication with cardiologist in myocarditis related to myositis. #ACR20 @RheumNow https://t.co/kTAZKWpw0S
Sole RetamozoSole ( View Tweet)
Does your pt have myocardial inflamm? Trop specific but not sensitive, BNP neither sens or specific. Consider EKG - sensitive (85%), but non-specific- But TTE is essential and cMRI is best! #ACR20 @RheumNow Great lecture from cardiologist, @HopkinsBayview APD https://t.co/6THm37KbQ3
Eric Dein ejdein1 ( View Tweet)
