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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)
They're VITAL!🤓 Prof @karen_kc123 presents the results of the RCT (huge population size) showing how 5-yr supplementation with Vit D3 &/or n-3 fatty acids ⬇incident autoimmune dse vs. non-takers.
Game changing?!
@RheumNow #ACR21 #ACRBest abs0957 https://t.co/X9QaB1B5Ac
sheila RHEUMarampa ( View Tweet)
PsA impacts many aspects of life. PRO such as VAS pain
and HAQ, are commonly assessed. The FACIT-Fatigue scale, ranked the highest by
patients. Personalized discussion is vital in assessment and shared decision making @RheumNow #ACR21 Abst#0751 https://t.co/gRfYK4sHc6 https://t.co/f5xjUnXsGQ
Dr. Antoni Chan synovialjoints ( View Tweet)
Evaluate effectiveness and Rx survival of different TNFI in cohort of axSpA
⭐️No difference among different TNFI
⭐️No difference between nr-axSpA and AS
⭐️Failure to initial TNFI did not diminish effectiveness or drug survival of subsequent TNFi Rx
Abst#0938 #ACR21 @RheumNow
swethaann23 swethaann23 ( View Tweet)
#ACR21 Abst#0588. TNF vs non-TNFi in obese RA pts
⭐️TNFi use ⬆️ disease activity vs ABA in obese pts
⭐️TNFi use ⬆️ activity vs TCZ in non-obese pts
⭐️No diff w RTX, Tofa
▶️Further research needed: Wt-based dosing? SC vs IV?
https://t.co/K8WycPTgxW @Rheumnow #ACRBest
Links:
Eric Dein ericdeinmd ( View Tweet)
Abst0897 #ACR21 @RheumNow radiographic progression in AS accelerates w/age, highest at age 30–39 (mean mSASSS change per year 1.148), followed by 40–49 , 20–29,≥50 & least < 20 (0.643). radiographic damage rapidly ⬆️ among 20s w/risk factors:⬆️ CRP &preexisting syndesmophytes https://t.co/tiAgKUyjJq
Olga Petryna DrPetryna ( View Tweet)
ORAL Surveillance MACE conclusions:
So this is fair: tofacitinib acts as a CV risk factor, there are many others, we need to address CV risk in RA pts.
Nevertheless, in terms of MI risk, tofa vs TNFi, if I had one CV risk factor, I know what I'd do.
#ACR21 ABST0958 @RheumNow https://t.co/4Z79XtTzl9
David Liew drdavidliew ( View Tweet)
For what it's worth, I'm struck by my conversation last week with one RA patient in clinic with stents.
3y ago post-MTX/HCQ had asked for a JAKi first line, immaculate RA response.
Listened, no blinking, okay thanks doctor - I'm happy where I am. Next question.
#ACR21 @RheumNow
David Liew drdavidliew ( View Tweet)
“For many patients, it doesn’t matter if there’s an increased risk, because they don’t want to go to the alternative” - Christina Charles-Schoeman, presenting ORAL Surveillance MACE data in the #ACR21 plenary
Discussions with pts needed, these data justify that need.
@RheumNow
David Liew drdavidliew ( View Tweet)
SELECT-AXIS 1: UPA 15 mg QD consistently efficacious over 2 years for ASAS40. Low radiographic progression rates in AS pts. No new safety findings were observed. Abs 0924 #ACR21 #RheumNow @RheumNow https://t.co/CWvH1OPGyR https://t.co/uC67fJZDCE
Dr. Rachel Tate uptoTate ( View Tweet)
Abst0509 #ACR21 @RheumNow study of plasma concentrations of Deucravacitinib show high functional selectivity for TYK2 while Tofa, Upa & Bari inhibit JAK1/2/3 to varying degrees show no meaningful inhibition of TYK2. Distinct class of kinase inhibitor as compared to JAKs
Olga Petryna DrPetryna ( View Tweet)
SELECT-AXIS 1 Post Hoc Analysis results showed improvement in PROs & reduction in back pain score at 12 weeks predicted clinical outcomes at 1 year in AS pts. Abs 0926 #ACR21 #RheumNow @RheumNow https://t.co/vRVpv1O6YS https://t.co/wjafMf1UPY
Dr. Rachel Tate uptoTate ( View Tweet)
With Deucravacitinib, a TYK2 inhibitor vs placebo, PsAID-12 and PsAID-9 scores were significantly improved
versus baseline at Week 16
and other PROs showing a clear improvement in PsA-related impact @RheumNow #ACR21 Abst#0750 https://t.co/JbeSE2dO94 https://t.co/pH79dXCYSs
Dr. Antoni Chan synovialjoints ( View Tweet)
SEC reduced SIJ bone marrow edema in active nr-axSpA pts. Majority of pts both in SEC and PBO arms showed no radiographic progression through 2 years. Abs 0921 #ACR21 #RheumNow @RheumNow https://t.co/yC2AZoacxF https://t.co/pjCL8HCanR
Dr. Rachel Tate uptoTate ( View Tweet)
#ACR21 #Abstr0864 How does obesity (BMI=/>30) affect #lupus outcomes? Data from Toronto showed:
💠⬆️hs-CRP
💠No in disease activity over 3yrs
💠⬆️CV events (combination of low grade inflammation + hypertension)
@RheumNow https://t.co/IBu8uNSAJi https://t.co/2aqz5e3rwi
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Googling rheumatic diseases. On average google search lacked essential information to guide patient decisions. Websites on AS scored the highest on the DISCERN and RA scored the highest on JAMA @RheumNow #ACR21 Abst#0742 https://t.co/k2o2AqYEeh https://t.co/ZKljvA2f4O
Dr. Antoni Chan synovialjoints ( View Tweet)
Can patient with low dx activity SLE stop HCQ, or at least try and reduce the dose?
Not if you want to avoid flares.
If there are safer subgroups to try it in, we haven't found them yet
(in fact higher dx activity➡️less risk ?other Rx)
SLICC inception #ACR21 ABST0959 @RheumNow https://t.co/NS2V4dEGHv
David Liew drdavidliew ( View Tweet)
Let's look at MI first.
Well, the numbers don't look great for tofa here.
fatal MI very small numbers
non-fatal MI - well that doesn't look good
(do we have combined both tofa doses vs TNFi?)
HR > 2 seems less than ideal - this would represent a substantial RF
#ACR21 @RheumNow https://t.co/5HSXFrMJCu
David Liew drdavidliew ( View Tweet)
🌞😎🍣 Vitamin D and Omega-3 FA ⬇️ Risk of developing autoimmune disease
1st prospective, randomized, double blind, placebo controlled trial
Vit D 2000IU and/or Omega 3-FA 1000mg ⬇️autoimmune disease by 25-30%
#ACR21 #ACRBest @RheumNow
Abs#957
https://t.co/7dODuplg7e https://t.co/GUKhYXbSXU
Robert B Chao, MD doctorRBC ( View Tweet)