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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)
My video take on this from yesterday for @RheumNow:
'11 Ways to Stay Away From RA' #ACR21
https://t.co/ELZaL1A20i https://t.co/bynPNibk3q
Links:
David Liew drdavidliew ( View Tweet)
Clinical pearls on Erdheim-Chester disease:
➕"Hairy Kidneys" on CT
➕"Coated" aorta or periaortitis
➕PET scan can confirm diagnosis - affects distal long bones
➕Refer to Oncology for treatment - it's a histiocytic neoplasm!🤓
@RheumNow #ACR21 #MedTwitter https://t.co/MsIqk1rWvE
sheila RHEUMarampa ( View Tweet)
RheumNow’s expanded coverage of the #ACR21 annual meeting is sponsored in part by @Novartis. All content chosen by #RheumNow & its Faculty.
Dr. John Cush RheumNow ( View Tweet)
My video take from yesterday for @RheumNow:
'Tired of Doing Nothing About Fatigue' #ACR21
https://t.co/EXjOibL5s9 https://t.co/cR6r8GdDor
Links:
David Liew drdavidliew ( 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)
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)