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Andy 0963 #ACR21 @RheumNow covid19 vaccine immunogenicity in rheum pts overall good at 71%, fairly dependent on Rx choice: rituximab 38% after 1g & only 7 % after 1gx2; abatacept IV 45%. Rest biologics >80%, ⬇️MTX &MMF. Low dose prednisone w/out biologics did not affect Ab+ rates https://t.co/TkCC1sgMHG
Olga Petryna DrPetryna ( View Tweet)
Infx oral session
0964 Bitoun, et al.
RTX lowers neutralizing Ab response compared to healthy controls, after COVID vaccination -- more supportive data
https://t.co/6jvWHSjIgr
#ACR21
Rheum Cat rheum_cat ( View Tweet)
#ultrasound led to a change in Dx or Tx 2/3 of the time in a Sports Med clinic! #ACR21 #ACRAmbassador #POCUS https://t.co/2CviSOQKiz
Arthur Mandelin, MD/PhD, RhMSUS, RMSK NU_Rheum_MSK_US ( View Tweet)
Tofacitinib vs TNF inhibitors in #RA patients +50yrs with >1 CV risk factor; the data from ORAL Surveillance that we have all been waiting for! #ACR21
Risk of MACE related largely to baseline CV risk https://t.co/SpuKTtP8ql
The Lancet Rheumatology TheLancetRheum ( View Tweet)
To add numbers to this - using ARR because it's easiest:
Vitamin D: 123/12,937 = 0.95% rheum dx
Placebo: 155/12,937 = 1.20% rheum dx
ARR = 0.25% or NNT of 400 to prevent 1 case of rheum dx
Better get prescribing ASAP!
Mike Putman EBRheum ( View Tweet)
#ACR21 #ACRAmbassador
Fascinating analysis of rheum dx from the (negative!) VITAL study (https://t.co/aMtMCIf1F1)
Very few pts 278/25,871 (1.1%) but HR 0.78, p = 0.045 for vitamin D preventing autoimmune disease
Do you believe it? If so, what's your public policy advice? https://t.co/ZkO5nHAJz9
Mike Putman EBRheum ( View Tweet)
ORAL-Surveillance, an open label Phase 3b/4 RCT of tofacitinib (JAKi) vs TNFi in RA
Numerical elevations in MACE and MI, highest among pts w/hx of CAD or high 10-year risk for MACE
I have been considering baseline CVD / VTE / CA risk when prescribing these since this broke https://t.co/8DAx8IgnZM
Mike Putman EBRheum ( View Tweet)
Dr Blazer sheds light on the multilayered SDOHs as they affect outcomes in chronic diseases. Head over to #ACR21 https://t.co/Jq7aiRV3MD
Chinny Jumai Osuorji,MD MediaRheum ( View Tweet)
Factors associated with Anti Drug Ab against TNFi over 2-y in axSpA pts are:
⭐️ 🔼 Disease activity
⭐️Development of adverse events
⭐️Treatment discontinuation
Abst #0936 #ACR21 @RheumNow
swethaann23 swethaann23 ( View Tweet)
Clinical Pearl at #ACR21 from Dr. John Stone:
⭐️Listen for bruits on patient's back, specifically, on both sides of the spine.
➡️If you hear a bruit, the Takayasu's lesion may be coming from either:
*️⃣Pulmonary artery
*️⃣Descending Aorta
#ACRBest @RheumNow https://t.co/gVpeh7iowk
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Just to fast-forward slightly, baseline CV risk was equal, since you asked... #ACR21 https://t.co/W3SLbFbQVE
David Liew drdavidliew ( View Tweet)
This is the overall MACE data. Those overall HR certainly in the wrong direction, even if they don't cross 1. #ACR21 https://t.co/5RGT3QMdti
David Liew drdavidliew ( View Tweet)
Pearl: Most oral lesions in #lupus are painless. The classic oral lesion is a lacy, reticular pattern superimposed on an erythematous plaque.
@RheumNow #ACR21 https://t.co/nxWnppxsZI
sheila RHEUMarampa ( View Tweet)
John Stone: "If I'd had time I would have said more"
Fantastic #SecretsAndPearls session! 👏 Huge breadth and depth of topics covered- if only there was more time!
#ACR21 @RheumNow https://t.co/oFyj8enMMk
Mrinalini Dey DrMiniDey ( View Tweet)
ORAL surveillance TOFA vs. TNFi:
in patients with > 50yo > 1 CV risk MTX IR
-# ⬆️ in MACE and MI (not stroke)
-MACE risk factors on TOFA smoking, >65 male gender
-# ⬆️ MACE in its w/ any of these RF
What are you going to tell your patients? #Abtr0958 #ACR21 #ACRBest @RheumNow https://t.co/81kVTH63bb
Aurelie Najm AurelieRheumo ( View Tweet)
Clinical Pearl at #ACR21 from Dr. J. Stone:
⭐️Ferritin:ESR ratio helps distinguishes systemic JIA flares from macrophage activation syndrome (MAS).
⭐️During MAS:
*️⃣Ferritin rapidly rises as an acute phase reactant
*️⃣ESR declines as fibrinogen is consumed.
#ACRBest @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
✨Great Pearls when screening patients for clinically suspect #Scleroderma or #Juvenile #Dermatomyositis
📌 Don’t Stop Work Up at Negative ANA if strongly suspect SSc
📌 #Myositis Specific Antibodies have different phenotypes in kids than adults (MDA-5, TIF-1g, NXP-2)
#ACR21 https://t.co/KrkkzA5bkV
Ashima Makol MD AshimaMakol ( View Tweet)
Clinical (Peds Rheum) Pearl at #ACR21 by Dr. John Stone:
⭐️Dilated capillaries at the eyelid margin is the last cutaneous sign to resolve in inflammatory myositis!
⭐️Do not stop treatment until this sign is gone!
#ACRBest @RheumNow https://t.co/5H3Q9mTN9x
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
HZV in pts w/ #rheumatic dse by Dr CCMok et al
🔸Prevalence rates of HZV infxn (per 100py): SLE 1.7, RA 0.64, other RDs 0.76
🔸RFs assoc'd w/1st HZV infection
📌#SLE dx, serum albumin, serum creatinine; ⬆lympho/neutro ratio, CYC & Prednisolone use
@RheumNow #ACR21 abs0862 https://t.co/TXRmoBBDXK
sheila RHEUMarampa ( View Tweet)
MACE risk Tofa vs TNFi ORAL surveillance: age 50+ w/1 additional CV risk, MTX-IR
👉higher # MACE, MI in Tofa 5 or 10 mg bid (no increase in stroke)
👉risks for MACE w/tofa: tobacco, ASA, age 65+, male sex
👉counsel high risk pts (?avoid use)
Abst#0958 #Plenary #ACR21 @rheumnow https://t.co/tg35cts9tw
TheDaoIndex KDAO2011 ( View Tweet)