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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

Links:

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)
Clinical Pearl at #ACR21 by Dr. John Stone: ⭐️Patients w/ RNAPIII positive SSc do not always have puffy hands, Raynaud's phenomenon, or ANA positivity! #ACRBest @RheumNow @SChatterjee https://t.co/9J6OBibi4l
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Oral Surveillance outcomes in a nutshell Tofacitinib two doses vs TNFi event driven trial more AEs of interest in Tofa groups MACE Malignancy SIE in older groups VTE esp #tofacitinib 10 mg BID @RheumNow #ACR21 #ACRBest abst#0958 https://t.co/j39g7yVVFB
Janet Pope Janetbirdope ( View Tweet)
Dr Naovarat reports on 18 year outcomes of HIV and rheumatic disease. 16 patients treated with TNFi, including 2 who switched to tocilizumab and ustekinumab. No major infections. Rising viral load in 1 led to discontinue. Abstr#0965 #ACR21 @RheumNow https://t.co/jcGPaURKmb
Richard Conway RichardPAConway ( View Tweet)
#ACR21 #Rheumatology #Pearl: In #Takayasu's, listen for bruits on the back- could be originating from pulmonary artery or descending aorta. @RheumNow https://t.co/0wGdR3Rqy2
Mrinalini Dey DrMiniDey ( View Tweet)
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