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Glucocorticoids in SLE: how to start, how to follow, how to stop
Current guidelines recommend limiting the use of glucocorticoids by coining the new concept of “bridging therapy”, that is, use GCs when the disease is active and get rid of them as soon as you can. This way of thinking is conceptually attractive, however, the formula for translation to real life settings is not included.
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Secondary Benefits to SGLT2 Inhibitor Use in SLE
An emulation trial of sodium–glucose cotransporter 2 inhibitors (SGLT2i) in systemic lupus erythematosus (SLE) patients yielded a significantly reduced risk of several cardiorenal complications among patients with SLE and type 2 https://t.co/aQK4Sc9tdU
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Contraception in SLE
Pregnancy in SLE receives significant attention in rheumatology due to increased risks. Historically, women with SLE were advised against pregnancy. As of 2004, the maternal mortality rate was 20 times higher than the general population. Although recent https://t.co/89df0TKtF5
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DANBIO registry study of 720 RA pts w/ a prior solid cancer (breast, colon. lung, endometrial, melanoma, bladder) in remission who received any biologic DMARD, TNFi or RTX found no incr risk of CA recurrence w/ any bDMARD, TNFi, RTX. Specifically, no incr in breast CA recurrence https://t.co/YJw8qXz1yM
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45 southern African American SLE pts compared to multiethnic cSLE, AA pts had signif higher Dz activity & greater damage accrual. Their mean SLICC score was 8.4, SLEDAI 13, but was 7.4 @6 mos & 4,7 @1 yr. They traveled an avg distance 75 miles to see Rheum https://t.co/R8WimzY0Az https://t.co/1lOJpjO2SY
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Rheumatologist Survey: What do you rely on to diagnose neuropsychiatric lupus (cerebritis)?
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2023 report from US NHANES study says #Gout affects 12.1 million in the USA. Gout prevalence incr from 3.6% in 2011/12 to 5.1% in 2017/2018. Recent increases do to doubling in Asian Americans from 3.3% to 6.6%. https://t.co/IBa3fOt83c https://t.co/06Ltm0FycI
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Procalcitonin > 0.9 ng/mL can be a critical marker for identifying bacterial infection in #SLE. Single center study of 116 juv. SLE pts dx bacterial infx in 17%. Procalcitonin was signif better than others: NLR, PLR, ESR, CRP, LC4R, ferritin (cut offs need to be defined) https://t.co/NAM8xopNW5
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"The most difficult thing is the decision to act, the rest is merely tenacity."
–Amelia Earhart https://t.co/ANVIvID8qj
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Complex Evolution of RA Management and Outcomes
FIRST is a Japanese longitudinal, real-world registry of rheumatoid arthritis (RA) management, and over the last 20 years has shown significantly improved outcomes, yet significant challenges and unmet needs remain. https://t.co/Vqe70WAijN
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Japan IORRA RA registry shows from 2011 to 2023, despite better Rx & control & less pred, Fractures went up in RA. From 2011 to 2023- DAS resmission 38 to 65%, bDMARD use 14 to 42%, GC use 38 to 22%, OP Rx 32 to 38%; But all FX incr 47 to 53/1000 Pys. https://t.co/cgz0Gkasai https://t.co/D2Uro7mEAT
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US guided lymph node Bx compared 25 controls, 14 ACPA (+) & 45 ACPA (-) RA pts. ACPA+ LN Bx showed upregulated adaptive imm. genes, but ACPA neg LN Bx showed higher innate imm genes - especially w/ higher neutrophil presence & incr CD15 + PMNs irrespective of ACPA status https://t.co/C42QMd2zap
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Immune Checkpoint Inhib causing Myasthenia Gravis w/ poor outcomes - 16 ICI Rx pts (9 Lung CA, 7 other tumors) Dx w/ MG; 11 w/ overlap myositis. Mean onset @ 49d. All Rx wp steroids, 6 immunosuppressives, 5 plasma exchange; only 2 complete resp. 6 deaths re: MG complications https://t.co/re73lh2Xfs
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Metformin Effective in Osteoarthritis
The diabetes drug metformin provided overweight/obese patients with osteoarthritis (OA) of the knee with significantly greater pain relief than did placebo in a small randomized trial, researchers said.
https://t.co/7krvFFfRFC https://t.co/g1UyNjazUv
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Inflammatory vs. Noninflammatory Pain
https://t.co/ZZLMnT8IVO https://t.co/AqqonM6Vht
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No Extra Cancer Recurrence Risk with Biologics in RA
Rheumatoid arthritis (RA) patients in Denmark with a history of solid tumor cancers, now in remission, faced no greater likelihood of cancer relapse when they were treated with biologic agents, compared with conventional https://t.co/dCspjN2oys
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Tuesday Night Rheumatology returns this month with the launch of Lupus Unlocked, starting with a special Journal Club session.
Join authors Dr. Richard Furie and Dr. Brad Rovin as they walk us through their pivotal studies on lupus nephritis:
📄 Obinutuzumab in Active Lupus https://t.co/PdhC857sfX
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Retrospective Medicare Claims data study of RA pts w/ metastatic non-small cell lung cancer who recv Rx w/ immune checkpoint inhibitor; found that ICI- Rx RA had the same survival as non-RA pts, and sterid use was not associated with worse survival https://t.co/JLlCfrRwvN https://t.co/zeqeYt5ZHq
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Complex Evolution of RA Management and Outcomes
FIRST is a Japanese longitudinal, real-world registry of rheumatoid arthritis (RA) management, and over the last 20 years has shown significantly improved outcomes, yet significant challenges and unmet needs remain. https://t.co/TwDIf5MJqF
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FDA has approved nipocalimab (Imaavytm), a FcRn for use in generalized myasthenia gravis (gMG). It is approved for using in gMG patents who are anti-AChR and anti-MuSK antibody positive adults and pediatric gMG patients aged 12 and older. https://t.co/CaSwCnCK8V https://t.co/A2COjk2hzY
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