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The Influence of Obesity on Choice of Biologic Agent in Rheumatoid Arthritis
In rheumatoid arthritis we have a wide range of options available to us when we progress to a biologic treatment option. We have little to differentiate between these agents based on the clinical trials.
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The rate of progression of nr-axSpA to AS is ~10% every 2 years. Study of 79 patients over 6 years, radiographic progression was 10.1% after 2 years (8/79), 8.3% between 2-4 years (4/48), and 12.5% between 4-6 years (3/24) @RheumNow #ACR21 Abst#0907 https://t.co/hOhpngANIl https://t.co/PiKDgiTES2
Dr. Antoni Chan synovialjoints ( View Tweet)
@SattuiSEMD presents @rheum_covid data on COVID-19 outcomes in vasculitis/PMR. High rates of severe outcomes, particularly for AAV and GCA (mortality >20% for both). Multiple factors associated with outcomes (see below). Abstr#952 #ACR21 @RheumNow #ACRBest https://t.co/0lw1QhuJct
Richard Conway RichardPAConway ( View Tweet)
Novel study exploring microbial differences in MZ twins discordant for psoriatic disease
⭐️Ruminococcus 🔽/❎ Gut of Ps pts and maybe associated with Ps Dis
⭐️NL skin scalp of Psoriatic pts 🔽 microbial diversity compared to unaffected twins
Abst#0944 #ACR21 #ACRBest @RheumNow
swethaann23 swethaann23 ( View Tweet)
Dr Manasson presents on microbiome differences between monozygotic twins discordant for psoriatic disease. Differences seen in gut (Ruminococcus virtually absent in psoriatic) and scalp non-lesional skin microbiomes Abstr#0944 #ACR21 @RheumNow https://t.co/8Ch0M4dwUH
Richard Conway RichardPAConway ( View Tweet)
Interim analysis of real world data on AQUILA (Dr Uta Kiltz et al): how gender affects SEC tx and retention rates:
🔷Improvement in BASDAI, PGA, global fnxn & depressive mood - similar in both ♂️&♀️
🔷High SEC retention rates irrespective of gender
@RheumNow #ACR21 abs909 https://t.co/rXa6ELXDJo
sheila RHEUMarampa ( View Tweet)
Dr Mahajan on lung disease in early RA. Common, airway disease in 60%, parenchymal disease in 30%. But minimal/no progression over 1 year which is reassuring. Abstr#574 #ACR21 @RheumNow https://t.co/s9r06MSStF
Richard Conway RichardPAConway ( View Tweet)
So important for our systemic vasculitis & PMR pts, @rheum_covid data highlighting the outsized COVID-19 risks they face.
Thanks @SattuiSEMD @RichardPAConway @EBRheum in particular for driving forward this badly needed work!
#ACR21 ABST0952 @RheumNow https://t.co/L7XS9OblxI https://t.co/LYxR1WUlhM
David Liew drdavidliew ( View Tweet)
Dr. P Crow #PhilipHenchLecture: from LE cell to IFN:
LE cell definition:
👉substance in plasma
👉nuclear material from WBCs altered by the plasma factor
👉active phagocytic cells engulf the altered material #ACR21 @rheumnow https://t.co/jE9wnct6lP
TheDaoIndex KDAO2011 ( View Tweet)
Jorge Plutzky giving a cardiologist perspective at #ACR21. "We've gone from lower is better, to lowest is best" on LDL lowering. PCSK9 inhibitors have changed the game.
@rheumnow https://t.co/oaBE99beSA
Eric Dein ericdeinmd ( View Tweet)
MUC5B and RA-ILD. Dr McDermott @jeffsparks show that MUC5B is associated with RA-ILD, older age at RA diagnosis, and ILD within 5 years of RA onset. Is this a different disease to other RA or modulation by the promotor variant? Abstr#0576 #ACR21 @RheumNow https://t.co/r2fQqxVY6N
Richard Conway RichardPAConway ( 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)
Interesting study by @DrPoddubnyy et al. looking into the efficacy of SEC on HLAB27 subtypes (post hoc analysis of SKIPPAIN trial)
➡ SEC effective for both HLAB27+ and - grps
➡ Significant response seen among HLAB27+ and HLAB27 homozygous pts
@RheumNow #ACR21 abs0917 https://t.co/St37kdGY65
sheila RHEUMarampa ( View Tweet)
And here is ORAL-Surveillance, small increase in MACE and malignancy with tofacitinib vs TNFi. 1 extra MACE per 319-567 patient years, 1 extra malignancy per 275 patient years. Abstr#0831 #ACR21 @RheumNow https://t.co/wMJnspTTBy
Richard Conway RichardPAConway ( View Tweet)
For rheumatologists, instinct says in RA everything’s better with MTX. For tofacitinib, where immunogenicity not an issue, is that actually true?
Canadian registry data: maybe no
after 36m, low no. ?valid, markups mine
Need to see more of this!
#ACR21 ABST0827 @RheumNow https://t.co/VVwd4SZgVx
David Liew drdavidliew ( View Tweet)
Factors associated w/ poor COVID19 outcomes in #SLE from the GRA @rheum_covid
📌Demographics - age, sex, region
📌Glucocorticoid use
📌 Comorbids - renal, CV
📌Untreated/active dse
❗Very important msg here: Control dse, manage comorbids & avoid GCs
@RheumNow #ACR21 abs0866 https://t.co/eXR3KqGrJa
sheila RHEUMarampa ( View Tweet)
Dr. Thomas reviews risk for progression to RA
👉+ACPA (9% risk)
👉1st degree relative 3-9X risk
👉70% risk in 5 years of both are true!👈
#ACR21 @rheumnow https://t.co/y5eUyacBFT
TheDaoIndex KDAO2011 ( View Tweet)
Radiographic progression in AS is greatest between ages 30-39. The presence of preexisting structural damage starts to accelerate it from earlier ages. Data from 1125 patients followed from 2001-2018 @RheumNow #ACR21 Abst#0897 https://t.co/g0t45R0lOd https://t.co/RvlO9EcMIX
Dr. Antoni Chan synovialjoints ( View Tweet)
3 year results of SELECT-COMPARE study of upadacitinib. No evidence of a signal in cardiovascular events or cancer. Reassuring, but really need an ORAL-Surveillance style study of upadacitinib to be confident. Abstr#0828 #ACR21 @RheumNow
Richard Conway RichardPAConway ( View Tweet)
An important message from Dr Ranjeny Thomas on #RA #disease control: "Patients can have a significant impact on the control of their disease, and the interventions we recommend need to be personalised to their resilience ability." #ACR21 @RheumNow https://t.co/h63uz5kfU8
Aurelie Najm AurelieRheumo ( View Tweet)