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JAK Inhibitors in Refractory Adult and Childhood-Onset Still’s Disease
Still's disease is an autoinflammatory disease characterized by spiking fever, rash, polyarthralgia, sore throat and even life-threatening complications, such as macrophage activation syndrome. It was first described by George Still in the late 1800s.
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"Studying the pandemic is definitely impaired by the pandemic"...loved the quote! by @cappelliMD
Epi and Public health Abstract session I #ACR21 @RheumNow
Bella Mehta bella_mehta ( View Tweet)
⭐️Imaging of the SIJ in psoriatic axSpA is similar to axSpA associated with iritis or colitis!
Abst#0902 (https://t.co/f55Vfi1LSS)
#ACR21 @RheumNow https://t.co/UCXrwPiyhh
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
"Healthier moms lead to healthier babies. This is how I frame the discussion regarding medications and PsA in my practice (with regard to reproductive health)." Dr. Talabi #ACR21 @RheumNow #RheumNow
Dr. Rachel Tate uptoTate ( View Tweet)
How concerned should we be for #hydroxychloroquine retinopathy. >4000 pts prospectively followed. 1/2 w RA & 15% w #SLE. New risks Asian with pericentral pattern and overall. Length of time on use and ⬆️wt based dose per day & CKD all risks. Abst#0989 #ACR21 #ACRBest @RheumNow https://t.co/XTfdQpVC7H
Janet Pope Janetbirdope ( View Tweet)
In pts w/o RF, liver bx prev suggestd if lifetime cumulative MTX dose was 1-1.5g, then 3.5-4g.
All pts in centre offered Fibroscan
liver stifness associations:
- age, BMI
- not cumulative MTX dose
maybe survival bias, but what we're doing now is fine!
#ACR21 ABST0786 @RheumNow https://t.co/I6IhS3jhmC
David Liew drdavidliew ( View Tweet)
Aware of COPA syndrome?
➡️Rare cause of immune-mediated lung dz
➡️Mimics RA-ILD, SLE, & vasculitis
➡️Adult-onset cases reported
Abst#0529 determined that mutations in the COPA gene underlie some cases of severe pulmonary fibrosis.
#ACR21 @RheumNow https://t.co/mCx3eT7Pv8
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
📢Do not miss the #Lupus Faculty panel discussion @RheumNow on a selection of interesting abstracts presented on Day 2 📝#ACR21 @KDAO2011 @Janetbirdope @bella_mehta @_Castillo_Pedro @RHEUMarampa https://t.co/e0v4qQIE4h
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
What to do if pt on a TNFi develops cancer? Can you safely restart TNFi later? Depends on cancer, timing - how long ago was cancer, Rx and patient preference. Data diff from RABBIT registry vs British bio registry @RheumNow #ACR21 #ACRBest 7S413 Have a look https://t.co/q9SFKlFJzg
Janet Pope Janetbirdope ( View Tweet)
Very interesting talks by Dr. Kim and Dr. Hyrich on DMARDs and Cancer risks
#ACR21 @RheumNow https://t.co/Dl5WPo7mmj
Akhil Sood MD AkhilSoodMD ( View Tweet)
This feels like an excellent starting point for Tuesday's ORAL Surveillance malignancy discussion.
RWE Cohort: HR 1.01 (0.83-1.22)
RCT-dup Cohort: HR 1.19 (0.86-1.64)
ORAL Surveillance: HR 1.48 (1.04-2.09)
Interesting day 4 ahead!
great talk @SeoyoungCKim #ACR21 7S413 @RheumNow https://t.co/YSau21goMr
David Liew drdavidliew ( View Tweet)
Does concomitant SJS affect tx effectiveness in RA?
Abst#0839 suggest yes!
➡️RA+SjS have an inferior response to TNFi than RA patients w/o SjS
BUT, RA/SJS pts w/ longer RA dz duration & ↑ DAS28 + HAQ-scores.
What's your clinical experience with this?
#ACR21 @Rheumnow https://t.co/TIc3raMOSJ
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
If obvious dermatomyositis, you don’t need EMG for dx but may use for severity of involvement or if failing Rx or r/o steroid myopathy. For ?polymyositis ALWAYS do bx and often do EMG as broad differential #ACR21 @RheumNow https://t.co/L1xu3OuRYJ
Janet Pope Janetbirdope ( View Tweet)
RheumNow’s expanded coverage of #ACR21 is sponsored in part by @bmsnews, @JanssenUS, @Novartis. All content chosen by RheumNow & its Faculty.
Dr. John Cush RheumNow ( View Tweet)
A worthwhile point:
despite historic concerns, in the modern era TNFi can used safely & well in HIV pts
18y follow-up, all pts high CD4
(their starting criteria: CD4>200, VL <60,000)
no reported opportunistic infx
good arthritis response
#ACR21 ABST0965 @RheumNow @CCalabreseDO https://t.co/5pbRg63ubr
David Liew drdavidliew ( View Tweet)
Abst#0572: In US veterans w/ RA followed for 17 yrs, several cytokines+chemokines
⭐️Associated w/ ↑ risk of incident MACE independent of typical CVD RF & RA activity
&
⭐️Predicted MACE even if in LDA/remission
WOW! We need to do better @ CVD risk strat!
#ACRBest @RheumNow https://t.co/J74rRa9EQE
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
#ACR21 #Abstr0865 It’s time for T2T to achieve LLDAS in #lupus. In a study of N=2040 pts, mortality was 2.3% mainly due to infection. Remission off steroid was the best but only met in 14%. LLDAS-50 achieved in 48% pts and ⬇️mortality by 56% @RheumNow https://t.co/CddqMuFIOM https://t.co/g346Cbybep
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Join the @RheumNow faculty tonight for a recap of Day 2 at #ACR21
⏰19:00 ET
⏰Midnight GMT- I promise to be well-caffeinated to present my many highlights from today! 😄
📺Register via the Zoom link below or watch on Youtube https://t.co/6HIQGR5T8z
Mrinalini Dey DrMiniDey ( View Tweet)
beautifully chaired by @cappelliMD
also elegant talk on 'M-triad' by the always articulate @lovetolearn27, made me think about my pt on the ward right now!
#ACR21 @RheumNow @CCalabreseDO @LCalabreseDO @got_rheum @MarieKostine @lexmeara @ReidMDMPH @NilashaGhosh @RheumDr_Nina https://t.co/2iu6zWp8Ge
David Liew drdavidliew ( View Tweet)
*️⃣CT-P13=1st monoclonal biosimilar to infliximab (IFX)
⭐️ReFLECT: 1370 French pts (142 RA, 411 axSpA, 96 PsA)
→2 groups: IFX-naïve starting CT-P vs switching from IFX to CT-P
*️⃣CT-P13 induced improvement in IFX-naïve & maintained dz in pts switched
Abst#0817 #ACR21 @RheumNow https://t.co/bASmGvhuIS
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)