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Emerging Therapies in Spondyloarthritis: A Promising Pipeline
Growing awareness of spondyloarthropathies over the last two decades has led to a better understanding of the pathophysiology of spondyloarthritis, and subsequently increased interest in more distinct, disease state specific treatment options.
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Novel treatment options for Giant Cell Arteritis
Giant cell arteritis is associated with significant treatment related morbidity due to the dependence on glucocorticoids as a treatment option. After sixty years of therapeutic stagnation, these are exciting times in the management of GCA. At this year's ACR Convergence meeting, encouraging data will be presented on options for GCA.
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👉Get contrast if ordering an MRI to eval for inflamm. arthritis
👉Heel spur vs. enthesitis? Look for erosions at dorsum of calcaneus & other signs of inflamm
👉DISH vs. axial PsA? DISH➡️contiguous bony ossific'n up anterior margin of the vertebral bodies; PsA not cont.
TheDaoIndex KDAO2011 ( View Tweet)
Delighted to be reporting for @RheumNow from #ACR21 with @KDAO2011 @Yuz6Yusof @drdavidliew @Janetbirdope @uptoTate @AurelieRheumo @ericdeinmd @doctorRBC @synovialjoints @MeralElRamahiMD @DrMiniDey @_Castillo_Pedro @DrPetryna @AkhilSoodMD @swethaann23 @RHEUMarampa Follow them all!
Richard Conway RichardPAConway ( View Tweet)
The future according to Dr. M Brenner?
👉Bioengineered cells to treat inflammation.👈
#BasicScience #YearInReview #ACR21 @rheumnow https://t.co/EgoYBEZgT0
TheDaoIndex KDAO2011 ( View Tweet)
#GreatDebate: add belimumab (BLMB) vs. voclosporin (VCS) to MMF for lupus nephritis (LN)
Dr. Petri argues for BLMB b/c: (1/2)
👉improvement in LN
👉improvement in non-renal lupus
👉decrease lupus renal mortality
👉**prevent GFR reduction **
👉long term efficacy
#ACR21 @rheumnow
TheDaoIndex KDAO2011 ( View Tweet)
KEEPsAKE trial 1 (DMARD-IR) and 2 (DMARD/biologic-IR) on risankizumab (IL23i) for PsA:
👉some benefits of risankizumab for axial disease
👉no data regarding bowel disease
👉pts did remain on background DMARDS, steroids.
(2/2)
TheDaoIndex KDAO2011 ( View Tweet)
Abst#0858 Hopkins SLE Cohort 860 pts, 65 w/COVID19, 228 vax'd:
👉COVID19 infx did not increase dz activity, but aPLs were increased (rash decreased likely d/t quarantine and no sun exposure)
👉COVID19 vaccine did not affect dz activity #ACR21 @rheumnow
https://t.co/C65qJuMIbk
TheDaoIndex KDAO2011 ( View Tweet)
Pearls esp important for older patients #acr21:
👉🏻social isolation and or social context makes a big difference in accomplishing #goals and achieving #whatmattersmost
👉🏻encourage and motivate patients to engage someone in their community #nudge @CreakyJoints @ArthritisFdn
Una Makris UnaMakris ( View Tweet)
How can behavioral therapy help people manage #ChronicIllness?
@AftonHassett mentions these at #ACR21:
- Psychiatric comorbidity
- Pain catastrophizing
- Fear avoidance
- Limited coping skills
- Poor sleep
- Physical inactivity https://t.co/1c8bThYNP0
CreakyJoints.org CreakyJoints ( View Tweet)
And I’m finally in the game!! On board for #ACR21
Enjoying hearing Virginia Pascal showing data on how opsonisation of red blood cells containing mitochondria results in the induction of Type I Interferon pathways
Great paper here https://t.co/QWJLncYmC3 #ACRambassador
Chris Wincup chriswincup ( View Tweet)
#ACR21 - Dr. Virginia Pascual speaking on #PrecisionMedicine in Lupus. Mitochondria in RBC's will cause more disease activity in Lupus patients. Th groups that remove Mitochondria have less disease activity. Hope this takes us to #precisionmedicine soon!. #Looms4Lupus https://t.co/sMOmeJPMJX
Looms4Lupus Looms4Lupus ( View Tweet)
So fitting that @ACRheum President @DrDavidKarp has highlighted the amazing work of @rheum_covid in the #ACR21 Opening Session.
In crazy times, it delivered results with unprecedented speed, when our patients needed it most. We will look back in history with thanks.
@RheumNow https://t.co/cTnAZP9UDl
David Liew drdavidliew ( View Tweet)
It's all happening for biologic therapies in PMR!
phase 2/3 double-blind RCT:
- new PMR
- n=36
- 11w PNL taper (until relapse - clinical not lab)
- weekly sc TCZ for 16w vs placebo
big benefit persists post-TCZ cessation
real steroid sparing
PMR-SPARE #ACR21 ABST0507 @RheumNow https://t.co/w8tgOPAtyJ
David Liew drdavidliew ( View Tweet)
Dr B Bermas noted AAP guidelines say avoid MTX while breastfeeding, but the literature show very little MTX crosses breast milk. Dr Sammaritano stated that is true, but we don’t know how much MTX accumulates,though. #acr21 @rheumnow @UTSWRheum https://t.co/9I7HszorEO
TheDaoIndex KDAO2011 ( View Tweet)
Would you allow a pt to continue MTX while breastfeeding? #acr21 @rheumnow
TheDaoIndex KDAO2011 ( View Tweet)
Abst 0501
Kakkar & colleagues examined immunogenicity of single dose of SARS-CoV-2 Vaccine in patients with systemic sclerosis
- Vaccine is safe
- Immunosuppression lowered Ab production but no effect on T cell response
#ACR21 @RheumNow https://t.co/NsLrWHh7ZS
Akhil Sood MD AkhilSoodMD ( View Tweet)
In GCA, why might you target GM-CSF over IL-6?
Entirely plausible TCZ might be leaving some Th1 stones unturned, esp:
vascular remodelling
downreg pathways
Transcriptomics from toci/mavri-treated TAB show it's plausible beyond just theory...
Cid group #ACR21 ABST0506 @RheumNow https://t.co/YephlzHOdj
David Liew drdavidliew ( View Tweet)
VEXAS a new genetic disorder, (V) Vacuoles, (E) E1-enzyme, (X) X-linked, (A) Autoinflammatory, (S) Somatic. These are the important clinical features to be looking out for in clinic @RheumNow #ACR21 Session6S410 L Wilson, DO Cordona https://t.co/dBBLox6vVg
Dr. Antoni Chan synovialjoints ( View Tweet)
#LongCovid management #ACR21
#CDC
🔴Multidisciplinary approach: Holistic management
🟢Arthralgias" NSAIDs
🟢Brain fog: cognitive training
🟢 Anosmia/ dysgeusia: olfactory training
🟢 Fatigue: Exercise
🟢 Anxiety/ Depression/ PTSD: psychotherapy
#ACRambassador https://t.co/dB1OHlO0bl
Nelly ZIADE 🍀 Nellziade ( View Tweet)