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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)
Excellent session on COVID-19 update on therapeutics chaired by @rheum_cat Prof. Luis Ostrosky outlining the therapies at different phases of COVID-19 including antivirals, convalescent plasma, anticoagulation, exercise and long-term endemic phase @RheumNow #ACR21 Session6S424 https://t.co/jso7x1v1oA
Dr. Antoni Chan synovialjoints ( View Tweet)
IL-18 in autoinflammatory Disorders session talk by Raphaela Goldbach-Mansky
- Discovered in 1995
- IL18 expressed in epithelial cells, keratinocyts, macrophages
- IL-18R neg regulated by IL-18 binding protein
https://t.co/U6TTDqEb7L https://t.co/R2lIo188ac
Links:
Dr. John Cush RheumNow ( View Tweet)
Round up of the QD Clinics for the last week, now available. #ACR21
QD153 - Serologically Active, Clinically Quiescent SLE QD154 - Paradoxical Psoriasis
QD155 - Scary Steroids
QD156 - How I Treat Rheumatoid Arthritis
https://t.co/MLimMt4bW0 https://t.co/Afs117eY7t
Dr. John Cush RheumNow ( View Tweet)
It is always difficult to distinguish infection and disease flares in autoinflammatory syndromes = 25 pt sJIA study at #ACR21 showing serum procalcitonin levels are useful when >0.95ng/ml @StillsDis_411 @rheumnow #abst0252
Bella Mehta bella_mehta ( View Tweet)
Abst # 0494
Dowell & colleagues showed that in RA patients using RISE registry
- disease activity correlated with burden of comorbidities
- this was linked to areas of low SES (ADI > 80) who received primarily Medicaid Coverage
https://t.co/xkdVnieHB2 #ACR21 @RheumNow https://t.co/jyZbV64qVz
Akhil Sood MD AkhilSoodMD ( View Tweet)
#ACR2021 Dr. L Sammaritano shows evidence for using belimumab during breastfeeding @RheumNow https://t.co/kDXXauoOZQ
Donald Thomas, MD lupuscyclopedia ( View Tweet)
Contraceptive methods available for pts, avoid estrogen in +aPL or active SLE #acr21 @acrheum reproductive guidelines @rheumnow https://t.co/dNfSyqjWKc
TheDaoIndex KDAO2011 ( View Tweet)
Remember: IUDs are the easiest contraception to recommend to SLE patients... Sammaritano lecture going on now #ACR2021 @RheumNow https://t.co/ZGRFIZyf5h
Donald Thomas, MD lupuscyclopedia ( View Tweet)
Insurance type, not race or distance to care, assoc'd w/ RA dz activity & burden. We need ^ rheums to care for socially deprived, rural, high comorbidity, Medicaid-covered RA pts w/ enhanced reimbursement & access to tx. Abs 0494 #ACR21 #RheumNow @RheumNow https://t.co/0es0i24gkS https://t.co/pBvhFR2DqE
Dr. Rachel Tate uptoTate ( View Tweet)
Biologics that can be use during pregnancy and lactation @rheumnow #acr21 reproductive guidelines https://t.co/4leM87GZI2
TheDaoIndex KDAO2011 ( View Tweet)
Delay breastfeeding within 4 hours if on pred> 20 mg. Meds safe in pregnancy and lactation #acr20 @RheumNow https://t.co/7l4jQw5idl
TheDaoIndex KDAO2011 ( View Tweet)
JAK inhibitors may be helpful for some patients with refractory adult and pediatric Still’s disease, but not in monotherapy (5 adults, 2 children, mean 11 month f/u, partial response in 4, failure in 3, steroid tapering difficult) @rheumnow #ACRbest #abst0195
Bella Mehta bella_mehta ( View Tweet)
Numeracy - (i.e. low health literacy) had lower self-reported adherence but paradoxically higher objective adherence in #Lupus @MithuRheum @rheumnow #ACRBest #abst0131
Bella Mehta bella_mehta ( View Tweet)
#ACR21 Abst#0463: Medicare claims data in ~3500 bDMARD-naive, sero+RA (avg 66 yo, 78%♀) showed those on Abatacept had longer time b4 tx stop (152d) @ 1yr vs TNFi (97d) or JAKi (89d)--is this reflective of tx efficacy? Where does ABT rank 4 u? @Rheumnow https://t.co/yfhxAsKBLl https://t.co/o84Ajmeyfk
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)