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#ACRbest Abstracts – Day 2
Our reporters have been prolific in finding the hot abstracts, those that were most attended or those that are getting the most buzz on social media. Here are RheumNow's #ACRbest abstract reports from Monday, November 13, 2023 at #ACR23, covering The Great Debate, SGLPT2 inhibitors in SLE, the SMART Study of MTX, TMP/SMX Prophylaxis, RA-ILD & TNF Inhibitors, cancer research and more.
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Maintain Vigilance for CV Risk Postpartum in Autoimmune Diseases
Pregnant women with autoimmune rheumatic diseases (ARDs) and antiphospholipid syndrome (APS) face significantly increased risks of cardiovascular events (CVEs). This increased risk is often attributed to ARDs, its medications or comorbidities associated with it.
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You said that CAR-T needs a #RCT in severe #SLE @RheumNow @ACRheum #ACR23 https://t.co/yilohqz1YE
Janet Pope ( View Tweet)
Watch: Lupus and the Patient Perspective
Dr. Kathryn Dao talks with patient advocate Amanda Greene about her patient poster (PP03) on "Lupus with Slime: Improve QOL and Increase ROM in SLE with Slime" at #ACR23.
https://t.co/JKU3w7sz4j https://t.co/IWHLJEi0qG
Dr. John Cush RheumNow ( View Tweet)
A#1486 @RheumNow #ACR23
STEMI outcomes - SLE v non-SLE
1,000,000 STEMIs, 4000 (0.4% SLE pts)
Younger age in SLE grp 61 v 67 yo
Increased risk of mortality: aOR 1.3 (CI 1.1-1.5, p<0.05)
LOS increased 4.7 v 4.5 d, increased hosp $
SLE: risk of CVD & worse prognostic effect
Eric Dein ( View Tweet)
PAPILUP: HPV in SLE
A#1479 #ACR23 @RheumNow
65 SLE pts v healthy v HIV+
45% not up to date, one only HPV vax
High risk HPV in 29% SLE pts, similar to gen pop
BUT multiple HR-HPV +abnml cytology higher 15% v 7%, similar to HIV+
Clearance impaired on GCs
RF: lupus duration
#ACRBest
Eric Dein ( View Tweet)
Petri @jhrheumatology data on SGLT2i in SLE
A#1490 #ACR23 @RheumNow
Prior to Rx, average annual change in eGFR was -3.1
After starting SGLT2i, average change decr to -0.9
Did not reach signif (p=0.27)
Average annual incr in UPCR was 0.4 -> 0.37 on SGLT2i, also not signif https://t.co/TviFyAwXbA
Eric Dein ( View Tweet)
GCs Major Driver of Depression in SLE Ab#1446 #ACR23
@RheumNow
1463 pts with SLE, prospective longitudinal study GC use: 49-57% of pts Prevalence of depression at any time: 89.8%, most of time 35%!! Risk factors: - Fibromyalgia OR 2.9 - GC OR 1.85
Eric Dein ( View Tweet)
PRES in SLE
A#1478 @RheumNow #ACR23
303 cases of Posterior Reversible Encephalopathy Syndrome in SLE
- Mean age 28, 91% F
- 42% HTN, HLD 15%, DM 10%
- 83% lupus nephritis. 80% dsDNA, 41% Sm, 38% aPL
- 78% seizures
- 3% mortality
- Transient in 45%, persistent in 19%, 8% sequelae
Eric Dein ( View Tweet)
Vasculitis in SLE
A#1443 @RheumNow #ACR23
804 SLE pts, 74% black, 9.5% h/o vasculitis
45% visceral vasculitis, 43% cutanous, 8% both
Pts w vasculitis: younger age of SLE dx- 27 v 31y
Risks: other SARD, renal dx, neuro dx, low compl
Trend to higher mortality 21 to 14% (no signif)
Eric Dein ( View Tweet)
Fate of ANA+/UCTD
A#1449 #ACR23 @RheumNow
207 asymptomatic ANA+ or UCTD followed
- <10% progress to SARD, 90% did not
Progression to SLE (11 pt), Sjo (5), SSc (3), RA (1)
Progressors to SLE: arthritis (91%), low compl (45%), alopecia (36%), ulcers (27%) - milder manifestations
Eric Dein ( View Tweet)
SGLT2 inhibitors compared to DPP4i may be better at reducing risk for MACE & renal progression in patients with SLE/LN and diabetes. SGLT2i risk for MACE (HR 0.69, 95% CI 0.48-0.99), and renal progression (HR 0.71, 95% CI 0.51-0.98). abst# 1579 #ACRbest #ACR23 @rheumnow
TheDaoIndex KDAO2011 ( View Tweet)
#ACR23 Abstr#1512 Can we improve trial design of Bcell depletion in #SLE? Feasibility RCT of RTX in organ specific MSK showed: a) feasible to use ultrasound & clinical as endpoints, b) new tool LAMDA is responsive, c)potential worsening before later improvement with RTX @RheumNow https://t.co/YmbUOWVdWS
Md Yuzaiful Md Yusof ( View Tweet)
Do you discuss HPV vax & cervical CA screening w/SLE & RA pts?
In this study, more women w/SLE discussed cervical CA screening w/their rheums(33.3% vs. 11.4% p<0.01) & more likely to have persistent abn paps on ffup
Similar HPV vax status for both grps
#ACR23 ABST1356 @RheumNow https://t.co/Vbu8hbZ1uh
sheila ( View Tweet)
#ACR23 Abstr#1509 SLR & Meta-Analysis of RCTs in lupus nephritis (N=16 studies):
-CNI (VOC/TAC/CyA) alone (OR 1.4) or combined MMF (OR 2.1) was assoc with CR vs SOC (MMF/Cyclo)
-Less GI AEs & cytopenia in CNI
Assuring data esp when cost is a hurdle for VOC @RheumNow #ACRBest https://t.co/9ScakIdXBN
Md Yuzaiful Md Yusof ( View Tweet)
#ACR23 Abstr#1479 In N=66 patients with #SLE, 29% had high risk HPV infection. Associated with lupus disease duration. In 2nd screening ~1yr after, multiple infections occurred in 15%, about similar vs women with HIV. Call to promote HPV vaccination in SLE 💉 @RheumNow https://t.co/UGIrCwu32x
Md Yuzaiful Md Yusof ( View Tweet)
#ACR23 Abstr#1579 More data on the role of SGLT2-i in #SLE. Data from EHR using propensity match scoring showed the use of SGLT2-i vs DPP4-i (for nonSLE indication) was associated with reduced risk of MACE (HR:0.69)and poor renal outcomes inc. ESRD (HR:0.71) @RheumNow https://t.co/7k0o3m18AN
Md Yuzaiful Md Yusof ( View Tweet)
In their cohort, Dr. Jorge reports that SLE pts who used SGLT2i had⬇️risk of MACE(HR 0.69 [95% CI 0.48-0.99]) & renal progression(HR 0.71 [95% CI 0.51-0.98]) vs DPP4 use
Risk of MACE also⬇️in LN subgrp
🧐💊A potential role of SGLT2i for SLE/LN?
#ACR23 ABST1579 @RheumNow #ACRbest https://t.co/Dod8DqRvLo
sheila ( View Tweet)
#ACR23 @RheumNow
SGLT2 inhibitors help CV & renal outcomes, but SLE pts excluded @AprilJorgeMD
ComparedSGLT2 to DPP4 inhibs, real world observation emulation study in SLE pts with T2DM
Lower incidence of MACE & renal progression
Subgroup w LN - risk reduction 10.2 MACE/100 py https://t.co/JpJ0yWNQBe
Eric Dein ( View Tweet)
Excellent start to Plenary II
Should we borrow SGLT2i and DPP4i use from endocrine?
SLE pts who initiated SGLT2 or DPP4: lower risk of MACE and renal progression
@RheumNow #ACR23 Abs#1579 https://t.co/RsaWuetyft
Robert B Chao, MD ( View Tweet)
