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Feet, foot

Pre-clinical RA: starting off the wrong foot

d Aurelie Najm, MD, PhD

Patients with clinically suspect arthralgia can represent a challenge for clinicians, in a sense that there are not yet reliable markers to predict evolution to clinical RA nor enough evidence to support routine prescription of conventional synthetic DMARDS or biologic treatments in this setting.

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#ACR21 #Abstr0189 Another case for early intervention. Median time-to-Rilonacept (IL1-i) monotherapy for recurrent pericarditis was 7.9 weeks! During this time, >94% pts discontinued steroid and/or colchicine either sequentially or concurrently @RheumNow https://t.co/ofi3Jtm6j6 https://t.co/b6PnFw4gUN

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Active RA w/ large joint swelling & co-existent CVD & diabetes associated with ⬆️risk of #AlzheimersDisease & related #dementia in RA pts. 👉~1300 patients 👉Among CVD conditions, #stroke & #CHF assoc w/ the risk of #dementia #ACR21 Abs#0284 @RheumNow https://t.co/N3x2ZtBFGe https://t.co/kFyf3A0gha

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Mrinalini Dey DrMiniDey ( View Tweet)
Risankizumab (IL-23i) KEEPsAKE 1 and 2 (phase 3) studies for PsA treatment ⬆️ACR20 response compared to pbo ⬆️secondary endpoints ⭐️no new safety signals Abs#453 #ACR21 #ACRBest @RheumNow https://t.co/7bwvIPMz38 https://t.co/TJaSqwipa5

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Robert B Chao, MD doctorRBC ( View Tweet)
Abs 457 #ACR21 @rheumnow Exciting work by @alhkim and colleagues on SARS-CoV-2 Vaccination in CID patients - Most (90%) developed Ab response but with reduced titers - GC users including some low dose mounted low responses - TNFi reduced in vitro neutralization of delta variant https://t.co/fJxnKmbccc
Akhil Sood MD AkhilSoodMD ( View Tweet)
Abs0266 #acr21 @RheumNow study of impact of pandemic on pts w/SLE (67%), RA (19%), & pSS (8%): 63%reported a flare since the pandemic & 16% had COVID-19. 19% reported no changes to their care.76% reported a change in their mood& emotional health. Was your pts experience similar?

Olga Petryna DrPetryna ( View Tweet)

2 year study of AxSpA pts in clinical remission who tapered TNFi. ⭐️52% successfully tapered to either 2/3, 1/2 or 1/3 dose ⭐️Baseline physician global score independent predictor of successful tapering Abs#364 #ACR21 @RheumNow https://t.co/9Kti5JGMYr https://t.co/y1Uj2dTABC

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Robert B Chao, MD doctorRBC ( View Tweet)
In a newly diagnosed SLE patient with class IV nephritis, already on HCQ, in addition to GC's, would you... #ACR21 #GreatDebate @rheumnow #LupusNephritis

TheDaoIndex KDAO2011 ( View Tweet)

#ACR21 #ACRBest @Rheumnow Abst #0452 Raychaudhuri et al. TB-PET/CT indices ➡️ disease outcome measures in PsA Identifies synovitis, enthesitis, dactylitis, nail matrix inflammation of PsA as compared to RA and OA Future use as a diagnostic tool for early disease of PsA https://t.co/uLsAWEkboS
swethaann23 swethaann23 ( View Tweet)
@ericdeinmd @RheumNow *TICOSPA IMO, more an issue of poor tools for activity monitoring and insufficiently diverse toolbox. Works in RA as lots of choices and good activity measures. Until AxSpa has those, don’t see how we hope to meet “tight control”.

Ethan Craig rheumecraig ( View Tweet)

@RheumNow #acr21 abst 195 prospective study of JAKi for refractory Still’s in 7 pts suggests JAKs can be useful as an add on but not in monotherapy : partial response 57%& failure in43%. No patient achieved complete remission. steroids could be decreased by63%~ https://t.co/rYHVReRHvL
Olga Petryna DrPetryna ( View Tweet)
Irish registry of AS pts included 76 women who were pregnant ⭐️58% uncomplicated, 41.9% complicated, 11% multiple complications ⭐️frequency of miscarriage ⬆️ ⭐️complications included C-section, preterm, NICU admission #ACR21 @RheumNow Abs#369 https://t.co/90dolEeTIw
Robert B Chao, MD doctorRBC ( View Tweet)
#ClinicalPearl. During Q&A of abst#0457 Kim A, et al plenary at #ACR2021 #ACR21 Dr Kim said with 3rd #COVIDvaccination dose the pts who had little or no response to spike protein DID mount a response. 3rd dose in vulnerable pts works #ACRBest @RheumNow

Janet Pope Janetbirdope ( View Tweet)

Secondary antiphospholipid syndrome (2APS) in SLE in Georgia Registry 👉12-14% of SLE pts 👉aCL 67%, LAC 51.5%, and aB2GP 7.7% 👉Inc rates of +dsDNA/Smith, livedo reticularis, serositis, & heme/renal/neuro d/o 👉⬇️rate in Black pts, but ⬆️thrombosis #ACR21 Abs 0078 @RheumNow

Pedro Castillo _Castillo_Pedro ( View Tweet)

Self-monitoring app for AxSpA pts ⭐️adherence over 6 months poor 😔 ⭐️high disease activity and older age related to ⬆️frequency of reporting Abs#373 #ACR21 @RheumNow

Robert B Chao, MD doctorRBC ( View Tweet)

This was in Lupus https://t.co/iqEPVFfHmc

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Dr. John Cush RheumNow ( View Tweet)

Lupus Nephritis in pregnancy: @HopkinsRheum Petri recommendations ⭐️AZA safe for LN, with tacro if needed ⭐️❌Voclosporin (alcohol content) ⭐️Belimumab uncertain @Rheumnow #ACR21 Great Debate

Eric Dein ericdeinmd ( View Tweet)

The good news: Most (around 90%) of people with chronic #inflammatory disease produced antibodies after the #COVID19 vaccine, but it was reduced compared to that of generally healthy people. #ACR21 #Plenary @alhkim https://t.co/KdWtIuuOtA
CreakyJoints.org CreakyJoints ( View Tweet)
Dr. Eric Yen presenting about lupus nephritis mortality in the USA (1999-2019): - Increasing trend in LN mortality x5 yrs - Increased odds of death for Black pts > Latinx > API > AI/AN - Urbanization (large central metro area) independent RF + effect modifier #ACR21 https://t.co/qf61SkCqw4
Danny Soulsby dsoulsMD ( View Tweet)
#ACR21 Year in Review: TICOPSA - tight control treat to target in AxSpa does not meet primary endpoint, but favorable secondary outcomes. Was the control group at academic center already receiving good tight control? @Rheumnow

Eric Dein ericdeinmd ( View Tweet)

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