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COVID-19 mRNA vaccination immunogenicity
(vs immunocompetent):
TNFi: 2.3x reduction
JAKi: 2.6x
AZA: 3.5x
MTX: 4.4x
steroids: 9x (but confounded by other meds)
MMF/MPA: 21x
B cell depleting: 57.7x (but 6m gap probably helps)
amazing work led by @alhkim
#ACR21 ABST0457 @RheumNow https://t.co/cl5vBpNzvQ
David Liew drdavidliew ( View Tweet)
Dr. @AlHKim on COVaRiPAD data:
274 pts chronic inflam dz (RA/SLE/IBD/SpA/MS/SS,/Vasculitis) vs 53 control
👉90% Ab+ response (⬇️3.4X titer)
👉MMF⬇️21X
👉MTX⬇️4.4X
👉AZA ⬇️3.5X
👉BCDT⬇️ 57.7X
👉JAKi ⬇️2.6 X
👉GCs⬇️9X
👉TNFi impaired neutralization delta
#ACR21 #plenary @rheumnow https://t.co/b0DgLjDi6E
TheDaoIndex KDAO2011 ( View Tweet)
Provocative study in pre-RA. SC Abatacept in patients with pre-clinical RA can:
-improvement MRI inflammation
-⬇️evolution to clinical RA at 6 months
-No new safety signal
Yes, but we need longer term follow-up and an estimation of NNT.
#OP0505 @Rheumnow #ACR2021 https://t.co/2P1Yk3IyeR
Aurelie Najm AurelieRheumo ( View Tweet)
New treatments in #psoriaticarthritis Brepocitinib TYK 2/JAK 1 inhibitor had superior efficacy vs PBO in active PsA at Week 16, with improvements in more refractory domains over 52 weeks. Safety consistent with other JAKi @RheumNow #ACR21 Abstr#0488 https://t.co/ugsV7uRwro
Dr. Antoni Chan synovialjoints ( View Tweet)
#ACR21 #Abstr0456 How can we explain cognitive impairment in #lupus? Using f- and DCE-MRI, a study showed:
💠Abnormalities in brain functional connectivity
💠Extensive Blood-Brain Barrier leakage (BBB)
BBB could be a future target @RheumNow https://t.co/KLeWfbQUQ0 https://t.co/ibNvBUWlMK
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Polyautoimmunity: axSpA and Familial Mediterranean Fever by Dr. Rachel Tate ( @uptoTate )
Mysteries behind polyautoimmunity have confounded rheumatologists for decades. One such association, the co-existence of FMF and axSpA, remains rare.
https://t.co/GbU1ikeyQw
#ACR21 https://t.co/dRd6yxjieS
Links:
Dr. John Cush RheumNow ( View Tweet)
So what’s interesting is that type I IFNs actually tighten the BBB. Is this dysfunctional in SLE? Or does this argue that CI does not correlate with SLE disease activity perhaps? #ACR21 #ACRAmbassador https://t.co/y5x2k3NQFi
Alfred Kim alhkim ( View Tweet)
COVaRiPad study - Immunosuppression affects COVID-19 vax Ab levels. 247 pts, 90% seroconverted but @ reduced (3.4 fold) titers. Lowest w/ MMF (21x) and B cell Rx vs MTX/AZA (3-4x). Pts on B cell therapy should wait 6 mos to recv vax #ACR21 Abstr# 0457 https://t.co/1gkCsJSDBk
Dr. John Cush RheumNow ( View Tweet)
Why is lupus nephritis mortality trending up in the US, in contrast to overall SLE mortality?
Race matters
Urban location can make things worse
I'm outside looking in but hope it's not too bold to say disparities affect whether you live or die from LN
#ACR21 ABST0454 @RheumNow https://t.co/wmB9l9fFTT
David Liew drdavidliew ( View Tweet)
Dr De Miguel on subclinical large vessel vasculitis in PMR. US assessment. 22% had subclinical GCA. 90% LVV, 10% cranial GCA. Abstr#0466 #ACR21 @RheumNow https://t.co/PDCynMAigi
Richard Conway RichardPAConway ( View Tweet)
#ACR21 #ACRbest @RheumNow
Abst#0366 by Garrido-Cumbrera et al. looked at shows that three out of four European axSpA patients have difficulty in finding a job.
swethaann23 swethaann23 ( View Tweet)
Interesting study on immune cell profiling in PsA pts
⭐️variability in T cell sub-populations in PsA pts
⭐️no difference in lymphocyte cell populations before/after therapy
Abs#0056
https://t.co/16PYxaxT2S
#ACR21
@RheumNow https://t.co/dWaJr7hJ1p
Robert B Chao, MD doctorRBC ( View Tweet)
T2T in AxSpA? ASDAS-qCRP & ASDAS-CRP showed an almost perfect agreement w/ regard to dz activity categories (96%.) Quick ASDAS-qCRP can be used in real time to make clinical decisions. Abs 0374 #ACR21 #RheumNow @RheumNow https://t.co/opOyedQUaZ https://t.co/aeUEsW9HsX
Dr. Rachel Tate uptoTate ( View Tweet)
Biologic dose tapering in #axialspondyloarthritis in 52% of patients if criteria are met (BASDAI)< 40, physician global score< 40 and no signs of disease activity the previous year, escalation to previous dose if there is a flare @RheumNow #ACR21 Abst#0364 https://t.co/4GntJ6jS11
Dr. Antoni Chan synovialjoints ( View Tweet)
Do RA autoantibodies incr the risk of MACE?
In study of ~2000 pts, ⬆️ concentrations of RA-related autoantibodies assoc. w/ MACE and/or CVD-mortality.
Autoantibodies may therefore directly contribute to excess CVD risk in RA...
Abs#0269 #ACR21 @RheumNow
https://t.co/ju3YCRonJt https://t.co/UcOMsYxVMP
Mrinalini Dey DrMiniDey ( View Tweet)
Which pt has more MIs post elective surgery? #ACR21 @RheumNow abst#0128
Janet Pope Janetbirdope ( View Tweet)
Finally a way to improve Fatigue in RMDs? PLUS it is non pharmaceutical and remote⚡️! Cognitive Behavioural approaches and Personalised Exercise Interventions:
⬇️ Fatigue Severity and Impact
⬆️ Sleep at 1yr in a multiarm RCT.
#OP0462 @RheumNow #ACR2021 https://t.co/5buGCYb5Ut https://t.co/4Wz2VmcL3x
Aurelie Najm AurelieRheumo ( View Tweet)
Winning Image Competition: Rheum Dz in Patients of Color: Dermatomyositis #ACR21 @rheumnow https://t.co/OFRDDgQqas
TheDaoIndex KDAO2011 ( View Tweet)
Erosive polyarticular chronic tophaceous gout
Regional Winner of East Asia and Pacific
Image Competition: Rheum Dz in Patients of Color
#ACR21 @rheumnow https://t.co/1wrNAhjsw6
TheDaoIndex KDAO2011 ( View Tweet)
SLE patients with +aPL was associated with:
➡️Nephritis
➡️Discoid rash
➡️Serositis
➡️Neurologic disorder
Consider aPL and LAC status in patients w/these manifestations and whether anticoagulation/antiplatelets may be needed
#ACR21 Abst#0077 @RheumNow
Pedro Castillo _Castillo_Pedro ( View Tweet)