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Gender Differences in SpA
One of the hot topics during the meeting was gender differences in SpA. Three abstracts presented addressed issues related to these differences particularly in the aspects of treatment response and disease activity.
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JAKs and Other Drugs in PMR
This has been an interesting ACR meeting in terms of PMR updates. I would argue that we are still far too wedded to glucocorticoids only in the management of PMR. Yes, some patients will do fine with just glucocorticoids but we persist far too long with a glucocorticoid only strategy in others who clearly need an alternative as glucocorticoid adverse events multiply.
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LEVI-04 a novel neurotropin3-i showed:
-significant analgesia across all measures
-improvement in functional measures and PGA for all doses in a Ph2 RCT
- well tolerated
Hopefully will prove to be a therapeutic option for knee #osteoarthritis in future
@RheumNow #ACR24 absL15 https://t.co/kWsyyyGxyU
sheila RHEUMarampa ( View Tweet)
Conaghan et al. LEVI-04, neurotrophin-3 inhibitor in knee OA. 518 patients. Significant improvements in WOMAC pain and function, and PGA. So sign of any increase in rapidly progressive OA (as with NGF inhibitors) @RheumNow #ACR24 Abstr#L15 https://t.co/qud4wTAikY https://t.co/0wjjG4U4bf
Links:
Richard Conway RichardPAConway ( View Tweet)
Pts w #osteoarthritis and T2 DM
👇
Who Have
⬆️pain
Have
worse control of #diabetes
Even after adjusting for #BMI
Chicken or egg - which comes 1st
🤷♀️
#ACR24 @RheumNow @ACRheum
Abst#2110 https://t.co/eN2xAw0EMG
Janet Pope Janetbirdope ( View Tweet)
Does #hand #osteoarthritis
Benefit from
#traction #splinting?
Nope 👎
Small 2 site #RCT - not helpful
I may Recommend #splinting - sometimes pts get
Pain relief - in my opinion
but this one didn’t help
#ACR24 @RheumNow @ACRheum
Abst#2108 https://t.co/K0Ud7uCb1P
Janet Pope Janetbirdope ( View Tweet)
How long is a long acting #intra-articular #steroid #injection in #knee #osteoarthritis?
#IA steroids can be q3monthly
#RCT of IA #fluticasone #propionate
Was superior to #placebo
Seemed to last approx 24 weeks
➡️ sub analysis in moderate pain, BMI<30
#ACR24 @RheumNow #2106 https://t.co/QBFCqXd1Q8
Janet Pope Janetbirdope ( View Tweet)
#Scleroderma #molecular #signatures in #skin predict long term outcomes
👇worst with inflammatory signature
This may have clinical and trial applicability
Nice work!
Abst0711 #ACR24 @RheumNow @ACRheum https://t.co/3CFxu6bACu
Janet Pope Janetbirdope ( View Tweet)
#PAH in #SSc still has a poor #prognosis
👎
Esp #ILD with PAH - a double whammy
But also
group 1 PAH
And
Some are unclassifiable ▶️also bad px
Need
Earlier detection
More interventions
?prevention
Abst#0678 #ACR24 @RheumNow @ACRheum @sclerodermaUM https://t.co/AEQsTC1pzQ
Links:
Janet Pope Janetbirdope ( View Tweet)
#MDA5 #dermatomyositis assoc #ILD
May do better w
#tofacitinib vs #CNI in 515 pts
Too bad they didn’t do a pragmatic RCT as we do t know the reasons for prescribing each #Rx
But impressive survival w #tofa
#ACR24 @ACRheum @RheumNow abst1736 https://t.co/HLJknSYcNJ
Janet Pope Janetbirdope ( View Tweet)
Risk stratification of GCA pts: who might lose vision?
Cranial MRI with vessel wall enhancement used to calculate additive score... # of vessels affected
Higher scores a/w ocular GCA > non-ocular GCA > no GCA and decreased w/ tx
@RheumNow #ACRbest #ACR24 https://t.co/knDVrl84Qs
Links:
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
#Publication #bias to Nth degree.
>1/3 of registered #postmeno #osteoporosis trials are NOT #published
👇search of trials
673 published
Vs
489 not published 890000 pts
MOSTLY when performed in the USA
No accountability for NOT publishing
#ACRbest #ACR24 @RheumNow #2122 https://t.co/UyMMbHhvvV
Janet Pope Janetbirdope ( View Tweet)
If your pt with #rheumatoid #arthritis is
#exhausted - there is a reason
#Meta-analysis of 70000 RA Pts
#Insomnia is ⬆️4X vs gen population
Due to
▶️#pain
▶️#inflammation
▶️#depression
🤷♀️
#ACR24 @RheumNow @ACRheum abst#0480
Janet Pope Janetbirdope ( View Tweet)
@DrLisaCS distills the challenges of MCTD 👇
🔵Clinical phenotyping key to improve patient outcomes
@jhrheumatology @RheumNow #acr24
https://t.co/APfXPwxvfE
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Great project by @kekuchinad to evaluate how PFTs bias our assessment and contribute to disparities
@CaoilfhionnMD
@jhrheumatology @BayviewMedicine
@RheumNow #ACR24
https://t.co/b5pAn3e9AR https://t.co/opzWrZ1NH5
Links:
Eric Dein ericdeinmd ( View Tweet)
Potential Impact of Weight Loss Drugs in Rheumatic Diseases
Dr. Arthur Kavanaugh highlights a session regarding weight loss and improvement in disease outcomes, specific weight loss drugs (SGL-2 and GLP-1), along with downsides when patients stop these medications. Reporting… https://t.co/Ilu2FXK2xi https://t.co/7CKSnfuey4
Dr. John Cush RheumNow ( View Tweet)
How often do you ask about #fatigue, #depression & #anxiety in pts with RMDs?
Study of >1000 pts found anxiety symptoms in 1/3 pts and significant association between fatigue & anxiety and depression
Highlights importance of regular review of MH symptoms
Ab2657 #ACR24 @RheumNow https://t.co/0zMOMybrCI
Mrinalini Dey DrMiniDey ( View Tweet)
Study by Maria Dall'Era et al. compared voclosporin-based triple immunosuppressive therapy with high-dose GC in active lupus nephritis.
- Fewer adverse events in the voclosporin group, despite a higher incidence of specific issues like decreased GFR and hypertension.
- 25%… https://t.co/ToRu2rdErC https://t.co/uUXzNNuLDb
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Loiseau et al. 4700 pSS, 47000 comparators. pSS associated with increased risk of every CV/VTE outcome. Did not have that in my priors! @RheumNow #ACR24 Abstr#2631 https://t.co/QKemUhbcG8 https://t.co/twpjdS2L63
Links:
Richard Conway RichardPAConway ( View Tweet)
SEC demonstrated high retention rates after 5 years in pts with PsA and r-axSpA in this real-world study.
Reasons for stopping SEC:
lack of efficacy
pt decision
lost to ffup
AEs
Reassuring data on SECs position in the treatment of PsA/AS.
@Rheumnow #ACR24 abs2344 https://t.co/zECEsheQIi
sheila RHEUMarampa ( View Tweet)
