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What's the added value of MRI in diagnosing #rheumatoidarthritis among pts w/ undiff'd arthritis?
Accdg to this study by N. Hollander et al, Tenosynovitis was independently assoc'd w/ RA development esp. among ACPA- UA pts 👇
@RheumNow #ACR21 abs0155 https://t.co/F6xlZ1Hy7u
sheila RHEUMarampa ( View Tweet)
Don't forget to discuss Influenza vaccination w/ your RA patients! Higher concerns about RA medications and low necessity of vaccination beliefs associated with a ⬇️ likelihood of vaccination and suboptimal vaccine coverage.
#ACR21 @RheumNow #Abst0141 https://t.co/c5GthZxh3n https://t.co/4Nt92CHFzV
Aurelie Najm AurelieRheumo ( View Tweet)
#GreatDebate: add on BLMB vs. VCS to MMF for LN
Dr. Petri argues for BLMB b/c:
👉cost is less
👉better adherance
👉not good for class V
👉voclosporin had greater nephrotoxicity
👉insuff data in pregnancy, but not contraindicated like VSC #ACR21 @rheumnow https://t.co/mk2eXwkxcG
TheDaoIndex KDAO2011 ( View Tweet)
#ACR21 Great Debate Dr. Brad Rovin:
Voclosporin: Combo with MMF is effective pts of diverse racial and ethnic backgrounds.
⭐️Big plus for a disease with large healthcare disparity issues
@Rheumnow https://t.co/rMpCRPLLGQ
Eric Dein ericdeinmd ( View Tweet)
Abst0385 #ACR21 @RheumNow Serum IL-22 significantly ⬆️ in pts w/ AxSpA (29 pts) vs alternative Dx &healthy (p< 0.001) suggesting serum IL-22 as diagnostic/differential biomarker for AxSpA. levels did not correlate w/mSASSS, BASDAI, ASDAS indices or serum CRP- no prognostic value https://t.co/2B8EWMaSDn
Olga Petryna DrPetryna ( View Tweet)
A cohort study on #uveitis in SpA by @DrDDRheum et al. showed that the axSpA grp had ⬆ incidence of uveitis and ⬆ uveitis flare rates vs. PsA grp.
Predictors of ⬆ risk of new uveitis flare accdg to grp👇
🔸PsA: Male and HLA-B27+
🔸axSpA: ⬆ ESR and CRP
@RheumNow #ACR21 abs0064 https://t.co/8IIET1zcYH
sheila RHEUMarampa ( View Tweet)
RELIANCE observational interim analysis in PFS pts treated w/ CAN. 168 CAPS, TRAPS, HIDS/MKD and FMF pts enrolled starting 10/17 - 12/20. 101 pts experienced an AE, 9 drug-related SAE. See table below. Abs 1090 #ACR21 #RheumNow @RheumNow https://t.co/4ship1G1tY https://t.co/EFlgUGNXdD
Dr. Rachel Tate uptoTate ( View Tweet)
@RADoctor retrospective cohort study, shows RA at ⬆️risk severe COVID-19 outcomes than general population. PsA not at⬆️risk. Abstr#0088 #ACR21 @RheumNow https://t.co/yZ1O5JDJgq
Richard Conway RichardPAConway ( View Tweet)
#ACR21 @RheumNow
Abst#0364 by Wetterslev et al. sought to identify axSpA characteristics of patients tapered off TNFI and showed clinical and radiographic improvement.
🔽52% were tapered off
⭐️The highest predictor of success is a low physician global VAS score
swethaann23 swethaann23 ( View Tweet)
Dr. Rovin at #ACR21 Great Debate:
▶️ Disagrees with Dr. Petri that GFR changes are caused by hemodynamics and is temporary, and non-nephrotoxic
▶️ Voclosporin + MMF is safe
@Rheumnow https://t.co/TxDyprnZ5u
Eric Dein ericdeinmd ( View Tweet)
Freq & severity of adverse events after #SARSCoV2 #vaccine in patients with autoimmune disease vs controls Abs#0104 #ACR21
•No incr. risk of AEs in autoimmune disease vs controls
•Minimal impact of vaccines on disease activity
@RheumNow
https://t.co/jGXP5UL4LP https://t.co/980NLWQYeX
Mrinalini Dey DrMiniDey ( View Tweet)
FAERS data of potential rheumatic irAEs:
'Arthralgia' consistently top of the list - readily underreported, causality unclear, hard to know what it is
This is why there's only a limited amount we can learn about rheumatic irAEs without dedicated study
#ACR21 ABST0438 @RheumNow https://t.co/8HElxUZS8n
David Liew drdavidliew ( View Tweet)
#ACR21 #GreatDebate: Dr. Rovin argues for VCS add to MMF b/c:
👉fewer side effects than legacy CNI
👉elevated in creatinine related hemodynamic reversible effect
👉did increase BP (but controllable)
@rheumnow (2/2) https://t.co/mmWp0sBveT
TheDaoIndex KDAO2011 ( View Tweet)
#ACR21 #GreatDebate: Dr. Rovin argues for VCS add to MMF b/c:
👉improvement in complete renal response
👉rapid proteinuria resolution (in days!)
👉protect podocytes➡️protecting glomeruli➡️protect GFR
👉effective in black patients.
👉rapid steroid taper
@rheumnow (1/2)
TheDaoIndex KDAO2011 ( View Tweet)
Dr Rovin: How do calcineurin inhibitors protect podoctyes?
👉by protecting synaptopodin (critical for stabilizing the actin cytoskeleton)
👉also by reducing podocyte apoptosis
@RheumNow #ACR21 #lupus #MedTwitter https://t.co/QZTwiT5Hd7
sheila RHEUMarampa ( View Tweet)
There remains a need to increase knowledge and awareness of #axialspondyloarthritis in this US study of nearly 200 primary care physicians, less than half of the time were IBP symptoms, psoriasis, HLA-B27, CRP or MRI checked @RheumNow, #ACR21 Abst#0370
https://t.co/6Uyy45OEYZ
Dr. Antoni Chan synovialjoints ( View Tweet)
Personalize decision points in belimumab vs voclosporin @jhrheumatology Dr. Petri
▶️ What is the outcome you are most interested in? GFR?
▶️ Is there extra-renal lupus
▶️ Infection risk
⭐️Ultimately, need biomarkers to know who will respond the best
@Rheumnow #ACR21 Great Debate
Eric Dein ericdeinmd ( View Tweet)
Abst0369 #acr2021 @rheumnow #acrbest ⬆️ level of pregnancy complications in axSpA in Irish registry. 41.9% complicated, 11.4% pregnan w/multiple complications. Miscarriage 20.5%. Amongst live births 10.8% c-section, preterm 11.4% . NICU admiss11.4%. ⬇️ breastfeeding rate at 33.7% https://t.co/plF8fykCKT
Olga Petryna DrPetryna ( View Tweet)
KL-6, Anti-Ku, anti-CENPB were assoc'd w/ #myositis &/or ILD in #lupus patients accdg to this study by Dr. T Cotton et al. This may help identify patients at risk for developing such.
@RheumNow #ACR21 abs0330 https://t.co/p0uxBOTLZm
sheila RHEUMarampa ( View Tweet)
RELIANCE interim data shows efficacy & safety of long-term CAN in FMF. This observational study is a good start, but offers questions regarding dosing of CAN in this patient population. Abs 0192 #ACR21 #RheumNow @RheumNow https://t.co/46o7AnUVj2 https://t.co/7oAPovbukl
Dr. Rachel Tate uptoTate ( View Tweet)