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Dr. Jeffrey Sparks gave a state of the art update on Advances in RA-ILD, many of which he and his group have played a big part in, on Saturday at RNL26.
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Natalie McCormick, PhD, of the Rheumatology and Allergy Clinical Epidemiology Research (RACER) Center within the Division of Rheumatology in the Mass General Brigham Department of Medicine
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The The Tocilizumab in Giant Cell Arteritis Spanish Collaborative Group studied giant cell arteritis with aortitis, comparing the efficacy of intravenous vs. subcutaneously (SC) tocilizumab (TCZ) - demonstrating the superiority of SC TCZ.
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A recent study examines trends in rheumatoid arthritis (RA)-related mortality among U.S. postmenopausal women (aged 55 and older). They found RA mortality rates have declined, yet disparities in who is most affected persist, especially for white women, and those over 85 yrs of age.
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Dr. Jack Cush reviews the news and reports from the past two weeks on RheumNow.Com
Dr. John Cush
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RT @richardPAconway
MUC5B is strong risk factor for RA-ILD. Specifically for UIP. Associated with both older-onset RA, and ILD earlier following RA presentation. #RNL26 https://t.co/qeLp1BqOEM
Dr. John Cush
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RT @ericdeinmd
RA-ILD #RNL26
Jeff Sparks
MTX and ILD
- Rare MTX-induced pneumonitis. 7 cases in n=4786 (0.3% cases) vs <0.1 on PBO, rare diff from ILD
- No increase in incident ILD - meta-analysis of 7 studies show OR 0.49 https://t.co/k2XeAzBsYB
Dr. John Cush
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RT @ericdeinmd
#RNL26 RA-ILD Jeff Sparks
ILD pooled prevalence 0.11
Sparks: "prevalence is high but not so high that we don't screen everyone," means lots of subclinical ILD
Subtypes:
UIP 50-60%, fibrotic
NSIP 30-40%, inflammatory
Less common: LIP, DIP, RB-ILD, DAD
Dr. John Cush
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RT @richardPAconway
Dr Sparks shows risk factors for RA-ILD. Important for diagnosis (and screening?) Focus interventions on the modifiable ones! #RNL26 https://t.co/lE9Mkbq8oh
Dr. John Cush
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RT @richardPAconway
UIP is predominant radiologic pattern in RA-ILD. Contrast with our other diseases. But by no means exclusive - up to 50% of RA-ILD have a more inflammatory pattern. Important treatment implications! #RNL26 https://t.co/HmW1mz429i
Dr. John Cush
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RT @richardPAconway
Updated data on RA-ILD from Olmstead County. Cumulative incidence of 15.3% over 20 years! #RNL26 https://t.co/wVrTc3QM6Y
Dr. John Cush
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RT @ericdeinmd
Mucosal Hypothesis RA #RNL26
Demoruelle
Mucosal origins of RA?
Key sites of immune-environment interaction initiate local inflamm, becomes systemic
Link of lung inflamm/immune dysregulation - ass w/ smoking, ILD
NETs in lung drive RA path?
Gut/oral microbes drive
Dr. John Cush
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Advances in RA-ILD
Dr. Jeffrey Sparks gave a state of the art update on Advances in RA-ILD, many of which he and his group have played a big part in, on Saturday at RNL26.
https://t.co/xO7hBRKeqE https://t.co/rs1MS08Svl
Dr. John Cush
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RT @richardPAconway
Dr Sparks. RA-ILD is common. Pooled prevalence of 11% from recent meta-analysis. Less common than SSc or IIM, but more frequent than we think! #RNL26 https://t.co/mJSmMakSBM
Dr. John Cush
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RT @richardPAconway
Dr Sparks. RA-ILD is common. Pooled prevalence of 11% from recent meta-analysis. Less common than SSc or IIM, but more frequent than we think! #RNL26 https://t.co/TCsDfeQjZC
Dr. John Cush
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RT @ericdeinmd
Mortality risk in RA #RNL26
Myasoedova
Most common mortality:
1.5-1.6x increase risk CVD
2-3x increase risk ILD
+ACPA increases risk in both https://t.co/Luwyy6UFg6
Dr. John Cush
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NEJM: Aortitis Due to Large-Vessel Vasculitis
63yoM w/ Hx HTN c/o 3 mos of CP, palpitations, abdominal pain. ESR-104, CRP 85 mg/L. CT showed thickening of the thoracic & abdominal aorta. After 6wks Rx w/ AZA, HCQ, Pred, ESR/CRP still high and pt stared on SC TCZ w/ improvement. https://t.co/1TBreptAFr
Dr. John Cush
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NEJM: Aortitis Due to Large-Vessel Vasculitis
63yoM w/ Hx HTN c/o 3 mos of CP, palpitations, abdominal pain. ESR-104, CRP 85 mg/L. CT showed thickening of the thoracic & abdominal aorta. After 6wks Rx w/ AZA, HCQ, Pred, ESR/CRP still high and pt stared on SC TCZ w/ improvement. https://t.co/IWm3ZQLBUN
Dr. John Cush
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Multinational retrospective review of CV risk in IIM (myositis) cohorts finds among 336 pts that > 1/3 are at moderate-high risk for CVD - but 34 % prescribed a statin. Moderate-high risk scores seen w/ necrotizing myopathy (OR 4.6), steroids (OR 1.8), dyslipidaemia (1.2) https://t.co/4IMiaHJvL3
Dr. John Cush
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Diffuse Alveolar Hemorrhage in Rheumatic Disease
A retrospective, cross-sectional, single-center study of adult rheumatic disease patients with diffuse alveolar hemorrhage (DAH), demonstrates a high proportion have coexistent pulmonary infection and significant mortality risk. https://t.co/K1fLo5iHpd
