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Monitoring Infliximab Drug Levels Improves Efficacy
Should we start considering therapeutic drug monitoring when prescribing TNFi for treatment of our rheumatologic conditions?
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Drug retention of TNFi vs. secukinumab in AxSpA pts
Abs#911
⭐️46% discontinued either treatment
⭐️TNFi with slightly better drug retention
⭐️Age, BASDAI, BMI did not favor any group
⭐️inefficacy - main reason
#ACR21 @RheumNow https://t.co/ynoomYrTvX
Robert B Chao, MD doctorRBC ( View Tweet)
Dr. Alexis Ogdie on opioid use in PsA and axSpA, highlighting need for better interventions.
🔹21% of PsA pts (n=828) and 27% of axSpA (n=334) reported prescription opiate use.
🔹⬆️BASDI & HAQ-DI =>⬆️opiate use & costs
https://t.co/Id658ocDVf
#ACR21 Abst1777 @RheumNow
Pedro Castillo _Castillo_Pedro ( View Tweet)
AxSpA/ PsA pts who completed ePRO Q between 2018-2021 showed 🔽 trend of PRO mostly in pts on biologic Rx
If ASDAS < 1.3 /PSAID-12 < 2➡️ pts were seen less frequently
⭐️🔽 clinic workload and better disease activity stratification
Abst # 1788 #ACR21 @RheumNow #ACRBest https://t.co/ilSrOjHQAk
swethaann23 swethaann23 ( View Tweet)
Dose Tapering of TNFi in AxSpA: Dr. Antoni Chan ( @synovialjoints) discusses abstract #0364 presented at the #ACR21 annual meeting.
https://t.co/pDnKFfeQdP https://t.co/7CZg2lkSFI
Links:
Dr. John Cush RheumNow ( View Tweet)
Hospitalisation for heart failure ⬆️ in inflammatory diseases. RA>PsA>AS>PsO . HRs 1.1-1.6 compared to general population. Abstr#1925 #ACR21 @RheumNow https://t.co/kKlGQM5Tcg
Richard Conway RichardPAConway ( View Tweet)
Why is there more CHF in #RheumatoidArthritis ? Also dose response between highest inflammation RA the PsA then axSpA then PsO. ?Cytokine profile varying with disease and maybe CRP. Who knows. Abst#1925 #ACR21 @RheumNow https://t.co/JIH3qwkLpx
Janet Pope Janetbirdope ( View Tweet)
Should we be measuring drug levels in pts taking infliximab?
⭐️Drug monitoring vs. standard dosing showed 73% sustained control vs. 55% (RA, PsA, SpA, UC, Crohn's, PsO)
#ACR21
Abs#1946
#ACRBest @RheumNow
https://t.co/sWMen50ljP https://t.co/F4Wpqis3id
Links:
Robert B Chao, MD doctorRBC ( View Tweet)
Machine learning algorithm demonstrated high level of accuracy (88%) and precision (0.95) in diagnosing potential cases of axSpA
⭐️Is there a role for ML to facilitate faster rheum eval for suspicious axSpA cases?
Abs#1922
#ACR21
@RheumNow
https://t.co/tAPfROPICU https://t.co/HJD37B9jZw
Links:
Robert B Chao, MD doctorRBC ( View Tweet)
Retrospective cohort study FORWARD databank :
⭐️ 🔼opioid use was associated with higher HAQ-DI and BASDAI scores among patients with PsA or AS
Annualized avg opioid use and costs 🔼with 🔼HAQ-DI and BASDAI scores for patients in both cohorts
Abst#1117 #ACRBest @RheumNow https://t.co/KB9QUITbAe
swethaann23 swethaann23 ( View Tweet)
SpA & Pregnancy Outcomes?
➡️SpA pts txed w/ bDMARDs at conception are not at higher risk for adverse pregnancy outcomes compared to those w/o bDMARD
➡️Stopping bDMARDs after conception assoc w/ ↑ dz activity during pregnancy + after birth & ↑flares
Abst#1730 #ACR21 @RheumNow https://t.co/Y4c7vI0cgS
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
All for one or one for all? Lumper or splitter? Highlight from #ACR21 was session 6S403 looking at axial involvement in AxSpa vs PsA. I share my thoughts here at https://t.co/i2nDvMklee @RheumNow https://t.co/62tRRiAcUJ
Dr. Antoni Chan synovialjoints ( View Tweet)
Dr. Atul Deodhar with an excellent presentation on treatment in axSpA and axPsA. Note ustekinumab and risankizumab did not show improvement in axSpA. However, these studies did not include axPsA.
@ACR21 6S403 @RheumNow https://t.co/F73lvpF2at
Pedro Castillo _Castillo_Pedro ( View Tweet)
Canadian study found no significant differences in effectiveness or tx survival among different TNFi, or in nr-axSpA or AS. Failure of 1st TNFi didn't diminish effectiveness or drug survival of additional TNFi. Abs 0938 #ACR21 #RheumNow @RheumNow https://t.co/u1efnfv2zA https://t.co/qsJw3nA9qn
Dr. Rachel Tate uptoTate ( View Tweet)
Work participation in patients with axSPA
Patients w/ axSpA often have increased absence from work as well as reduced productivity at work, which can lead to wider economic & social burden.
Dr. Dey (@DrMiniDey) discusses abstracts from #ACR21.
https://t.co/eAMLPR2zoT https://t.co/NuIajGa7gx
Links:
Dr. John Cush RheumNow ( View Tweet)
RHEKISS registry: SpA pts on bDMARDs at conception are NOT at inc. risk for adverse pregnancy outcomes. Discontinuation of bDMARDs after conception is assoc'd w/ inc. dz activity during/after pregnancy & flare risk. Abs 1730 #ACR21 #RheumNow @RheumNow https://t.co/b2wI9GZios https://t.co/wsuvv3hF0v
Dr. Rachel Tate uptoTate ( View Tweet)
Post hoc analysis of pooled data from 19 clin trials on SEC & CV risk & systemic #inflammation in PsO, PsA, AS
📌Traditional CV parameters remained stable on all SEC treated grps
📌SEC sig. ⬇hsCRP & NLR
@RheumNow #ACR21 abs1835 https://t.co/iCaGFbXNXn
sheila RHEUMarampa ( View Tweet)
French study shows more than 75% of RA/SpA pregnancies resulted in a live-birth, BUT 50% of pts had at least one unfavorable pregnancy outcome! However, miscarriage prevalence lower than in reported literature. Abs 1724 #ACR21 #RheumNow @RheumNow https://t.co/64PspIKPTu https://t.co/LyfHVARAgd
Dr. Rachel Tate uptoTate ( View Tweet)
SERENA interim analysis on interruption of secukinumab in AS and PsA
🔹>=16 wks of Rx before interruption of >= 3 mo.
🔹75-80% of pts reinitiated w/o loading phase
🔹AS: BASDAI, PGA stable
🔹PsA: SJC, TJC returned to Rx baseline
https://t.co/3G6rVW8TPv
#ACR21 Abst#1361 @RheumNow
Pedro Castillo _Castillo_Pedro ( View Tweet)
Have you heard of pSpA? (Peripheral) pSpA: distinct clinical phenotype w/ intermediate features between pure PsA & pure axSpA but w/ a higher disease burden compared to both diseases, & lower use of b-DMARDs. Abs 1787 #ACR21 #ACRbest #RheumNow @RheumNow https://t.co/Wsysm7A0Y3 https://t.co/rwQ8ukBEDq
Dr. Rachel Tate uptoTate ( View Tweet)
