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Interesting study on 5yr CV event risk in early #rheumatoidarthritis pts who received T2T mgt shows no difference in CVE risk in ERA grp vs control
ERA cohort:
> Longer remission = protective for CVE
> ⬆ HAQ = predictive of CVE
Tighter control, ⬇ CVEs
@RheumNow #ACR21 abs0282 https://t.co/GG7HPvWd0r
sheila RHEUMarampa ( View Tweet)
Excited for the first full day of #ACR21, reporting for @RheumNow!
Esp looking forward to:
⭐Posters: #Epidemiology, #PublicHealth, #COVID19, #SpA, #RheumatoidArthritis, #PatientOutcomes
⭐Plenary session
⭐Scientific sessions covering #axSpA, #PsA and more
Mrinalini Dey DrMiniDey ( View Tweet)
How much ritux for AAV maintenance?
Ever since we started using it, no-one's been sure.
If absolute B cell depletion is your goal, @VUMCRheum data suggest >3.3mg/d is safest for that
500mg q6m = 2.7 mg/d
500mg q4m = 4.1 mg/d
1000mg q6m = 5.5mg/d
#ACR21 ABST0416 @RheumNow https://t.co/mYAgKhHT7j
David Liew drdavidliew ( View Tweet)
Dr. Chambers review @MotherToBaby prospective data on HCQ use in pregnancy (n=279):
👉no major defects (regardless of dose)
👉no oral clefts
👉SGA slightly lower in exposed group b/c of underlying dz
👉no case of retinopathy in babies after 1 year f/u @rheumnow #Pregnancy https://t.co/vw2eryFgro
TheDaoIndex KDAO2011 ( View Tweet)
Abst#271 #ACR21. RA activity predicts left ventricular mass change in pts without CVD
⭐️35% had abnormal LV geometry at baseline TTE
⭐️55% at f/u TTE 3-6 years later
⭐️Increase in concentric remodeling on LV
@Rheumnow https://t.co/uHnqITcTy9 https://t.co/KmV8volVwd
Links:
Eric Dein ericdeinmd ( View Tweet)
@DrDDRheum presents on uveitis in SpA. AxSpA>PsA, 30% vs 7.6%. PsA: B27+⬆️ risk, smoking ⁉️ and DMARDs protective. AxSpA: Elevated CRP⬆️ risk, biologics protective. Abstr#0064 #ACR21 @RheumNow https://t.co/psw20RGDst
Richard Conway RichardPAConway ( View Tweet)
Dr. Chambers reviewed @MotherToBaby data of pregnant rheum women during the pandemic noted:
⬆️EtOH use in pregnancy,
⬆️stress, anxiety, depression
⬆️obesity
⬇️likelihood to get prenatal care
#ACR21 @rheumnow #RheumPregnancy https://t.co/GCYCIuiunS
TheDaoIndex KDAO2011 ( View Tweet)
#ACR21 Abst#0276:
Pulse pressure (PP) = Systolic BP - Diastolic BP, measures arterial compliance
⭐️RA: higher PP than controls
⭐️PP was independent risk factor for subclinical atherosclerosis
▶️ Look at the vitals, we have this at every pt visit!
@Rheumnow https://t.co/KZaf1AwO6Q https://t.co/kN4xGxWiV9
Links:
Eric Dein ericdeinmd ( View Tweet)
It's what's below the surface that's most scary.
see: RA & the heart
- why do RA pts without cardiovasc dx/Sx get LV remodelling over time
- why is it worse with worse RA control?
RA goes deeper than the joints & our pts need to hear that!
@Columbia #ACR21 ABST0272 @RheumNow https://t.co/NDHLZwoEjy
David Liew drdavidliew ( View Tweet)
Dr Springer on pharmacological response of RTX in ANCA-vasculitis. Suggest that 500mg every 6 months may not achieve sufficient B cell depletion in all. What are the clinical implications? Is anyone dosing 500mg as standard? Abstr#0416 #ACR21 @RheumNow https://t.co/w36hSYbW1B
Richard Conway RichardPAConway ( View Tweet)
Some great #SpA posters on #WorkParticipation
#ACR21
Abs#0358
•~700 pts
•379 (64.2%) took sick leave in last 12m
•#Absenteeism in 23.7% & #presenteeism in 84.1%
•Huge impact on work participation in SpA despite incr no. of therapeutic agents
@RheumNow
https://t.co/pwz4s8D1FU https://t.co/wpbjeXNpgm
Mrinalini Dey DrMiniDey ( View Tweet)
Despite >20y of bDMARDs, our patients still have a 50% greater risk of cardiovascular issues
(similar to family history or abdominal obesity)
Cardiovascular disease in RA is not historic, it's today's reality we too often ignore.
2020 data @VUamsterdam #ACR21 ABST0286 @RheumNow https://t.co/Az4wHNUOGe
David Liew drdavidliew ( View Tweet)
Meta-analysis from @rheum_covid with @HsiehEvelyn shows that people with rheumatic disease are at⬆️risk of SARS-CoV-2 infection and⬆️mortality from COVID-19. Abstr#0086 #ACR21 @RheumNow #ACRBest https://t.co/B7tWs02gfc
Richard Conway RichardPAConway ( View Tweet)
#ACR21 Abst#0284. RA and Dementia?
⭐️1366 pts with RA, retro pop-based cohort
⭐️Risks: older age, diabetes, CVD.
⭐️Large joint swelling swelling HR 2.2 (1.2-3.9). No significance by RF/CCP/ESR/erosions/nodules
▶️CVD risks appear > RA activity
https://t.co/2uN2lBs4tr @Rheumnow https://t.co/HEOXPosE5Z
Links:
Eric Dein ericdeinmd ( View Tweet)
Diabetes puts you at risk of cardiovascular disease, right?
What about RA?
Look at this graph and compare the pair.
"already it was impossible to say which was which” - George Orwell, Animal Farm
#ACR21 ABST0287 @RheumNow https://t.co/r0yaeC530l https://t.co/mKJhoyJ2Cn
David Liew drdavidliew ( View Tweet)
Study by @BethIWallace @Tuhina_Neogi shows that we seem to treat fibromyalgia symptoms with steroids in RA patients. Its a bad idea in fibromyalgia, and has got to be bad practice in RA too. Abstr#0120 #ACR21 @RheumNow
Richard Conway RichardPAConway ( View Tweet)
#ACR21 Abst#0271. ⬆️ Risk of carotid atherosclerosis in first few years of RA diagnosis. Authors recommend routine carotid screening in pts at time of diagnosis.
Q: would you routinely screen all patients at time of diagnosis?
@Rheumnow
https://t.co/A9akqyVRGF https://t.co/SYGkJHQzWf
Links:
Eric Dein ericdeinmd ( View Tweet)
PsA bDMARD use in Australia🇦🇺
(where once you qualify for a bDMARD in general, it's the physician's free choice)
1. cool Sankey diagram showing switches
2. given the chance, people switch in all directions & switch hard
(registry linked with insurance)
#ACR21 ABST0201 @RheumNow https://t.co/jcVPa8jXsR
David Liew drdavidliew ( View Tweet)
COVID-19 has been tough on everyone, but especially tough on our patients in rheumatology.
We need to think about the long-term impacts, but also about how we can do it better next time.
@HSpecialSurgery #ACR21 ABST0266 @RheumNow https://t.co/JdOqZ8Svin https://t.co/c0rlY9PfDv
David Liew drdavidliew ( View Tweet)
STEP-KOA trial: a promising intervention for knee #osteoarthritis?🤔
@RheumNow #ACR21 #YearinReview https://t.co/6Vkx0WR0tx
sheila RHEUMarampa ( View Tweet)