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#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)
Abst#0276:
Pulse Pressure (PP) can predict carotid plaque in RA!
➡️PP (SBP – DBP) assoc w/ subclinical CVD in gen populat. How about in RA?
⭐︎ RA pts had higher PP than controls
⭐︎ PP = only independent RF for subclinical athero
#ACR21 @Rheumnow https://t.co/esLDW8iggf https://t.co/6d2D9hXC1i
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Nintedanib open-label extension study in PF-ILD (progressive fibrosing)
- active arm continuing: similar rate of change as RCT (78 v 77)
- placebo arm initiating: similar as well
Missing data (COVID-19) but effect appears related to exposure
INBUILD-ON #ACR21 ABST0186 @RheumNow https://t.co/hWe7ypbex6
David Liew drdavidliew ( View Tweet)
Abst#0269: Autoabs confer risk of incident CVD in US ⚦ veterans w/ RA
⭐︎ MACE risk: ↑ concentrations of RF (HR 1.15) & malondialdehyde acetaldehyde (anti-MAA) (HR 1.2)
⭐︎ CVD Death: ↑ concentrations of CCP (HR 1.27) & anti-MAA
#ACR21 @Rheumnow
https://t.co/UeOz91Bh3P https://t.co/PJwP1H4eNk
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
How it started How it's going
inspirational talk @DzifaDey, building rheumatology up in Ghana, smart solutions across all domains, and scaling up to help across West Africa
#ACR21 'Challenges & Innovation in Global Rheumatology' session @RheumNow @TheLancetRheum https://t.co/9aG6pes4qy https://t.co/wo6f90ocEP
David Liew drdavidliew ( View Tweet)
💻 Telemedicine: would you rather have a telephone or a video clinics? Non inferiority RCT shows 80% satisfaction rates and phone-only non-inferior to video visits. I would have expected patients to prefer video visits 🧐 #ACR21 #Abst0112
@RheumNow https://t.co/klgMJ6EthH https://t.co/17ffTAZCfv
Aurelie Najm AurelieRheumo ( View Tweet)
#ACR21 Abst#0269
⭐️TCZ: ⬆️cholesterol, LDL, TG. ⬇️ hsCRP compared to TNFi. No ⬆️ risk of Reynold risk score (RRS)
Take-away: good data on TCZ effect on lipids, but I wouldn't use RRS to calculate CVD risk on med that ⬇️ CRP @Rheumnow https://t.co/zMltktfHkS https://t.co/bwKXiGIi8a
Links:
Eric Dein ericdeinmd ( View Tweet)
#Abstr0076 #ACR21 Can we predict #thrombosis in #lupus patients? Predictors of serology transition at 5yrs:
✅LAC+ to LAC-:Afro-American,HCQ and normal C3
⛔️LAC+ to 🩸Clot:Obesity, low C3 and not on HCQ
Data need in those with Triple Positivity @RheumNow https://t.co/byeL5NjVUS https://t.co/CchtZir2GN
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)