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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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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
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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
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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
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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)
5 yr multinational PROOF study - enrolled 1612 axSpA pts enrolled (65% xray+ axSpA; 35% nr-axSpA) nraxSpA had more enthesitis, PSO IBD. Over time, more TNFi use (less NSAIDs) w/ less disease activity #ACR21 Abst #0363 https://t.co/5DdDlCjq9h (Graph: NSAID use over time) https://t.co/5JE69vTIy9
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Dr. John Cush RheumNow ( View Tweet)
Pregnant pts w/ PsA, but not AxSpA, at increased risk of pre-eclampsia. In RA pregnancies, pre-eclampsia risk increases w/ dz severity prior/during pregnancy. We need to discuss potential risks w/ pts and OB team. Abs 1722 #ACR21 #RheumNow @RheumNow https://t.co/yeQmNAZ1jV https://t.co/cBfeVKQHfr
Dr. Rachel Tate uptoTate ( View Tweet)
Upadacitinib showed similar efficacy in AS pts compared to PsA pts with axial involvement
⭐️PsA pt w/ axial involvement and AS pts with differences in baseline characteristics
#ACR21 @RheumNow
Abs#1802
https://t.co/QvyayelBYU https://t.co/50dNQm30vf
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Robert B Chao, MD doctorRBC ( View Tweet)
Fr AQUILA study: #Uveitis status in AS or PsA pts given SEC
👁🗨3 pts w/o uveitis at BL developed new onset uveitis during study
👁🗨Most pts w/uveitis at BL - status remained unchanged or improved
👁🗨SEC did not ⬆ risk of uveitis
@RheumNow #ACR21 abs1738 https://t.co/IGUpgXBLvt
sheila RHEUMarampa ( View Tweet)
