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Are Rheumatologists doing Enough for Cervical Cancer?
Should rheumatologists be counseling patients on cervical cancer prevention and screening?
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#Yr in #Preview #ACR2023 J Buyon
Pregnancies in #SLE have high #VTE risk - look at Ob/Gyn guidelines for prophylaxis of LMW #heparin - all SLE pregnancies recommend #ASA & #HCQ
biomarkers for #renal #lupus, #HCQ levels ?aid #Rx
-#SLE nephritis low prednisone
2 IS>1
@RheumNow
Janet Pope ( View Tweet)
#Hope for people with #SLE
Insights from #ACR23
#Lupus #nephritis - half the oral #prednisone is = to 1 mg/kg induction after IV #solumedrol LESS PRED
#Anifrolimumab reduces similarly skin, jts, other common organs in #SLE RCTS APPROX 2X improvement vs PBO
@RheumNow @ACRheum https://t.co/OtdfTxZxr4
Janet Pope ( View Tweet)
Frail pts with SLE is associated with 🔸prolonged hospitalizations (28.89%), 🔸significantly higher in-pt mortality (2.88%)
🔸fewer days-to-readmission (59.8%)
vs. non-frail pts with SLE
(CLeung et al)
Screen your SLE pts for frailty too.
#ACR23 ABST2590 @RheumNow https://t.co/c4YP5h2ypn
sheila ( View Tweet)
#ACR23 Abstr#2587 Can we agree on how to measure frailty in #SLE? A cohort study: moderate agreement at best among SLICC-FI, SPPB, FRAIL=>2 & PROMIS PF=<40. SLICC-FI was robust predictor of all outcomes except for cognitive impairment. FRAIL & PROMIS not far behind @RheumNow https://t.co/qWjM4crPvg
Md Yuzaiful Md Yusof ( View Tweet)
The Heart of Lupus
During ACR 2023 Convergence, several abstracts were presented evaluating the prevalence of CV disease and exploring new tools to predict CV disease. The ones that caught my eye included...
https://t.co/5Qk2fF3nlA #ACR23 https://t.co/Rja7K44BUf
Dr. John Cush RheumNow ( View Tweet)
COVAD2 data:
⬆️proportion of SLE pts from lmHDI countries were on CS(73% vs 59% p=0.0002), antimalarials(81% vs 68% p=0.0002) & IS(66% vs 53%p=0.0009) vs pts from hvhHDI countries
Comorbids more in younger pts from lmHDI (prob from CS use)
#ACR23 ABST2269 @RheumNow @rheumarhyme https://t.co/4CLGFYG1d0
sheila ( View Tweet)
L17 #ACR23 @RheumNow
Afimetoran TLR7/8 inhib for cutaneous lupus
Safety: No SAEs, mild-mod AEs, lower than PBO
Nasopharyngitis & bronchitis
Trough concentration consistent from D8 to 113, support 30 mg qd
CLASI change; MCDI 50% Afim v 0% PB, CLASI-50 Afim 50% v 0%
Inhib of IFNGS https://t.co/cKYY6rmIWE
Eric Dein ( View Tweet)
L17 @ #ACR23
New therapy on horizon for cutaneous LE (CLE)?
⭐️AFIMETORAN
➡️ TLR7/8 inhibitor
➡️1st-in-class orally bioavailable, potent
⭐️Phase Ib trial
➡️Criteria:
👉18-65 yo SLE vs biopsy proven CLE
👉CLE Dz Area & Severity Index (CLASI-A) at least 6
👉ANA… https://t.co/HPqw4d0AHl https://t.co/5u9aEvzdMb
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Telitacicept (BlyS/APRIL inhibitor) ph3 in RA
wholly in China, after SLE approval there (SLE trial now w global sites)
Efficacy okay, no better than other b/tsDMARDs
What's the hook here, in a crowded RA market incl biosimilars?
Safety does look good though
#ACR23 L20 @RheumNow https://t.co/UzQ0f18E2A
David Liew drdavidliew ( View Tweet)
ICYMI
Interesting study by Dr LWGarcia et al:
👉IFN-a serum levels predicted failure to respond to tx 2 years after a flare in pts w/ LN
👉Pts w/⬆️BL IFN-a levels had greater risk of having 2 or more subsequent flares
#ACR23 ABST2297 @RheumNow @ZahiTouma https://t.co/WJZnNUPUbT
sheila ( View Tweet)
Q for Rheumatologists:
How often do you counsel appropriate SLE patients about cervical ca screening and/or vaccination?
Re: PAPILUP Study A#1479 #ACR23 - shows PAP findings of HR-HPV+abnml cytology comparable to HIV+ pts
@RheumNow
Eric Dein ( View Tweet)
Agimeteran a TLR7/8i 30 mg in #cutaneous #lupus which differentiated from placebo. Small single site #RCT. Far more pts improved #CLASI by 50% vs PBO #ACR23 #ACRbest @RheumNow @ACRheum L15 In larger RCT now! https://t.co/zssjgpydVY
Janet Pope ( View Tweet)
Burden of flare & organ damage of SLE pts from the Asia Pacific cohort:
Prevalence of organ damage at BL - 39%
Incidence of damage accrual: ~58 per 1000PY
Pts w/ >=2 flares accrued damage
Flares independently⬆️risk of damage accrual
#ACR23 ABST2261 @RheumNow @rheumarhyme https://t.co/nW34sI9FdP
sheila ( View Tweet)
#ACR23 Abstr#2332 We need to compliment the Complement #SLE. Post-hoc analysis of SOC + PBO from Dapirolizumab Phase 2 RCT showed reduced response in patients who flared with low complement levels vs normal or persistent activity. To consider as a stratifier @RheumNow https://t.co/BcN6ExLD0s
Md Yuzaiful Md Yusof ( View Tweet)
Treatment of lupus nephritis #ACR23
Dall’Era M, Furie R, Mosca M
@RheumNow https://t.co/Md2DsOrY5F
Dr. Antoni Chan ( View Tweet)
Part 2: Clinical Year in Review #ACR23 https://t.co/Yb8Xh2UKFY
Mithu Maheswaranathan, MD ( View Tweet)
Lupus Nephritis and the Target with PR3+ in proliferative classes with more aggresive phenotype..
#Lupus biopsy.. #ACR23 https://t.co/fGJX57hWx4
dX.Martínez ( View Tweet)
Latest in Lupus Treatment at #ACR23
• Dr. Dall’Era & Dr. Furie
• Approach to Lupus Nephritis 🫘
• Treating Non-Renal SLE / Skin
#Lupus #RheumTwitter #Rheumatology https://t.co/sagVipdNJe
Mithu Maheswaranathan, MD ( View Tweet)
