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Taking AI Out of AutoImmunity: Predicting disease before it develops
the predictive value of a positive ANA test—especially in the absence of other clinical symptoms—remains a challenge. A positive test often leads to further testing, yet it does not necessarily indicate whether a patient truly has an underlying autoimmune disease. The development of AI and machine learning algorithms presents an opportunity to interpret autoantibody tests and predict autoimmune diseases. Here are three studies looking at this issue.
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Where there’s smoke, there’s flare: how pollution fuels RA
Associations between air pollution and disease activity in rheumatoid arthritis have previously been demonstrated. Abstract 0978 sought to determine the association between fire smoke and other pollutant exposures with the risk of RA and RA-associated interstitial lung disease (RA-ILD).
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#2222
📊 New data on #RA-ILD:
🔴In early RA, ILD prevalence hits 21.4% after 10 years, with 8.2% cumulative incidence at 5 years (IR 14.9/1000 PY).
🔴ILD often precedes or coincides with RA onset.
🔴NSIP > UIP
🔴airway involvement less common than expected.
#acr24 @RheumNow
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
RA patients affected by frailty at a younger age
in @VARA frailty associated with lower BMD
But frailty is modifiable!
#GeriRheum
#ACR24 @RheumNow ABST#2140 https://t.co/BoTGoESB43
Jiha Lee JihaRheum ( View Tweet)
RheumNow’s expanded coverage of #ACR24 is sponsored in part by Bristol Myers Squibb and UCB. All content is chosen by RheumNow & its faculty
Dr. John Cush RheumNow ( View Tweet)
Risks for HCQ cardiotoxicity:
👉>5 yrs use
👉>5 mg/kg/d (cumulative dose >500,000 mg)
👉CKD
👉use NSAID
👉preexisting heart dz
👉presence of ocular, derm, SkM toxicity
- Dr M Garschik #ACR24 @rheumnow https://t.co/LFobgls4jm
Links:
TheDaoIndex KDAO2011 ( View Tweet)
Study of 25K+ patients using TrinetX on immune checkpoint inhibitors shows no significant mortality difference between those with pre-existing autoimmune disease (AID) and those without.
Mortality rates:
AID: 39.8%
Non-AID: 40.2%
Large-scale evidence supports ICIs in AID… https://t.co/BI5jK9jsoM
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
A#2531 @AlisaMueller
CRISPR deletion of fibroblasts, gave cytokine activation to mimic inflamm
Are there gene depletions that affect inflamm pathways?
👉SIX1 reduces inflamm potentiation
👉NFIL3 deletion promotes inflamm, degradation
@RheumNow #ACR24 https://t.co/Nqghb5UaBR
Links:
Eric Dein ericdeinmd ( View Tweet)
A#2532
Pre-existing AID for immunoRx?
Excluded from trials
4 prior studies showed no diff in mortality w AID
Propensity-matched cohort study
Followed median 250 days
Hazard ratio: 1.07 (unmatched), 0.97 (matched) - no diff. Mortality about 40% in grps
@RheumNow #ACR24 https://t.co/zyVCPts6s6
Links:
Eric Dein ericdeinmd ( View Tweet)
If a mother has had TNFi during pregnancy, can a baby have a live oral rotavirus vaccine (usually at 2mo)?
This claims data suggests no increase in diarrhoea
Adds to similarly reassuring 🇨🇦prospective cohort data https://t.co/2Tz9zRhPjz
Vaccinate away!
#ACR24 ABST0806 @RheumNow https://t.co/66OIAR8W6l
Links:
David Liew drdavidliew ( View Tweet)
We know most preexisting autoimmune disease is very mangaeable when checkpoint inhibitors are needed.
So great to see that, in the VA, autoimmune disease pts largely haven't missed out on potentially lifesaving cancer immunotherapy.
Keep on reassuring!
#ACR24 ABST1985 @RheumNow https://t.co/ApOACBLi4K
David Liew drdavidliew ( View Tweet)
Lung ultrasound for ILD in SSc/IIM would be great, no radiation and by the bedside - but a lot of skill required to interpret in reality.
Maybe AI/computer vision can come to the rescue?
Some nice models @StanfordRheum - will be watching this space!
#ACR24 ABST1965 @RheumNow https://t.co/0uXBSVSE4c
David Liew drdavidliew ( View Tweet)
RheumNow Day 2 Recap: ACR Convergence 2024 Highlights https://t.co/YAwOEaNsWs
Links:
Dr. John Cush RheumNow ( View Tweet)
RheumNow’s expanded coverage of the #ACR24 Annual meeting is sponsored in part by Novartis. All content is chosen by RheumNow & its faculty
Dr. John Cush RheumNow ( View Tweet)
What a result!!!
Crowed split 49% against and 51% for MCTD as a unique disease entity
Given pre-debate poll of >70% for MCTD, looks like an overall win for the “NOT” group
Fantastic session from all the presenters
@RheumNow #ACR24 https://t.co/GgTVQ1VNWP
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
🔶Clinical Year in Review #ACR24 🔶
Talk By @MHPillingerMD
• Review some of the most impactful studies in Rheumatology from the past year!
#RheumTwitter #Rheumatology https://t.co/1ULDB2l4gX
Mithu Maheswaranathan, MD MithuRheum ( View Tweet)
How does #race & #ethnicity impact mortality in RA?
Study in CDC national mortality database
➡️RA mortality differed by race & ethnicity
➡️Highest premature mortality in Native Americans
Findings may be used to inform resource allocation & management
Ab1747 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
Wu et al. MDA5-DM. Propensity-score cohort study. 672 patients. Tofacitinib vs CNI. Primary outcome 1 year death or lung transplant. HR 0.70 favouring tofacitinib. @RheumNow #ACR24 Abstr#1736 https://t.co/A0aHhp1q9c https://t.co/LbutJDBllr
Links:
Richard Conway RichardPAConway ( View Tweet)
Can we do more to routinely assess fracture risk in RA?
In RA pts ≥65, hip fracture & MOF are more common in pts with active disease, worse with higher disease activity
➡️Need better and more frequent bone health assessments in our RA pts
Ab1748 #ACR24 @RheumNow https://t.co/whfnLnkpLd
Mrinalini Dey DrMiniDey ( View Tweet)
A#1747
RA mortality by race/ethnicity
Database study
>200,000 pts had RA as contributing cause of death
5.1 ASMR in American Indian >>> all other groups
No decr over time in grp, unlike other grps
Odds of death 1.67 compared to white pop
10.8x higher in pts <44
#ACR24 @RheumNow https://t.co/nXLcQkQPu4
Links:
Eric Dein ericdeinmd ( View Tweet)
