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Difficult to Manage Axial Spondyloarthritis
Studies show that patients with difficult-to-manage axSpA have a higher disease activity; however, the lack of a consensus definition led researchers and clinicians to utilize their own proposed definition, resulting in variability of the characteristics of non-responders.
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How Online Searches Reveal Patient Needs
Managing health conditions is rapidly evolving as patients increasingly turn to online resources for answers—over 65% search for health-related questions online. Our study analyzed Google search trends for rheumatic disease topics, offering a fascinating glimpse into how online search behavior can reveal patient needs and experiences. This approach, known as "infodemiology," tracks real-time Google Trends data to understand symptom- and treatment-related searches for rheumatic conditions.
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Abstract #0805
Data from OTIS Registry shows Certolizumab pegol (Cimzia) exposure during pregnancy was not associated with increased risk of major birth defects, structural defects, or adverse pregnancy outcomes. #ACR24 @RheumNow
Akhil Sood MD AkhilSoodMD ( View Tweet)
What's the assoc between RA disease activity & ILD?
Results @MassGenBrigham show early active RA is assoc with
➡️6x incr risk of #ILD
➡️4x incr risk of RA-related lung disease
Early DMARDs are vital to reduce articular & extra-articular manifestations!
Ab0802 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
❔Can rheum drugs have beneficial effects on cognition?
💊Possible benefits with MTX and TNFis but certainly an active area of research and more studies needed
#ACR24 @RheumNow https://t.co/lCnIRLwNjK
Mrinalini Dey DrMiniDey ( View Tweet)
Ab#0458 #ACR24
10 year outcomes of 176 patients with seroneg RA
32 pts (18%) had change in dx - SpA (11), seropos RA (6), OA (5), crystal (3), CTD (3), Ifn-related/paraneopl/RS3PE, sarcoid (1)
40 (23%) had drug-free remission
30 (17%) started b/tsDMARD
@RheumNow
Eric Dein ericdeinmd ( View Tweet)
Langford et al. Abatacept NOT effective in GPA in ABROGATE RCT. 65 patients. Relapse/worsening in 62% vs 68%. No difference in any secondary end-point. @RheumNow #ACR24 Abstr#0823 https://t.co/yRFZ2diJFF https://t.co/LgXkPnDArE
Links:
Richard Conway RichardPAConway ( View Tweet)
A systematic review highlights the impact of glucocorticoids (GC) during pregnancy and lactation. Increased risks of preterm birth were noted with GC exposure, advocating for minimized doses and pregnancy-compatible treatments. Encouragingly, low levels of GC found in breast milk… https://t.co/7CnJUBrUDQ https://t.co/ZeGHFHNT13
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Does apremilast have cardiometabolic benefits?
Abstract 0598: In PsA patients, 1-year treatment with apremilast associated w/ ↓ body fat mass, including android fat, and was linked w/ improved disease activity (DAS28-CRP). #ACR24 @RheumNow https://t.co/11n4gQN7Xo
Akhil Sood MD AkhilSoodMD ( View Tweet)
Data from the study by Dr. Aguilar et al showed that high dose NSAID use was not assoc'd with incident HTN in their cohort of early axSpA patients.
Shows important role of NSAIDs in #axSpA but still should be used judiciously
@RheumNow #ACR24 abs540
@rheum_cat @rheumarhyme https://t.co/LK5yFZynu4
sheila RHEUMarampa ( View Tweet)
Dhir et al. RCT of increasing folic acid from 5-10mg per week to 15-35mg per week if MTX intolerance. No benefit! Although significant placebo response and folic acid is relatively benign. @RheumNow #ACR24 Abstr#0525 https://t.co/D3yfV6a8t6 https://t.co/QpDa1alvMz
Links:
Richard Conway RichardPAConway ( View Tweet)
Data from the French DESIR cohort reveals no significant link between high-dose NSAID use and incident hypertension in patients with axial spondyloarthritis. Two thirds were high dose NSAID users at baseline. Incident hypertension occurred in 11% individuals during follow-up.… https://t.co/EAICDwzxNT
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Pasoto et al. Holding MMF for 1 week after zoster vaccine (RZV) improves response with no increase in flare @RheumNow #ACR24 Abstr#0247 https://t.co/q757bMFp7I https://t.co/rwjz3q3MaO
Links:
Richard Conway RichardPAConway ( View Tweet)
Older adults with RA receive less DMARDs, the standard of care. Dr. Bruno Fautrel shows TOC tolerance in older adults is comparable to younger patients. Let's treat the patient, not their age! #ACR24 @RheumNow ABST#0516 https://t.co/054RWGh3a7
Jiha Lee JihaRheum ( View Tweet)
Small but useful open label RCT of MMF vs CYC vs TAC in SLE nephritis
Surprisingly similar rates of remission at week 24... suggests TAC could be an option for induction?
#ACR24 @RheumNow Abstr#0670 https://t.co/rO0ufturHW
Links:
Mike Putman EBRheum ( View Tweet)
Which immunomodulators dampen recombinant zoster vaccine immunogenicity?
In this 🇧🇷 study in autoimmune dx patients, overrepresented in non-responders are:
- rituximab pts
- 'combined therapy'
strategies needed for them
but reassuring for the others!
#ACR24 ABST0248 @RheumNow https://t.co/he1ICa9WZg
David Liew drdavidliew ( View Tweet)
Mycophenolate isn't great for vaccine immunogenicity, but withholding MMF for one week after both doses of recombinant zoster vaccine boosts Ab titres ++ in this Brazilian RCT.
A week off post-vaccine: definitely worth considering in stable disease
#ACR24 ABST0247 @RheumNow https://t.co/lajS5DzRbD
David Liew drdavidliew ( View Tweet)
It's been a wild ride over the last 20 years of RA b/tsDMARDs, and fascinating to see how our prescribing habits have changed over that time.
MarketScan data tell a story of fashion and fame. What will the next 20 years be like?
#ACR24 ABST0509 @jeffsparks @RheumNow https://t.co/wCcWgkHrvc
David Liew drdavidliew ( View Tweet)
Major update in tx for GCA beyond Toci
SELECT-GCA showed upadacitinib 15mg daily achieving higher rates of remission with SHORTER (26wk) steroid use compared to placebo (52wk)
No significant adverse safety signal w JAKi including MACE/malignancy
@RheumNow #ACR24 Abstract 0770 https://t.co/45D0Txed2N
Links:
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
#0509
📊 RA DMARD Trends in US (2001-2021)
🧑🤝🧑 407,728 DMARD starts in 229,365 patients
📉 csDMARD use fell (79.7% → 54.7%)
‼️Methotrexate dropped 29% → 15%
📈 bDMARDs (20.3% →33.1%),tsDMARDs (0.1% → 12.2%) both ⬆️⬆️
💊Biosimilar uptake low
#ACR24 @RheumNow @jeffsparks https://t.co/JepaWj7azY
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
