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Is #IL1 inhibition for 4 months a winner in #GCA —NOPE
Anakinra daily 100mg sc 4/12
Underpowered but equal relapses and d/c #steroids not different
#relapses esp after d/c #anakinra
N=30 d/c due to #COVIDpandemic
#1699 #ACR24 @RheumNow @ACRheum https://t.co/1TgloS5x8O
Janet Pope Janetbirdope ( View Tweet)
#HRT is not much of a risk of
Breast cancer
Compared to
A drink a day of #ETOH
#ACR24 @RheumNow @ACRheum https://t.co/LFgqbFocpb
Janet Pope Janetbirdope ( View Tweet)
de Boysson et al. RCT anakinra in GCA. 30 patients. Week 52 relapse 53% in anakinra vs 46% in placebo. @RheumNow #ACR24 Abstr#1699 https://t.co/sqDWUlkXAX
Richard Conway RichardPAConway ( View Tweet)
Sarilumab is better than #MTX in #PMR
Reminder #RCT of #MTX in #PMR was a NEGATIVE #trial #1697
60 % #sarilumab in #RWE could d/c
#Prednisone after failure of initial #pred #Rx >1yr pred prior vs 40% MTX
Comparative effectiveness sari v MTX
#1700 #ACR24 @ACRheum @RheumNow https://t.co/4YXIBz0OK7
Links:
Janet Pope Janetbirdope ( View Tweet)
A retrospective analysis by Dr. ERayens et al showed that RA pts >/=50y given 2 RZV doses were less likely to develop HZ vs. unvaxxed grp
Incidence of PHN was also lower in the vaccinated group (0.2py vs.1.9py)
RZV is effective in preventing HZ & PhN
@Rheumnow #ACR25 abs0977 https://t.co/JhYBYnLmhl
sheila RHEUMarampa ( View Tweet)
Bolhuis et al. PMR MODE study. MTX 25mg/week in recently diagnosed PMR. 52 weeks. 56 patients. Nada, zip, no effect. GC free remission 67% vs 68%. No difference in any secondary outcome. @RheumNow #ACR24 Abstr#1697 #ACRbest https://t.co/Mb909u1zFT https://t.co/dShyBF4WST
Links:
Richard Conway RichardPAConway ( View Tweet)
RA-ILD:
💡Lifetime prevalence seems low but ~40% can have subclincal.
💡Screen early in symptomatic pts.
💡RA disease control decreases ILD progression and mortality.
💡RA-ILD UIP pattern seems to respond to immunosuppression.
#ACR24 @RheumNow https://t.co/q3iACMeYVU
Links:
Adela Castro AdelaCastro222 ( View Tweet)
When you stop 🛑 #TCZ #tocilizumab at
6 months of #Rx in #PMR
RELAPSES are V high
DON’T stop #Toci in PMR too
Early
Rapid and frequent flares
#ACR24 @RheumNow @ACRheum #1698 https://t.co/IX5EJOcIY5
Janet Pope Janetbirdope ( View Tweet)
This will change my practice!
#RCT #MMF + #MTX
superior to
#Cyclophosphamide then #Azathioprine
In
#Tayakasu’s #arteritis N=150
RCT ~1g BID #mycophenolate + 15mg/wk #Methotrexate
Vs #cyclo ➡️100mg #azathioprine
All got #glucocorticoids
#ACR24 @RheumNow @ACRheum #1696 https://t.co/OpRep1vsmx
Janet Pope Janetbirdope ( View Tweet)
Safer and less relapses in
#Takayasu’s #arteritis
In
#MTX + #MMF
Vs
#Cyclo ➡️ #azathioprine
@RheumNow #ACRBest @ACRheum abst#1696
WOW 😮 Amazing! https://t.co/y3BDjdAa6P
Janet Pope Janetbirdope ( View Tweet)
Can we use MTX+MMF to treat active #TAK rather than CYC?
➡️MTX+MMF vs CYC/AZA over 52W
MTX+MMF had:
⬆️Better efficacy in inducing & maintaining remission
❕Comparable safety to CYC/AZA
⏩This combination may prove preferable to using CYC
Ab1696 #ACR24 @RheumNow https://t.co/S0A8YNk3qL
Mrinalini Dey DrMiniDey ( View Tweet)
#Methotrexate is a dud in #PMR for benefit above #glucocorticoids !
#RCT MTX25mg/wk + Pred 15
Mg/d tapered to 0 at 1 yr vs #Prednisone + placebo same taper
NO BENEFIT from #MTX
#1697 #ACR24 @ACRheum @RheumNow
As FYI
Poster at #EULAR observed
#Leflunomide better than #MTX https://t.co/RepBmOKIsA
Links:
Janet Pope Janetbirdope ( View Tweet)
Very neat simulated model of GC regimens in AAV pt on fixed RTX by @zach_wallace_md and co
Over 5 years:
- No difference in relapse btwn standard GC vs. minimal GC + avacopan
- Higher DMII rates in standard group
Adds to trial + real world data
@RheumNow #ACR24 Abst 1598
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Belimumab, anifrolumab and voclosporin exhibited an increase in claims from 2017-2022 for #SLE
Belimumab ~ 600% increase!!
@RheumNow #ACR24 abst#1259 https://t.co/norl1xk2KF
Bella Mehta bella_mehta ( View Tweet)
#SLE treatments #ACR24:
Compared efficacy & safety of belimumab vs. telitacicept (targets B-lymphocyte stimulator (BLyS) and proliferation-inducing ligand(APRIL))
Both improved disease activity with no difference in efficacy
Belimumab had lower infection rates
@RheumNow abst1544
Bella Mehta bella_mehta ( View Tweet)
More data from PAISLEY, deucravacitinib in SLE
Small but significant benefit w/respect to joints, a little disappointing tbh
Would like to see this for all manifestations ie pericarditis, pleuritis, etc
Anyone have an infographic or useful chart?
#ACR20 @RheumNow Abstr#1552 https://t.co/tXUoUtssxo
Links:
Mike Putman EBRheum ( View Tweet)
Low uptake of SGLT2i in Lupus nephritis
SGLT2i users had similar adverse event rates as ACEi/ARB users
SGLT2i users experienced more weight loss
#ACR24 @rheumnow abst#1534 https://t.co/tB5o7tyhu5
Bella Mehta bella_mehta ( View Tweet)
Study on SLE treatments:
Compared adverse events of anifrolumab vs. belimumab
Similar risks for mortality, sepsis, herpes zoster, dialysis, MACE, PE/VTE, COVID-19, URI, pneumonia, and mental illness #ACR24 @RheumNow abst#1527
Bella Mehta bella_mehta ( View Tweet)
Alright help me out here; this is pretty implausible, right?
Why would be pts be 11% more adherent to UPA? What's the bio-plausibility here? UPA 10% better than other JAKs?
Could do a network meta analysis; betting this doens't replicate
#ACR24 @RheumNow Abstr#1362 https://t.co/vpPq3vu9Wf
Links:
Mike Putman EBRheum ( View Tweet)
No Increase in Cardiovascular Events with JAK Inhibitors in IBD Patients
UMKC researchers have compared the use of JAK inhibitors versus tumor necrosis factor (TNF) blockers in inflammatory bowel disease (IBD) patients, but failed to see an increase in major adverse… https://t.co/IOzckJIfYf https://t.co/8S6FnffVLG
Dr. John Cush RheumNow ( View Tweet)
