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Are Emulation Trials a Fantasy?
Are emulation ‘trials’ helpful, despite the biases that occur with observational data, or do they truly mimic the results of randomized controlled trials (RCTs)?
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ACR 2024 - Day 1 Report
ACR Convergence 2024 opened today with a full slate of presentations, posters and specialty meetings. The meeting began with a flip: the plenary sessions started at 9AM and the poster session began at 1030 AM. Below are some of the highlights from day one in Washington, DC.
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Is Pregnancy Truly the Solution for RA?
Pregnancy is perhaps the oldest treatment in rheumatoid arthritis (RA) and has been associated with a natural improvement in disease control in 50-75% of patients. Others, however, are not as successful with unchanged disease activity or worsening of their autoimmune disease.
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#1375🏋️♀️ Strength Training in RA
➡️ 12-week trial 28 ♀️
High-intensity(HIRT) v. Low-intensity+blood flow restriction(LIT-BFR)
🔴Equivalent gains:Lat-pulldown, biceps curl
🔴Knee extension:HIRT>LIT-BFR (non-significant)
✅ LIT-BFR: Alternative for RA sarcopenia
#ACR24 @RheumNow
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Is participation in RISE assoc with improved quality of care?
➡️Enrolment assoc w ⬆️performance in several quality measures
➡️Most marked in practices with lower baseline performance
⏩Registry participation has potential to improve quality of rheum care
Ab1644 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
#1326
🔬 Predicting Imminent Inflammatory Arthritis
➡️543 anti-CCP+ at-risk (high/low) tracked
🔑Predictors for IA in high-risk:
🔴EMS≥30min(OR 11)
🔴RF+(OR 6)
🔴US PD(OR 5)
🔴smJTC (OR 5)
🔑Predictors for IA in low risk:
🔴RF+(OR 8)
🔴Anti CCP >3xULN(OR 7)
#ACR24 @RheumNow https://t.co/ou9HNcNb8X
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Improved fertility in women with RA when treated with a Treat-to-Target (T2T) approach aimed at remission.
Key findings:
- Shorter time to pregnancy (TTP) in PreCARA cohort (84 days) vs. PARA cohort (196 days).
- Increased TNF-inhibitor use and lower NSAID/prednisone use in the… https://t.co/YyD2lpXVRC https://t.co/LH5LMOH8al
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Half of the respondents chose #IL17i for #psoriatic #arthritis #PsA Rx for #Achilles #tendonitis
Interesting as lots
Of data
On #enthesitis wIL23i
Likely all
Effective #PsA Rx helps #tenosynovitis
some have
➡️ data on #efficacy
⬆️ bio rationale
#ACR24 @RheumNow @ACRheum https://t.co/wzefjsfdaj
Janet Pope Janetbirdope ( View Tweet)
Dr @andreafava presents their noninvasive biomarker panel that predicted the probability of histologically active LN.
Panel outperformed UPCR, C3, C4 & antidsDNA.
Aid in clinical-decision making? Lots of potential for monitoring tx response.
@Rheumnow #ACR24 abs1642
#ACRbest https://t.co/C7ZNdvbIQ7
Links:
sheila RHEUMarampa ( View Tweet)
In the @ACRheum MSK Ultrasound Guidance:
In difficult-to-treat RA, MSUS can distinguish symptoms of active synovitis from other sources of pain.
(consensus: mod)
CURRENTLY do you often use ultrasound when RA gets difficult to treat, and synovitis isn't obvious? #ACR24 @RheumNow
David Liew drdavidliew ( View Tweet)
One situation I've seen MSK ultrasound have impact ++ in the real-world is showing patients their own RA disease activity.
Arthritis might be the invisible disease sometimes, but seeing it in full Doppler colour on screen means a lot to many.
#ACR24 MSK USS Guidance @RheumNow https://t.co/wd9s6FAfp4
David Liew drdavidliew ( View Tweet)
The @ACRheum RA outcome measures toolkit has all the relevant tools for measuring outcomes in rheumatoid arthritis (and exactly how to do it).
https://t.co/GZ7tZ6fNMK
Great for all US rheumatologists, but also very handy for all of us globally
#ACR24 16S30 @JYazdany @RheumNow https://t.co/MSHA353MKR
Links:
David Liew drdavidliew ( View Tweet)
RheumNow Day 1 Recap: ACR Convergence 2024 Highlights https://t.co/xjCMpzXhTE
Links:
Dr. John Cush RheumNow ( View Tweet)
Race of b/tsDMARDs in RA, the “JAK-pot” study.
JAKi and TNFi with more rapid early improvement in CDIA, HAQ, and pain compared to ABA or IL-6 inhibitors…..although effects blunted after adjusting for patient and RA characteristics
#ACR24 @RheumNow ABST#0501 https://t.co/8M4wX3LAbW
Jiha Lee JihaRheum ( View Tweet)
How does #cardiovascular risk vary with #ACPA & #biologics in #RA?
⬆️BMI assoc with ⬆️MACE risk in ACPA+ pts
In ACPA- pts, BMI inversely assoc with MACE risk among pts on biologics
Further evidence to consider ACPA, BMI & MACE as part of RA management
Ab0870 #ACR24 @RheumNow https://t.co/UkkC146DWS
Mrinalini Dey DrMiniDey ( View Tweet)
Cross-sectional study finds metabolic dysregulation in RA-ILD is indicative of poor prognosis- FGF-21 assoc w. poor survival.
Another link btwn CV risk factors, metabolic syndrome & RA? Should we be doing more to manage metabolic risk factors in RA-ILD?
Ab0803 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
Not just the presence but higher levels of biomarkers predict RA-ILD progression.
#ACR24 @RheumNow ABST#0804 https://t.co/5jhBjXDUeY
Jiha Lee JihaRheum ( View Tweet)
Medication-assisted weight loss has boomed in recent yrs. How does weight loss affect disease activity & PROs in RMDs?
≥5% weight loss, after taking a med, led to better disease activity & QoL
Data may inform RCTs to explore effect of these meds in RMDs
Ab0845 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
Don’t miss the “window of opportunity” for aggressive treatment in early RA!
with active RA, risk of ILD 6x and RA-related lung disease 4x higher
#ACR24 @RheumNow ABST#0802 https://t.co/yxlfInte6A
Jiha Lee JihaRheum ( 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)
