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🌟 Join us for the Aging Strong session at #ACR24!
We are thrilled to have Dr Cynthia Boyd, division director of Geriatrics at Hopkins, visit us to discuss how to manage multicomplexity in older rheumatic patients.
#GeriRheum @RheumNow
@cynthiaboyd16 @UnaMakris https://t.co/QZpOmdgzOR
Jiha Lee JihaRheum ( View Tweet)
📈 Data from @UIowa_Rheum on how rurality impacts delay to diagnosis in #GCA
📍 0747
👉🏼 People living in more rural areas have an increased time to diagnosis & treatment- further prospective studies needed to delineate effects of rurality further
@RheumNow #ACR24
@LemonReneeNi https://t.co/3YMcI9ha3T
Mrinalini Dey DrMiniDey ( View Tweet)
Yokose et al. Population study using NHANES. Gout patients had 1.6 higher fold risk of gallstone disease. What? Why do we care? Well, GLP-1s associated with higher risk gallstones also... @RheumNow #ACR24 Abstr#0133 https://t.co/nf4R0hQe50 https://t.co/wDrEDeNbpT
Links:
Richard Conway RichardPAConway ( View Tweet)
🧬 #SLE patients show major community mobility limits: 50% don't leave their neighborhood weekly without help. Life Space Assessment finds lower mobility vs. other chronic conditions. Better mobility linked to higher SES & lower disease activity. @RheumNow #ACR24 abst#0145 https://t.co/2sfXNlJ9JD
Bella Mehta bella_mehta ( View Tweet)
Pharmacologics:
Cannabis absorption and metabolism is variable
Inhaled absorption 10-35%
THC is 97% protein bound, lipophilic and deposits in fat and spleen
Liver function is critical for THC metabolism
16S18 @BharatKumarMD
#ACR24 @RheumNow
Eric Dein ericdeinmd ( View Tweet)
IV or inhaled THC:
Works quickly with high peak, feel euphoric but not sustained response
Oral is much better for medicinal usage
@RheumNow #ACR24 https://t.co/3PatgEFjZh https://t.co/wrrLMpfL5D
Links:
Eric Dein ericdeinmd ( View Tweet)
How to take cannabis?
Do NOT rec inhaled
- makes drug level go up high/fast, benefit for rec use but not for medicinal
- bronchitis, ?oral cancer
Other risks: psychosis - risk in youth, memory loss (poor studies), dependence, respiratory if inhaled
Clauw 16S18 #ACR24
@RheumNow https://t.co/coYNl7VOT3
Eric Dein ericdeinmd ( View Tweet)
Clauw: think of THC and CBD as “completely different”
Cannabidiol - safe, not psychoactive, “can use liberally”
THC - psychoactive with effects on CB1 and CB2 receptors. CB1 affects the brain where CB2 is more in inflammation
#ACR24
@RheumNow https://t.co/A0TgSpAO64
Links:
Eric Dein ericdeinmd ( View Tweet)
Moderating a great talk about POTS - great slide & nice presentation technique
Dr. Adler flashed a screen of the ROS for pts w/POTs, overwhelming as expected… then overlaid common causes and phenotypes - really like this as a framework!
#ACR24 @RheumNow https://t.co/mCmtygxxv4
Mike Putman EBRheum ( View Tweet)
TAPIR study of continuing vs stopping steroids in ANCA vasculitis in remission. Relapse at month 6 in 16% vs 4%. OR 4.22, but low rate in either group. If treated Rituximab, no difference! Merkel et al. @RheumNow #ACR24 Abstr#0774 #ACRbest https://t.co/pKa4U5L2fW https://t.co/MjzE14SeGi
Links:
Richard Conway RichardPAConway ( View Tweet)
Happening now:
16S18 Into the Weeds: Cannabis in Rheum
@EleniTiniakou @BharatKumarMD
Do you discuss marijuana with your patients?
@RheumNow #ACR24
Eric Dein ericdeinmd ( View Tweet)
Harnessing power of AI in Rheumatology. Strengths and weaknesses of AI will need to be assessed. Amanda Nelson shares the limitation of AI @RheumNow #ACR24 https://t.co/G8FNVco7Qp
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Lots of ‘CARTS’, not enough ‘work horses’!
There are now ~40 CAR-T protocols in #lupus incl many presentations at #ACR24
-most are uncontrolled
-selection of pts is key.
We need a pathway forward for reg approval & guidelines for studies!
@RheumNow @ACRheum 18abst #OOO4 https://t.co/Mckwvn3Ffn
Janet Pope Janetbirdope ( View Tweet)
More evidence: persistence of imaging abnormalities is probably NOT an adequate metric of LVV tx failure
Boiardi et al - 87% TAK/LV-GCA pt w persistent dz on imaging despite clinical remission, TAK>GCA
PET avidity more persistent in GCA
@RheumNow #ACR24 Abstract 1617
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Location of research matters Ab#0772
Global recruiting patterns impact PBO in PsA
PBO results improve w time - 0.9%/year
More globalization of trials w time
Gross nation index (GNI) neg ass w ACR20 - inclusion of less affluent controls affects higher PBO response
@RheumNow #ACR24
Eric Dein ericdeinmd ( View Tweet)
Poster#0035
🚨Postpartum RA Risk & Mucosal Immunity
👩🍼Elevated anti-CCP-IgG in cervicovaginal fluid of postpartum women (n=25) vs. controls.
🧪Local anti-CCP production despite negative serum
❓Childbirth-associated mucosal inflammation may drive RA onset.
#ACR24 @RheumNow https://t.co/plvtyJDSY1
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
To GLP or not to GLP—is it still even a question in obesity management given pluripotent benefits 👇🏻
Dr. Louis Aronne recommends
➡️ Start low and titrate slow 💊
➡️ Provide pt education on GI side effects, ondansetron effective for nausea
#ACR24 @RheumNow https://t.co/SzVg2dopCo
Links:
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
CKD keeps a persistent low grade inflammatory state! Implications: CKD ⬆️risk for CV dz through different mech @RheumNow #ACR24 https://t.co/KcCvyTVaav
TheDaoIndex KDAO2011 ( View Tweet)
Planned to post so much more from #ACR24; my favorite slides from today will have to suffice.
From the #BCRC Dr Monica Guma’s - diet and microbiome.
Dr @NamrataRheum -a reminder that we are all aging.
Dr Connie Weyand’s -metabolic checkpoints in RA T cells and macrophage. https://t.co/MtsheVsUEQ
Links:
Kristen Young kristenyoung ( View Tweet)
Hypophosphatasia:
🦴Inherited disorder of metabolism with low tissue nonspecific alkaline phosphatase (TNSALP)
🦴Impaired bone mineralisation
🦴Accumulation of pyrophosphate
🦴1/100,000-300,000
🦴6 main forms
@RheumNow #ACR24
Mrinalini Dey DrMiniDey ( View Tweet)
