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JAK inhibitors in GCA?
The SELECT-GCA study, looking at upadacitinib in GCA, anchored the ACR 2024 opening plenary for a reason - it is highly notable and badly needed.
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Quaack etlal. PreCARA study (vs PARA, historical control). T2T in RA improves fertility - time to pregnancy 84 days vs 196 days. T2T strategy also led to less NSAIDs and prednisolone. @RheumNow #ACR24 Abstr#1647 #ACRbest https://t.co/vYCCUqpCLo https://t.co/PUHJOxgGbL
Links:
Richard Conway RichardPAConway ( View Tweet)
#2282
🔬 Personalised Approach to TNFi in RA
📊 N=50👇; 43 responders
🔑 Findings
💥TNFR2 rs1061622 polymorphism linked to TNFi response
💥 MR/RR alleles ⬆️ 10X odds non-response v. MM allele (OR = 10.1,p=0.04)
🎯Genotyping may guide personalized RA therapy.
#ACR24 @RheumNow https://t.co/MQKZUCEPxj
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
#1165
📊 PBMCs of IIM patients with myocarditis(n=4) showed distinct gene expression v controls(n=4) v IIM alone(n=4)👇
💥 B-cell dysregulation may drive myocarditis in IIM
🎯Key immunological insights into🫀involvement in IIM
#ACR24 @RheumNow @JuliePaikMD @jhrheumatology https://t.co/PceZUS929S
Links:
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Plenary II: pregnancy in RA
When a treat to target approach is used to achieve remission, pregnancy rates nearly similar to general population!
Time to pregnancy less than half that of non-T2T comparators
@RheumNow #ACR24 https://t.co/B9F9M8t9Kt
Links:
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Infertility in women with RA 2x higher
Risk factors
- age
- disease activity
- use of NSAIDs
- use of pred >7.5mg/day
With T2T aiming for remission, fertility improves and becomes similar to the general population
#ACR24 @RheumNow ABST#1647 https://t.co/B2Tx4dju4Z
Jiha Lee JihaRheum ( View Tweet)
What is the impact of social connections on lupus?
Abstract #1503: In an NYC SLE cohort, greater social integration and support correlated with less pain, depression, disability, and frailty, while loneliness was linked to worse outcomes.
@RheumNow #ACR24 #SDoH https://t.co/5OCCExee06
Akhil Sood MD AkhilSoodMD ( View Tweet)
#1456
💥In a real-world UK PsA cohort, 25% had joint erosion @ diagnosis
➡️Mean disease duration 34mo. @ diagnosis
➡️Mean disability score = mod. to severe
💥Delay in diagnosis=poor outcomes
‼️Are we doing enough to catch PsA early? ?
🔑Earlier detection key
#ACR @RheumNow
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
#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)
#1474
🔬Severe PsA? Guselkumab (GUS) has promise!
➡️In bionaive pts with severe disease activity,
GUS v. PBO resulted in:
🔴73% improvement in joints
🔴53% lower disease activity
🔴63% better PtGA by 2 years
➡️Rapid results by W2, sustained through W100.
#ACR @RheumNow
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
A meta-analysis of 11 randomized trials shows no significant difference in efficacy of bDMARDs for early vs. established axial spondyloarthritis (axSpA). Treating at different stages yields comparable short-term outcomes. Abstr#1468 #Spondyloarthritis #RheumatologyResearch… https://t.co/QYuTcVj2m1 https://t.co/ADzEEbCvUM
Links:
Antoni Chan MD (Prof) synovialjoints ( 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)
The post hoc analysis of the SURPASS study evaluated predictors of radiographic spinal progression in axial spondyloarthritis patients treated with IL-17A (secukinumab) or TNF inhibitors over 2 years.
Key findings:
- New syndesmophytes: 18.2% (SEC 150 mg), 15.8% (SEC 300 mg),… https://t.co/jke6OHdPjZ
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
@DrLauraCoates presented Sex differences in clinical presentations of PsA:
-Women present >polyarthritis, enthesitis and worse PROs which translates to ⬆️ DAPSAs in spite of less Rx progression.
-Men more oligoarthritis, axial involvement, higher skin disease.
#ACR24… https://t.co/iapZF0nZWX https://t.co/jZ79WfxZwh
Links:
Adela Castro AdelaCastro222 ( View Tweet)
🔥Sex matters in PsA
🔑Differences in :
➡️clinical phenotypes
➡️radiographic progression
➡️disease impact
➡️pt perception of disease
➡️response to Rx
#ACR24 @RheumNow https://t.co/iOXQmoxgp0
Caoilfhionn Connolly CaoilfhionnMD ( 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)
A study presents a novel urinary biomarker panel that predicts histologically active lupus nephritis (LN) with high accuracy.
Key findings:
- AUC of 90% for predicting NIH Activity Index > 2, outperforming traditional biomarkers.
- Identified 12 critical proteins linked to… https://t.co/6ZhqNaxpQM
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
The DESIR cohort of Dr. Franc et al. showed that female pts with early axSpA had significantly lower AMH levels vs. general population reflecting low ovarian reserve & fertility.
Mechanism?
Bigger studies need to be done
@RheumNow #ACR24 abs577 https://t.co/842rX79bq6
sheila RHEUMarampa ( View Tweet)
@KDAO2011 help me out here; what is the point of analyses like this?
NO difference in PROs comparing voclo vs plbo...
...but if you split by responder status its different
Prescribing the drug doesn't help PROs, but when it works it works? 🤔
#ACR @RheumNow Abstr#1538 https://t.co/339drHwUuK
Mike Putman EBRheum ( 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)
