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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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McDermott @jeffsparks et al. SAIL-RA prospective study. 172 early RA patients. RA lund disease in 16%, RA-ILD in 11%. Disease activity strongest predictor RA lung disease, HR 4.89, and RA-ILD, HR 6.17. @RheumNow #ACR24 Abstr#0802 #ACRbest https://t.co/ia0koG64mL https://t.co/U1KdgcUfOy
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Richard Conway RichardPAConway ( View Tweet)
Ab#0427 #ACR24
HSS: menopause & systemic rheum disease severity
1/3 women report worse disease associated w menopause
Reported more flares, menopausal symptoms
Findings were similar between SLE and RA, but SLE patients were >2x more likely to discuss w their rheum
@RheumNow
Eric Dein ericdeinmd ( 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#474 #ACR24
Hsieh and @NamrataRheum
Cancer Survival in RA
Unable to do meta-analysis due to lack of data
HR for lung cancer in RA 1.04
No clear evid of increased risk, but more data and studies needed
Great research project by a high school student (!!)
@RheumNow https://t.co/Sfrf2v2UO4
Eric Dein ericdeinmd ( 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)
👴🏼 Ageing & RMDs at #ACR24
🧠 14 factors associated with dementia
❗️Justin Levenson tells us that if we could address all of these, we could reduce dementia risk by 45%!
@RheumNow https://t.co/SgC5KMohXy
Mrinalini Dey DrMiniDey ( View Tweet)
Interim analysis of a Phase 4 study of ARD (RA 25%, SLE 25%) patients shows recombinant herpes zoster vaccine(RZV) good safety profile, with no impact on disease activity (flare rates: 13.6% vs. 12.4%). Immunogenicity: 93% response in ARDs vs. 99% in controls. Rituximab & MMF… https://t.co/U3s48fLduX https://t.co/WTvD5shtXB
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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Can we predict who will develop #RA-#ILD?
Wheeler et al showed a combination of genetic risk score, peripheral protein #biomarkers & clinical risk factors can help identify RA-ILD in RA patients.
Does this bring us closer to #PersonalisedMedicine?
Ab0799 #ACR24 @RheumNow https://t.co/JZkJNGmLM1
Mrinalini Dey DrMiniDey ( View Tweet)
The use of ultrasound in clinically suspect arthralgia can complement MRI early diagnosis of RA. Abstr#228 Gupta A @RheumNow #ACR24 https://t.co/rpVqZKeMXE
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Galloway et al report OCP/HRT use in RA is not associated with VTE in UK population based study. Increased risk by having RA, HR 1.52. Risk OCP HR 1.43, HRT HR 2.32 - neither statistical significant but very wide CI's! Hmm... @RheumNow #ACR24 Abstr#0134 https://t.co/CZNoRfYWe8 https://t.co/uC6jA9lcX9
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Richard Conway RichardPAConway ( 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
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Richard Conway RichardPAConway ( View Tweet)
Courvoisier et al. JAK-pot study analysis. Which therapies work quicker in RA? JAKi (as expected) and TNFi (what!?) faster than IL6 and abatacept. @RheumNow #ACR24 Abstr#0501 https://t.co/7DPPwHlqpP https://t.co/3mOJ62hZhp
Links:
Richard Conway RichardPAConway ( View Tweet)
Serrano-Combarro et al. Abatacept in RA-ILD. 343 patients. In 23.3% ILD progressed on abatacept. Is that good or bad? We need comparative studies! @RheumNow #ACR24 Abstr#0475 https://t.co/nUEDdjGguA https://t.co/sXEF72MafK
Links:
Richard Conway RichardPAConway ( View Tweet)
Serrano-Combarro et al. Baricitinib in RA-ILD . 72 patient case series. PFTs in picture. HRCT stable/improved in 72% over 24 months. Dyspnoea stable/improved in 90%. @RheumNow #ACR24 Abstr#0476 https://t.co/aVI2kRZkMN https://t.co/4l5GKsFKtm
Links:
Richard Conway RichardPAConway ( View Tweet)
#0066
🧬Epigenetics, Gut Microbiota & RA
🔬 110 RA patients v 110 controls
🦠 Collinsella abundance a/w DNA methylation changes (PRHOXNB, TBC1D22A) in RA, correlating with disease activity.
💡❔Role of gut microbiota & epigenetic markers as RA biomarkers
#ACR24 @RheumNow https://t.co/yZn0KkRpE6
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Is biologic response different in men vs women with axSpA?
A Meta-analysis of 11 studies including 11,199 axSpA pts evaluated sex-related response to bDMARDs
-Male pts more likely to achieve BASDAI 50 and ASDAS low disease activity responses compared to females.
#Abst0599… https://t.co/FopBLS4bF6 https://t.co/PpoZB9HwZN
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Adela Castro AdelaCastro222 ( View Tweet)
Dunn et al. Are the medications recommended for RA-ILD by the ACR guidelines used in the real-world. NO! 4108 RA-ILD patients. Only 12% on one of the first line recommended therapies! @RheumNow #ACR24 Abstr#0214 https://t.co/OzW90OA1Vd https://t.co/S1MKmEDrLF
Links:
Richard Conway RichardPAConway ( View Tweet)
Cool data from the JAK-POT study
Have heard JAKs faster than TNF; perhaps not the case!
If anything, TNFs outperformed the others in this study
Trying not to over-read this, but supports my re-emerging preference for TNF
#ACR24 @rheumnow Abstr#0501 https://t.co/NDyPwju3ds
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Mike Putman EBRheum ( View Tweet)
#0513
🔬 Rituximab in RA: IgG levels & infection
➡️ 164 patients (mean age 59, IgG 14g/L, dx duration 13yrs)
🧬 IgG levels ⬇️over time (6 years/25 infusions)
⚠️ Infection-related hospitalizations peaked year 1 ⬆️risk w/ concurrent steroid(HR 2.1,p=0.002)
#ACR24 @RheumNow
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
