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Medeiros-Ribeiro et al. Holding MTX for 2 weeks after recombinant zoster vaccine increases response with no increase in flare. @RheumNow #ACR24 Abstr#2612 https://t.co/NEop0XB5Ak https://t.co/P4S2qzbkTs
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Richard Conway RichardPAConway ( View Tweet)
SmPCs recommend interrupting immunosuppression (IS) in infection
What happens if you continue the drug?
Ab2611 found no difference in infection outcomes btwn temp interruption & continuation of IS in infection
Could continuation be a safe option in some pts?
#ACR24 @RheumNow https://t.co/14SN6a4Wm8
Mrinalini Dey DrMiniDey ( View Tweet)
RIP to Glucocorticoids in GPA
For many years glucocorticoids were the mainstay of our treatment of granulomatosis with polyangiitis (GPA).
https://t.co/WqpO6ACqtu https://t.co/vb8qx3uHA0
Dr. John Cush RheumNow ( View Tweet)
Wang et al. Propensity score matched cohort study. 63,302 individuals. Colchicine associated lower risk of THR/TKR, HR 0.87. @RheumNow #ACR24 Abstr#2557 https://t.co/UUU3Tm67ML https://t.co/uKi0e8E7HV
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Richard Conway RichardPAConway ( View Tweet)
Xia et al. Upadacitinib in refractory Behcets. Open label, 8 patients. Follow-up 4-14 months. Lower disease activity 2.5 vs 1.5. Lower pred, 11.9 vs 8.1. @RheumNow #ACR24 Abstr#2515 https://t.co/ZXsJkNRlTm https://t.co/S8LhpqZ8X3
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Richard Conway RichardPAConway ( View Tweet)
Ahmadzay et al. Real world secukinumab in PsA data in 1202 patients. Smokers/ex-smokers have 30% lower treatment retention. But if they maintain treatment, appear to respond equally well. BMI no effect. @RheumNow #ACR24 Abstr#2350 https://t.co/XVPmEBbRu8 https://t.co/QyJirWRKvq
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Richard Conway RichardPAConway ( View Tweet)
US biosimilar exp
Interchangeable biosimilar - can substitute for reference product wo consulting MD
Primary endpt: pharmacokinetic data
61 approved biosimilars
@RheumKay: “pts should share in financial benefits”
Currently 5-87% discount
#PBMReform @ACRheumDC
@RheumNow #ACR24 https://t.co/RqwbZalZko
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Eric Dein ericdeinmd ( View Tweet)
Triboulet et al. JAKi in RA-ILD. 42 patients. Stability of PFTs over median 21 months. HRCT stable in 62%. Progressive ILD on HRCT in 19%. @RheumNow #ACR24 Abstr#2249 https://t.co/PY9BrCfNHc https://t.co/r8fIgrjyDu
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Richard Conway RichardPAConway ( View Tweet)
Important study in SLE: out of 590 pts with pericarditis, 20% had recurrence w/in 1 year
Higher in early dx, younger pts, higher dx activity, & pred exposure
Is prednisone risk confounding by indication? Or causative?
#ACR24 @RheumNow @andreafava Abstr#2372 https://t.co/Seyi4F6weY
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Mike Putman EBRheum ( View Tweet)
@DianeLacaille Canadian biosimilar exp
Biosimilar transition v originator controls x2 yrs
Weighted model: no decr in ETN biosimilar discontinuation v originator. IFX shows slight decrease - NOT statistical signif
Safety- no difference, slight incr rheum visits
@RheumNow #ACR24 https://t.co/0GMfLAyzOo
Eric Dein ericdeinmd ( View Tweet)
Updated ACR guidelines on management of lupus nephritis (LN). Consider early biopsy. Focus on triple therapy in LN. From the panel discussion, Tacrolimus can be an alternative to CNI (Voclosporin) where there is no access to this. Manage comorbidities such as CV risk, bone… https://t.co/4R02YnRXDP https://t.co/3J7YcF5ucQ
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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Galloway et al. 117,050 individuals. VTE risk in RA consistently increased, irrespective of age, sex, BMI. Risk VTE 46% higher in RA! @RheumNow #ACR24 Abstr#1901 https://t.co/SQPcPiBeF2 https://t.co/BQkERUsGlL
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Richard Conway RichardPAConway ( View Tweet)
Do pts w autoimmune disease (AID) respond differently to immune checkpoint inhibitors (ICI) & have different mortality or iRAE risk vs pts without AID?
Study of pts on ICI showed no significant difference in mortality in pts w & without pre-existing AID
Ab2532 #ACR24 @RheumNow https://t.co/suywDdGIB1
Mrinalini Dey DrMiniDey ( View Tweet)
Overall very reasonable, aligning ACR recs w/other guidance groups & updated data
Remember: guidelines are meant to be broken. Some patients can likely avoid pulse, others may need more steroid on the back end, biopsies are not benign
#ACR24 @RheumNow
Mike Putman EBRheum ( View Tweet)
Recommend "Triple Therapy" = Glucocorticoids + two other agents
Practically, that means MMF + belimumumab OR CNI for most pts
For the CYC afficionados, the lower-dose EUROLUPUS protocol is preferred
#ACR24 @RheumNow https://t.co/0gRISXSw0c
Mike Putman EBRheum ( View Tweet)
Happening now, new guidelines for mgmt. A few highlights:
Recommend prompt GC therapy, pulse x1-3d followed by oral pred (<0.5mg/kg/d) w/taper to <5mg by 6 months
Aligns with EULAR recs for a much-lower dose than most clinicians currently doing
#ACR24 @RheumNow https://t.co/B71i7FBYlQ
Mike Putman EBRheum ( View Tweet)
Abstract 2503: Clofutriben (HSD-1 inhibitor) minimizes adrenal suppression. Adding clofutriben to prednisolone boosts ACTH & cortisol levels with fewer patients with suppressed morning cortisol (≤5.0 mg/dL) (34% vs 14%).
@RheumNow #ACR24 #GCTox
Akhil Sood MD AkhilSoodMD ( View Tweet)
Low uveitis rates in patients with axial spondyloarthritis and psoriatic arthritis treated with bimekizumab (BKZ) over the long term.
Key findings:
- AxSpA: 3.7% incidence (1.3/100 PY) with BKZ.
- PsA: Only 0.2% incidence (0.1/100 PY).
- All events were mild/moderate, with no… https://t.co/jkUwHJk3FJ https://t.co/gTcCzeC88e
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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Hyrich:
ETN originator vs biosimilar initiation
- DAS28 - no signif change at B/L, 6mo, 12 mo.
Switch?
Matched pts in ETN switch v cont originator - good b/l control on Rx
-DAS28 maintained w switch
10% did go back to originator, felt less good tho similar DAS
#ACR24 @RheumNow https://t.co/RHRit5CtUu
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Eric Dein ericdeinmd ( View Tweet)
Early observational data suggesting JAK inhibitors can play a role in TAK tx
We have seen this with UPA in GCA this conference… time for SELECT-TAK !
@RheumNow #ACR24 https://t.co/B2Wa8sOFTp
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
