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Polyautoimmunity: axSpA and Familial Mediterranean Fever

Rachel Tate, DO

Mysteries behind polyautoimmunity have confounded rheumatologists for decades. One such association, the co-existence of Familial Mediterranean Fever (FMF) and axial spondyloarthritis (axSpA), remains rare. In fact, we believe the rate to be between 0.5% and 7.5%.

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Industry Abstract Previews #ACR21 - Horizon, Aurinia, AstraZeneca

Jack Cush, MD

The pharmaceutical companies will feature the results of their pivotal clinical trials and data analyses at ACR Convergence 2021.  Below is a listing of some of their best studies for you to review and look for in the meeting.

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Management of Immune-Related Adverse Events - ASCO Guideline

Jack Cush, MD

The American Society of Clinical Oncology, Inc (ASCO) has updated its guidelines and recommendations for the management of immune-related adverse events (irAEs) in patients treated with immune checkpoint inhibitor (ICPi) therapy. Below are select statements from this guideline.

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How Should Patients With Autoimmune Diseases Approach COVID Vaccination?

MedPage Today

Healthcare is a personal and individualized relationship between a provider and patient. Each patient is treated according to their particular symptoms and personal health characteristics.

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RheumNow Podcast – Rheumatologist Smoke-Enders (10.22.2021)

Jack Cush, MD

Today I have a few questions: Is tramadol really a weak narcotic? Should we really still be doing placebo-controlled trials? What are we going to do about our patients who are smokers? This and more, in this week's review of the news and journal articles.

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Also DESIR cohort: male gender & higher education independently assoc'd w/ lower hazard of Sick Leave (SL.) Older age & higher disease activity assoc'd w/ more SL. AxSpA dz activity & SES play roles in SL predictions. Abs 0380 #ACR21 #RheumNow @RheumNow https://t.co/1lRhDAu7Ug https://t.co/RRG6BeUqvs

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Dr. Rachel Tate uptoTate ( View Tweet)
Factors that predict trajectories of radiographic progression in #axialspondyloarthritis 4 major patterns in the PSOAS cohort. Male gender, longer disease duration, raised CRP and smoking associated with higher spinal progression @RheumNow #ACR21 Abst#450 https://t.co/PvDE7T0MZp

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Dr. Antoni Chan synovialjoints ( View Tweet)

Abst 0450 #ACR21 @RheumNow PSOAS cohort 4 trajectories of radiographic progression in AS: Non-progressors 37%, late-progressors 26%, early-progressors 19%, rapid-progressors 18%.⬆️ disease burden: male, longer disease duration & smoking . ⬆️eCRP=higher disease progression https://t.co/wUdBNzJPy0
Olga Petryna DrPetryna ( View Tweet)
ASRI data: high frequency of pregnancy and fetal complications (miscarriage, c-section, early delivery, NICU admission) in AxSpA pts. We need more studies regarding risks/tx/outcomes/breastfeeding guidance. Abs 0369 #ACR21 #RheumNow @RheumNow https://t.co/4BR2ZPPjyB https://t.co/qyTwtfEMMy

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Dr. Rachel Tate uptoTate ( View Tweet)
ASAS-PerSpA worldwide study: axSpA most common SpA from in family hx. Except in Middle Eastern/N. African pts, a FH of axSpA associated w/ +HLA-B27 in axSpA pts. PsO and IBD FH more likely -HLA-B27 . FH of ReA rare. Abs 0368 #ACR21 #RheumNow @RheumNow https://t.co/iHBccAcvLi https://t.co/FCoyVg3MGw

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Dr. Rachel Tate uptoTate ( View Tweet)
We should aim for early treatment and good retention in ax-SpA to prevent structural evolution. >12 months of TNFi treatment in the previous 2 years associated w/ ⬇️ radiographic progression of SIJ in r- and nr-axSpA in GESPIC, #Abst0174 @RheumNow #ACR21 https://t.co/2V1q4dUwFO https://t.co/lxQU4zAP1I

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Aurelie Najm AurelieRheumo ( View Tweet)
Cluster analysis in axSpA pts classified 2 groups (predominantly axial vs peripheral dz) and showed lower TNFi drug survival rates in those with prominent extra-axial manifestations. Abs 0365 #ACR21 #RheumNow @RheumNow https://t.co/ArgQ7mNqeD https://t.co/XqF7rPneMV

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Dr. Rachel Tate uptoTate ( View Tweet)
3/4 axSpA EMAS pts had/perceived to have employment challenge. Poor physical/mental health, lower education, hx job change due to axSpA associated w/difficulties/perceived difficulties. Earlier dx/rx AND advocacy needed. Abs 0366 #ACR21 #RheumNow @RheumNow https://t.co/dlGhOymxVQ https://t.co/CWD6U1vRE0

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Dr. Rachel Tate uptoTate ( View Tweet)
Danish axSpA study shows pts in remission on TNFi may be able to taper and remain in remission at the 2 year mark. Abs0364 #ACR21 #RheumNow #ACRbest @RheumNow https://t.co/LBR5cSThQY https://t.co/sCqqhuBaTS

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Dr. Rachel Tate uptoTate ( View Tweet)
Gender differences in AS pts? IL-23R, IL-12R, IL-6R, JAK, STAT and TYK2 ⬇️regulated in men Small study of 20 pts, but could it guide targeted therapy based on gender?🤔 Abs#0050 https://t.co/OQHQCCzfuC #ACR21 @RheumNow

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Robert B Chao, MD doctorRBC ( View Tweet)

Pain in #spondyloarthritis is complex and multifactorial. Study of nearly 3000 patients, higher pain intensity was associated with working life impairment, spinal stiffness, education, gender, depression, anxiety and sleep @RheumNow, #ACR21 and Abst#0360 https://t.co/xEVI4L0Chw

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Dr. Antoni Chan synovialjoints ( View Tweet)

Excited for the first full day of #ACR21, reporting for @RheumNow! Esp looking forward to: ⭐Posters: #Epidemiology, #PublicHealth, #COVID19, #SpA, #RheumatoidArthritis, #PatientOutcomes ⭐Plenary session ⭐Scientific sessions covering #axSpA, #PsA and more

Mrinalini Dey DrMiniDey ( View Tweet)

@DrDDRheum presents on uveitis in SpA. AxSpA>PsA, 30% vs 7.6%. PsA: B27+⬆️ risk, smoking ⁉️ and DMARDs protective. AxSpA: Elevated CRP⬆️ risk, biologics protective. Abstr#0064 #ACR21 @RheumNow https://t.co/psw20RGDst
Richard Conway RichardPAConway ( View Tweet)
Some great #SpA posters on #WorkParticipation #ACR21 Abs#0358 •~700 pts •379 (64.2%) took sick leave in last 12m •#Absenteeism in 23.7% & #presenteeism in 84.1% •Huge impact on work participation in SpA despite incr no. of therapeutic agents @RheumNow https://t.co/pwz4s8D1FU https://t.co/wpbjeXNpgm

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Mrinalini Dey DrMiniDey ( View Tweet)
#ClinicalPearl #JAKi works in #ankylosingspondylitis (AS). Trial of #tofacitinib positive. Don’t confuse with jack ass! @YearinReview #ACR21 @RheumNow presented by Karen Costenbader https://t.co/2VvEMhiI8L
Janet Pope Janetbirdope ( View Tweet)
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