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Identifying Gaps in axSpA: Lessons from European Map of Axial Spondyloarthritis (EMAS)
Despite the increasing scientific knowledge on axSpAs, a substantial gap still remains. Delay in diagnosis continues to pose a threat in the early identification of patients and those already on treatment may deal with additional issues such as work productivity or quality of life.
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Risks for RA:
- chromosome 6 has HLA risk genes encoding HLA-I and -II
- HLA-DRB1 *04:01 and *04:04 stonrgly assc w/ RA in white Americans/Europeans
- the Shared epitope increase risk for RA & severe disease; high assc with ACPA+
Protective➡️HLA-DRB1*13:01 @rheumnow #ACR21 2/2
TheDaoIndex KDAO2011 ( View Tweet)
Chances for RA if a family member has RA?
Dr. B Masri reviews familial studies:
👉person w/1st degree relative w/ RA has 2-4 X risk
👉Multigen study standard incidence ratios: 3.02 child, 4.64 siblings, 9.31 in multiplex family, 6.48 twins, 1.17 in spouses #ACR21 @rheumnow 1/
TheDaoIndex KDAO2011 ( View Tweet)
Dr. Ranjeny Thomas on preventing RA:
👉60% genetics/immunopathogenesis (noncontrollable factors)
👉40% lifestyle modifications: healthy diet, healthy weight, avoiding tobacco, reduce occupational exposure, improve exercise/sleep, decrease stress.
#ACR21 @rheumnow 1/2 https://t.co/eoh3kcekR8
TheDaoIndex KDAO2011 ( View Tweet)
Don't forget to catch up with our @RheumNow Faculty Panel discussion on What's Hot and Not Daily Recap for Saturday #ACR21 @RichardPAConway @AurelieRheumo @bella_mehta @_Castillo_Pedro https://t.co/x2xu6k2h9x
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
MTX and liver: FibroScan scores compatible with liver fibrosis are significantly correlated w/ several parameters
-BMI
-waist circumference
-male gender
-age
but NOT MTX cumulative dose in a cohort of 500+ patients.
#Abst0786 @RheumNow #ACR21 https://t.co/RkSpVqN4qF https://t.co/9TENaR0WZ3
Aurelie Najm AurelieRheumo ( View Tweet)
Drug retention of TNFi vs. secukinumab in AxSpA pts
Abs#911
⭐️46% discontinued either treatment
⭐️TNFi with slightly better drug retention
⭐️Age, BASDAI, BMI did not favor any group
⭐️inefficacy - main reason
#ACR21 @RheumNow https://t.co/ynoomYrTvX
Robert B Chao, MD doctorRBC ( View Tweet)
Detecting inflammation in SIJ for axSpA is by MRI but Artificial intelligence convolutional network aids this:
-In the Validation set: Trained CNN ▶️91.8% accuracy; Sens 88.9% Sp 93.5%
- Holdout set: 81.5% accuracy; Sens 67%; Sp 84.5%.
Abst# 0905 #ACR21 #ACRBest @RheumNow https://t.co/qmOxk9JQOC
swethaann23 swethaann23 ( View Tweet)
Dr. R Thomas: current studies on prevention of RA:
👉oral DMARDS (MTX, HCQ)
👉biologics (RTX, abatacept)
👉 studies regulating T cells to restore tolerance
👉biomarkers of tolerant state & look at people who don't develop RA
👉 imaging as window of subclin dz. #ACR21 @rheumnow https://t.co/5bsu5459az
TheDaoIndex KDAO2011 ( View Tweet)
#ACR21 Abs#0818: Starting biologics in moderate vs severe RA activity:
▶️ Moderate disease activity: more likely to reach LDA, remission
▶️ Severe disease: greater overall improvements, but less likely to reach remission
https://t.co/9jBtN9wUGF @Rheumnow
Links:
Eric Dein ericdeinmd ( View Tweet)
Tocilizumab biosimilar study. Pharmacokinetic and pharmacodynamic bioequivalence. Delighted to see this, we really need a toc biosimilar after the negative impact of supply shortages of Actemra/Roactemra this year on patients. Abstr#0823 #ACR21 @RheumNow https://t.co/MMVCwaar3r
Richard Conway RichardPAConway ( View Tweet)
How useful are validated #PROMs in remote monitoring?
Abs#0746 Remote patient-completed assessments of disease activity may be useful in #telehealth settings- a study looking at single-item and scale measures.
#ACR21 @RheumNow
https://t.co/Xr6pqJy91q https://t.co/PKAugkgNzU
Mrinalini Dey DrMiniDey ( View Tweet)
#SLE pts will.... answer in abst#0858 #ACR2021 @RheumNow
Janet Pope Janetbirdope ( View Tweet)
So it's day 2 at #ACR21, and you know what that means - it's ORAL Surveillance day!
This is the figure everyone will be talking about, leading up to details in the plenary.
Why are the other bars higher than the pink bars?
ABST0831
plenty of @RheumNow coverage coming on this https://t.co/B80cSmhNV7
David Liew drdavidliew ( View Tweet)
Abst#0788 #ACR21. Forgot to measure vitamin D?
▶️ Red cell distribution width (RDW) inversely correlates w vit D 25(OH) levels prior to MTX
⭐️ RDW ⬆️ after starting MTX, no longer correlates
https://t.co/b5EPDmGE18 @Rheumnow https://t.co/cNN14ErOmF
Links:
Eric Dein ericdeinmd ( View Tweet)
ORAL Surveillance
In mod-severe RA pts >50yo, with CV RF & no hx malignancy, patient-years of exposure required for one event (vs TNFi):
MACE
tofa 5mg bid: 567
tofa 10mg bid: 319
malignancy
tofa 5mg bid: 276
tofa 10mg bid: 275
#ACR21 ABST0831 @RheumNow https://t.co/9vyXPTMFzj
David Liew drdavidliew ( View Tweet)
#ACR21 Abst#0793. Japanese multicenter US cohort (KUDOS) study, looked at difficult to treat (D2T) RA pts
▶️ 1/5 pts are D2T (fail 2+ b/tsDMARD, mod disease or GCs)
⭐️ Contributors of good outcomes: IL-6i (OR 9.6), concomitant MTX (OR 7.1)
@Rheumnow https://t.co/9YSa4ebQlR
Links:
Eric Dein ericdeinmd ( View Tweet)
Greater #comorbidity burden is assoc. w/ worse improvement and disease activity in 1st yr of treatment in ERA @earlyarthritis.
Comorbidities esp affect SJC and patient and physician global assessments.
#ACR21 Abs#0798 @RheumNow
https://t.co/02BRqYp9Yk
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR21 Abst#0801 Early remission at 6 mos is a predictor of long-term remission in patients w new onset RA
▶️ DAS28-CRP, SDAI, CDAI at 6mo predicted remission at 60 months
https://t.co/vWy7EmseZp @Rheumnow https://t.co/HWJSjvFY8d
Links:
Eric Dein ericdeinmd ( View Tweet)
Good news for #COVID vaccine in #SLE. ✅doesn’t cause #lupus flares ➡️ no increase in APS. What about #SARS-CoV2 infection in SLE. Flares ↔️ stable but ⬆️APS Abs. from Hopkins cohort. Petri #ACRBest #ACR21 abst0858 @RheumNow https://t.co/ABx4C4lwvs
Janet Pope Janetbirdope ( View Tweet)
