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The evolving JAK inhibitor story
Black box Warnings regarding JAK inhibitor use and MACE, malignancy, thrombosis and mortality - full safety data remains to be examined.
@ACRheum #ACRambassador #ACR21 https://t.co/imQ1LSxeXM
Tanmayee Bichile, MD BichileT ( View Tweet)
"We have to stop meeting like this" @DrDavidKarp @Rheumnow #ACR21. I was hoping to have some Ghirardelli chocolates in SF... But here's hoping for Philly cheesesteaks next year 🤞
Eric Dein ericdeinmd ( View Tweet)
plenary I. #ACR21
Interesting data with the delta variant from @alhkim https://t.co/oUCOXSc9wA
Marie Kuchynski MD Doctorkuch ( View Tweet)
#ACR21 #ACR2021
Rheumatology Reproductive Health
👉🏻 Biologics and breast milk
👉🏻 Good vaccine response with TNFi (like with covid vaccines )
👉🏻 ustekimumab seems safe in pregnancy
👉🏻 Tofacitinib/ small molecules may cross placenta/ be in breast milk ➡️ contraindicated in preg/BF https://t.co/qk3sLR4QHz
EnvisionRheumat ERheumat ( View Tweet)
@alhkim presenting COVaRiPAD data on SARS-CoV-2 vaccination. Most mount immune response. Risk of poor response BCDT >> MMF >> GCC > MTX/AZA/JAKi/TNFi > immunocompetent. Abstr#0457 #ACR21 @RheumNow https://t.co/lf8cAEWGXf
Richard Conway RichardPAConway ( View Tweet)
Can we predict who which PsA pts will be radiographic progressors?
Abs#449 identified 103 candidate biomarker peptides corresponding to 69 proteins that could ID progressors
More data needed
#ACR21
@RheumNow
https://t.co/OLfPRNjTKV https://t.co/6UTn1J7nJH
Robert B Chao, MD doctorRBC ( View Tweet)
Abst0437 #ACR21 @RheumNow factors assoctd w/poor response to mRNA Covid-19 vaccine in rheum pts Rx w/Rituxan: ⬆️ exposure to RTX over time, ⬇️ IgG levels prior to RTX, short interval btw RTX course & BNT162b2 vacc. RA highest&ANCA-vasculitis lowest probability for a + response. https://t.co/DsrJBlNvr7
Olga Petryna DrPetryna ( View Tweet)
#ACR21 Abst#0457: #COVID19 Vaccine Responses In Patients w Autoimmune Diseas
⭐️Prosp observ: pre-vax▶️5 mo.
⭐️ 90% +Ab responses, but ⬇️ titer
⭐️MMF 21x⬇️ titer, MTX 4.4x⬇️, AZA 3.5⬇️
⭐️BCDT: 58, JAK: 2.6, TNF 2.3
⭐️GC ⬇️ even on <5mg!
https://t.co/BGU4CP9M0s @Rheumnow #ACRbest https://t.co/7QhsTGTwnZ
Links:
Eric Dein ericdeinmd ( View Tweet)
Sublingual Cyclobenzaprine for fibromyalgia. It seems to improve pain, and across the board on secondary endpoints. But all by a modest effect. Big placebo response also. Not time to get overly excited yet. Abstr#0477 #ACR21 @RheumNow https://t.co/aUtwaH5oEh
Richard Conway RichardPAConway ( View Tweet)
Wanted to highlight our work @HSpecialSurgery presented at #ACR21 using unsupervised clustering of multimodal data - histology and ultrasound to identify phenotypes such as moderately inflammatory subtype in #osteoarthritis @RheumNow #abst0212
some features highlighted in fig https://t.co/HRzhMXctB9
Bella Mehta bella_mehta ( View Tweet)
#ACR21 Abst#0284
My 56 yo ♀RA pt expressed concern for developing dementia last wk. This study helps recognize her RF beyond aging:
➡️ Large joint swelling (HR 2.2)
➡️ CVD (HR 2.4): stroke (HR 3.2) + chronic HF (HR 1.8)
➡️ DM (HR 1.6)
#ACRBest @Rheumnow
https://t.co/wsZnaLwSmD
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
#ACR21 Plenary Abs#0457 @alhkim #COVaRiPAD study:
👉Patients with inflammatory diseases on #immunosuppression have impaired #SARSCoV2 immunity post-vaccine
👉#Steroids, MMF & B cell depletion therapy more severely affect responses
👉https://t.co/7qTABcpm0h
@RheumNow #ACRBest https://t.co/EfuHjh3vw5
Mrinalini Dey DrMiniDey ( View Tweet)
Abst0254 #ACR21 @RheumNow CARRA SJIA cohort defines factors associated with medication free remission for ≥6 month-period: younger age, normal CRP levels & shorter time btw diagnosis and start of Rx. none of pts who developed MAS (3.9%) able to d/c Rx for ≥6 months
Olga Petryna DrPetryna ( View Tweet)
COVID-19 mRNA vaccination immunogenicity
(vs immunocompetent):
TNFi: 2.3x reduction
JAKi: 2.6x
AZA: 3.5x
MTX: 4.4x
steroids: 9x (but confounded by other meds)
MMF/MPA: 21x
B cell depleting: 57.7x (but 6m gap probably helps)
amazing work led by @alhkim
#ACR21 ABST0457 @RheumNow https://t.co/cl5vBpNzvQ
David Liew drdavidliew ( View Tweet)
Dr. @AlHKim on COVaRiPAD data:
274 pts chronic inflam dz (RA/SLE/IBD/SpA/MS/SS,/Vasculitis) vs 53 control
👉90% Ab+ response (⬇️3.4X titer)
👉MMF⬇️21X
👉MTX⬇️4.4X
👉AZA ⬇️3.5X
👉BCDT⬇️ 57.7X
👉JAKi ⬇️2.6 X
👉GCs⬇️9X
👉TNFi impaired neutralization delta
#ACR21 #plenary @rheumnow https://t.co/b0DgLjDi6E
TheDaoIndex KDAO2011 ( View Tweet)
Provocative study in pre-RA. SC Abatacept in patients with pre-clinical RA can:
-improvement MRI inflammation
-⬇️evolution to clinical RA at 6 months
-No new safety signal
Yes, but we need longer term follow-up and an estimation of NNT.
#OP0505 @Rheumnow #ACR2021 https://t.co/2P1Yk3IyeR
Aurelie Najm AurelieRheumo ( View Tweet)
New treatments in #psoriaticarthritis Brepocitinib TYK 2/JAK 1 inhibitor had superior efficacy vs PBO in active PsA at Week 16, with improvements in more refractory domains over 52 weeks. Safety consistent with other JAKi @RheumNow #ACR21 Abstr#0488 https://t.co/ugsV7uRwro
Dr. Antoni Chan synovialjoints ( View Tweet)
#ACR21 #Abstr0456 How can we explain cognitive impairment in #lupus? Using f- and DCE-MRI, a study showed:
💠Abnormalities in brain functional connectivity
💠Extensive Blood-Brain Barrier leakage (BBB)
BBB could be a future target @RheumNow https://t.co/KLeWfbQUQ0 https://t.co/ibNvBUWlMK
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Polyautoimmunity: axSpA and Familial Mediterranean Fever by Dr. Rachel Tate ( @uptoTate )
Mysteries behind polyautoimmunity have confounded rheumatologists for decades. One such association, the co-existence of FMF and axSpA, remains rare.
https://t.co/GbU1ikeyQw
#ACR21 https://t.co/dRd6yxjieS
Links:
Dr. John Cush RheumNow ( View Tweet)
So what’s interesting is that type I IFNs actually tighten the BBB. Is this dysfunctional in SLE? Or does this argue that CI does not correlate with SLE disease activity perhaps? #ACR21 #ACRAmbassador https://t.co/y5x2k3NQFi
Alfred Kim alhkim ( View Tweet)
