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Are Emulation Trials a Fantasy?
Are emulation ‘trials’ helpful, despite the biases that occur with observational data, or do they truly mimic the results of randomized controlled trials (RCTs)?
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Quaack etlal. PreCARA study (vs PARA, historical control). T2T in RA improves fertility - time to pregnancy 84 days vs 196 days. T2T strategy also led to less NSAIDs and prednisolone. @RheumNow #ACR24 Abstr#1647 #ACRbest https://t.co/vYCCUqpCLo https://t.co/PUHJOxgGbL
Richard Conway RichardPAConway ( View Tweet)
Quaack etlal. PreCARA study (vs PARA, historical control). T2T in RA improves fertility - time to pregnancy 84 days vs 196 days. T2T strategy also led to less NSAIDs and prednisolone. @RheumNow #ACR24 Abstr#1647 #ACRbest https://t.co/vYCCUqpCLo https://t.co/PUHJOxgGbL
Richard Conway RichardPAConway ( View Tweet)
#2282
🔬 Personalised Approach to TNFi in RA
📊 N=50👇; 43 responders
🔑 Findings
💥TNFR2 rs1061622 polymorphism linked to TNFi response
💥 MR/RR alleles ⬆️ 10X odds non-response v. MM allele (OR = 10.1,p=0.04)
🎯Genotyping may guide personalized RA therapy.
#ACR24 @RheumNow https://t.co/MQKZUCEPxj
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
#1330
🔬F-Calprotectin in Early RA
➡️ New-onset RA pts(n=104) had ⬆️ F-calprotectin vs controls(n=50)(71 v. 17µg/g; p<0.001)
🔑Higher F-calprotectin linked to ⬆️ DAS28 & NSAID use
⬇️levels @ 6 months Rx
❓Role of subclinical gut inflammation in early RA
#ACR24 @RheumNow
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Plenary II: pregnancy in RA
When a treat to target approach is used to achieve remission, pregnancy rates nearly similar to general population!
Time to pregnancy less than half that of non-T2T comparators
@RheumNow #ACR24 https://t.co/B9F9M8t9Kt
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Infertility in women with RA 2x higher
Risk factors
- age
- disease activity
- use of NSAIDs
- use of pred >7.5mg/day
With T2T aiming for remission, fertility improves and becomes similar to the general population
#ACR24 @RheumNow ABST#1647 https://t.co/B2Tx4dju4Z
Jiha Lee JihaRheum ( View Tweet)
#1350
🔬 Microbiome & RA: Impact on Disease Activity & Vascular Function
➡️ Salivary microbiome a/w arterial stiffness (AIx)(p 0.019)
➡️ Stool microbiome a/w DAS28-CRP(p 0.027)
🔴Key taxa👇identified for each; no common taxa for both disease activity & AIx.
#ACR24 @RheumNow https://t.co/54Sumzzd27
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
17S19 session on steroid free future
@LesleyJacksonMD @EBRheum @BritAdlerMD
Is a (near) steroid free future for RA, ANCA, Lupus
#ACR24 @RheumNow
Eric Dein ericdeinmd ( View Tweet)
#1456
💥In a real-world UK PsA cohort, 25% had joint erosion @ diagnosis
➡️Mean disease duration 34mo. @ diagnosis
➡️Mean disability score = mod. to severe
💥Delay in diagnosis=poor outcomes
‼️Are we doing enough to catch PsA early? ?
🔑Earlier detection key
#ACR @RheumNow
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
#1375🏋️♀️ Strength Training in RA
➡️ 12-week trial 28 ♀️
High-intensity(HIRT) v. Low-intensity+blood flow restriction(LIT-BFR)
🔴Equivalent gains:Lat-pulldown, biceps curl
🔴Knee extension:HIRT>LIT-BFR (non-significant)
✅ LIT-BFR: Alternative for RA sarcopenia
#ACR24 @RheumNow
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Is participation in RISE assoc with improved quality of care?
➡️Enrolment assoc w ⬆️performance in several quality measures
➡️Most marked in practices with lower baseline performance
⏩Registry participation has potential to improve quality of rheum care
Ab1644 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
#1326
🔬 Predicting Imminent Inflammatory Arthritis
➡️543 anti-CCP+ at-risk (high/low) tracked
🔑Predictors for IA in high-risk:
🔴EMS≥30min(OR 11)
🔴RF+(OR 6)
🔴US PD(OR 5)
🔴smJTC (OR 5)
🔑Predictors for IA in low risk:
🔴RF+(OR 8)
🔴Anti CCP >3xULN(OR 7)
#ACR24 @RheumNow https://t.co/ou9HNcNb8X
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Improved fertility in women with RA when treated with a Treat-to-Target (T2T) approach aimed at remission.
Key findings:
- Shorter time to pregnancy (TTP) in PreCARA cohort (84 days) vs. PARA cohort (196 days).
- Increased TNF-inhibitor use and lower NSAID/prednisone use in the… https://t.co/YyD2lpXVRC https://t.co/LH5LMOH8al
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Improved fertility in women with RA when treated with a Treat-to-Target (T2T) approach aimed at remission.
Key findings:
- Shorter time to pregnancy (TTP) in PreCARA cohort (84 days) vs. PARA cohort (196 days).
- Increased TNF-inhibitor use and lower NSAID/prednisone use in the… https://t.co/YyD2lpXVRC https://t.co/LH5LMOH8al
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Half of the respondents chose #IL17i for #psoriatic #arthritis #PsA Rx for #Achilles #tendonitis
Interesting as lots
Of data
On #enthesitis wIL23i
Likely all
Effective #PsA Rx helps #tenosynovitis
some have
➡️ data on #efficacy
⬆️ bio rationale
#ACR24 @RheumNow @ACRheum https://t.co/wzefjsfdaj
Janet Pope Janetbirdope ( View Tweet)
Dr @andreafava presents their noninvasive biomarker panel that predicted the probability of histologically active LN.
Panel outperformed UPCR, C3, C4 & antidsDNA.
Aid in clinical-decision making? Lots of potential for monitoring tx response.
@Rheumnow #ACR24 abs1642
#ACRbest https://t.co/C7ZNdvbIQ7
sheila RHEUMarampa ( View Tweet)
In the @ACRheum MSK Ultrasound Guidance:
In difficult-to-treat RA, MSUS can distinguish symptoms of active synovitis from other sources of pain.
(consensus: mod)
CURRENTLY do you often use ultrasound when RA gets difficult to treat, and synovitis isn't obvious? #ACR24 @RheumNow
David Liew drdavidliew ( View Tweet)
One situation I've seen MSK ultrasound have impact ++ in the real-world is showing patients their own RA disease activity.
Arthritis might be the invisible disease sometimes, but seeing it in full Doppler colour on screen means a lot to many.
#ACR24 MSK USS Guidance @RheumNow https://t.co/wd9s6FAfp4
David Liew drdavidliew ( View Tweet)
The @ACRheum RA outcome measures toolkit has all the relevant tools for measuring outcomes in rheumatoid arthritis (and exactly how to do it).
https://t.co/GZ7tZ6fNMK
Great for all US rheumatologists, but also very handy for all of us globally
#ACR24 16S30 @JYazdany @RheumNow https://t.co/MSHA353MKR
David Liew drdavidliew ( View Tweet)