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#ACR23 Abstr#0782 Triple therapy in #lupus nephritis. Propensity match data AURORA vs ALMS showed pts treated with voclosporin+MMF+low dose GC vs MMF+High dose GC achieved earlier reduction in UPCR & fewer AEs. Cdnt control for everything e.g. HCQ but assuring @RheumNow #ACRBest https://t.co/dmriAyQPr0
Md Yuzaiful Md Yusof ( View Tweet)
What do you think of CAR T Rx in severe #SLE? @RheumNow @ACRheum #ACR23
Janet Pope ( View Tweet)
Ab#0596 #ACR23 @RheumNow
R Furie on Decravacitinib in SLE
48wk double-blind trial. PBO v DEU 3mgBID, 6 mgBID,12 mg qd
Higher response, faster time to SRI(4), BICLA and dual response v PBO. More likely to sustain response from w32-48. https://t.co/M34d3nQmwv
Eric Dein ( View Tweet)
LEGACY Cohort - Rx monitoring AZA/Tacro in SLE pregnancy
Ab#0586 #ACR23 @RheumNow
70 pregnancie. 33% prescribed AZA, 9% TAC
AZA - 91% subtherapeutic or non-adherent
More likely in non-Caucasian, on steroids, longer SLE duration, prior lupus nephritis
TAC - 3/6 therapeutic levels
Eric Dein ( View Tweet)
Targeted OX40L (co-stimulatory APC protein w/ possible polymorphisms in SLE) study by Womba et al, found OX40L targeted CAR-Tregs had superior in vitro suppression of activated T cells & dendritic cells relative to Control-Tregs. #ACR23 Abs 0799 https://t.co/GgCGGIvhHF @rheumnow https://t.co/GZMEUCTooh
Dr. Rachel Tate ( View Tweet)
Should the cost of #CAR-T stop us from considering in severe refractory #lupus? So far update of German group show remission - drug free and great safety. But hold on..we need RCTs with an active control and longer f/u, but I am impressed! #ACR23 #ACRbest @ACRheum @RheumNow #784 https://t.co/mRMWLCbpCY
Janet Pope ( View Tweet)
#ACR23 tidbits from Sunday @ACRheum @RheumNow
1 Less steroids better w other #Rx in #GCA, #PMR, #SLE #nephritis, #nonrenal #lupus BUT NOT in Severe GCA
2 Trend for combined immune modulators in #lupus GN or w a #CNI
3 #HCQ is better than sliced bread in #SLE aim for drug level
Janet Pope ( View Tweet)
Differences in #glucocorticoid dosing. In #lupus #nephritis less steroids are the same as high dose steroids. Placebo arms of pooled data from #LN #RCTs. Less is equal! #ACRbest #ACR2023 @RheumNow @ACRheum abst0781 High dose steroids tended to have lower MMF doses https://t.co/XwTlsy4xKE
Janet Pope ( View Tweet)
Abs#0608 #ACR23 @RheumNow
Cenerimod: sphigosine 1-phos (S1P) 1 receptor modulator for SLE
P2 CARE Study
51% of pts had high IFN1 sign., ass w/ high dsDNA
Cenerimod 4 mg: decreased dsDNA and IFN-a protein at 6 mo vs b/l
In high IFN pts, 4 mg Cen: decrease SLEDAI, SRI-4
Eric Dein ( View Tweet)
Abs#595 #ACR23 @RheumNow
R Furie on 4 yr TULIP-LTE pts with b/l renal involvement
33% on anifrolumab continued to wk 208 vs PBO 6%
Renal improvement at w208 in 9/10 pts, vs no avail PBO data
Conclusion: more Anifrolumab pts remained in study & reached SLEDAI-2K renal improvement
Eric Dein ( View Tweet)
Translational implication/application of the #APOL1 story :
Risk stratification, novel treatments, impact of tissue susceptibility to damage #ACR23 @RheumNow #DuboisLecture #SLE @ashira_md https://t.co/k23vFjeDeG
TheDaoIndex KDAO2011 ( View Tweet)
#ACR23 Please find my preview article on selected #SLE abstracts to be presented at year’s conference - towards Glucocorticoid-Free zone in lupus @RheumNow
https://t.co/1kM7LWc64V https://t.co/WK9X7UpsNi
Md Yuzaiful Md Yusof ( View Tweet)
In their study, Dr Deng et al identified TRAF5 as susceptible gene for SLE-PAH
✳️TRAF5 deficiency activates BMP/TGFB signaling w/⬆️PAEC apoptosis
✳️TRAF5 overexpression attenuated PAH sxs in mice
TRAF5 as potential BM for dx/novel tx target in SLE-PAH?
#ACR23 ABST0723 @RheumNow https://t.co/WT9vQo8y8s
sheila ( View Tweet)
In this real world EHR-based SLE cohort, AJorge: BEL was assoc w/⬇️risk of damage prog vs. MMF (HR 0.74 [95% CI 0.67-0.83) but no diff bet BEL vs. MTX/AZA at 3yrs
Further prospective studies req'd?
BEL remains an option for non-renal SLE tx.
#ACR23 ABST0606 @RheumNow https://t.co/KabBeXKpvk
sheila ( View Tweet)
Did you know?
👉APOL1 variants are protective against trypanosomiasis.
👉Despite reassuring renal biopsies, SLE pts with #APOL1 variants had:
⬆️progression to ESRD, ⬆️atherosclerosis, ⬆️osteonecrosis (likely related to endothel dysfnx) #ACR23 @ashira_md @RheumNow #DuboisLecture https://t.co/w1lnGMPFAQ
TheDaoIndex KDAO2011 ( View Tweet)
CV events in women w/ ARDs pregnancies:
-2.0% of 19,340 pregnant ARDs
Adjusted relative risk:
-4 fold in ARD
-15 fold in primary APS
-6 fold in SLE
-SLE + APS 18 fold
25-30% occur in early post partum!
Need for continued vigilance after delivery
@RheumNow #ACR23 ABST0722 https://t.co/hLeN61WBnB
Aurelie Najm ( View Tweet)
CVE’s higher in pregnant pts with SLE + APS, primary APS and Lupus nephritis especially in the postpartum period. Rheums need to be involved with their patients’ care during pregnancy! Abstr#0722 #ACr23 @rheumnow https://t.co/P6sbJtd6xW
TheDaoIndex KDAO2011 ( View Tweet)
Always great to see UCSD represent at #ACR23!
Pregnant women with rheumatic diseases and antiphospholipid syndrome higher a HIGHER risk for acute cardiovascular events
30% of events occurred postpartum
@RheumNow Abs#0722 https://t.co/CqZedfOlBC
Robert B Chao, MD ( View Tweet)
#ACR23 Real-world multicentre study showed steroid-sparing effect of Belimumab in #SLE. At 2 years, proportion of patients on =>10mg/d decreased from 52% to 3%. 18% and 13% achieved LLDAS and DORIS remission. Support its use esp. in those relying on glucocorticoids @RheumNow https://t.co/ad5XH3pmYc
Md Yuzaiful Md Yusof ( View Tweet)
Plenary 1 #ACR23
CVE in ARD/APS is a significant risk factor during pregnancies and the risk stays even after delivery for a significant amount of time. California based administrative data study! abst#722 @RheumNow https://t.co/HawhS4Gqko
Bella Mehta bella_mehta ( View Tweet)
