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Here’s a collection of some of the best abstracts presented on day 2 of ACR 2024 as selected by the RheumNow faculty.
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Plenary sessions began the day, followed by thousands on the abstract floor. Here are a few of my favorite presentations from day 2 at ACR 2024.
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With the advent of FDA-approved anti-obesity medications such as semaglutide and tirzepatide, a new avenue for managing this challenging patient population has emerged. But how might these drugs impact the trajectory of RA, and are we on the cusp of a paradigm shift?
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For decades, glucocorticoids (GCs) have formed the backbone of polymyalgia rheumatica (PMR) management.
Dr. John Cush
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Shifting Trends in Initial RA Treatment Approaches
A recent study by Sparks et al (Abstract #0509) reveals evolving trends in disease-modifying antirheumatic drug (DMARD) usage for rheumatoid arthritis (RA) over two decades in the U.S.
https://t.co/6FN0WayZZR #ACR24 https://t.co/dc3CiNpKmx
David Liew
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Nice data from the OTIS Autoimmune Disease in Pregnancy Project re: certolizumab-exposed pregnancies:
- spontaneous loss rate comparable to non-disease controls
- no stillbirths
- preterm similar to disease controls
Plenty positive for CZP in pregnancy!
#ACR24 ABST0805 @RheumNow https://t.co/XCRYsioxC0
Antoni Chan MD (Prof)
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A study exploring the benefits of treating RA patients to remission after achieving low disease activity (LDA).
Key findings:
- Among patients initially at LDA, achieving remission (CDAI ≤2.8) led to significantly better functional outcomes and reduced durable medical equipment… https://t.co/SNPKlRieur https://t.co/YIQNMf3Oap
TheDaoIndex
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Abst#1493 complete renal response (< 0.5 g/g w/< 10 mg/day pred); renal remission (UPCR < 0.3 g/g w/< 5 mg/day pred). 60 LN pts followed 3 yrs: 40% CRR & 19% RR. Pts not in CRR/RR had⬇️eGFR w/more decline in eGFR over time. No difference b/t CRR/ RR @rheumnow #ACRbest #ACR24
David Liew
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Steroids in checkpoint inhibitor rheumatic irAEs need to be approached with caution.
Persistent higher doses earlier on might dampen ICI response.
@HSpecialSurgery ICI-IA (inflamm arthritis) cohort
big diff in survival based on early steroid exposure
#ACR24 ABST1989 @RheumNow https://t.co/3WAZ3ZLbFw
David Liew
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Rheumatic irAEs can get on the CAR-T bandwagon, too!
CAR-T can invoke new rheumatological issues (not just cytokine release) - see @DrGomezPuerta's experience.
Infrequent, but if CAR-T in general becomes common, yet another job for us to attend to...
#ACR24 ABST2004 @RheumNow https://t.co/xBSlhUdkNr
David Liew
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Now that nipocalimab is approved for Sjogren's Disease, what about vaccination response whilst on this FcRn inhibitor (inherently lowers IgG)?
Actually, not bad: takes a little longer to get there, but reassuring!
(always fun to get to know a new med)
#ACR24 ABST1988 @RheumNow https://t.co/IYqIGo5xVP
Adela Castro
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Post hoc analysis of SPIRIT H2H evaluated nail involvement as a measure of ttnt response in PsA.
-Pts with nail involvement treated with IXE or ADA had higher SJC and TJC improvement vs those without involvement at W12, W24 and W52.
-IXE achieved rapid response for DAPSA-LDA as… https://t.co/SR36qCthQo https://t.co/hI3tD5hATJ
Brian Jaros, MD
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The anti-MCTD group strikes back
Of cohort of over 1,000 RNP+ pt, only 17 clinically diagnosed with MCTD
Majority of patients, despite potential overlap, treated for other primary rheum dz
@RheumNow #ACR24 https://t.co/vkQ6UPs34y
sheila
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In this systematic review & metaanalyis by Dr. RFarhat et al, tacrolimus whole blood levels decrease in the 1st & 2nd trimesters then increase back to pre-pregnancy levels postpartum.
Needs further studies to guide dose adjustment.
@RheumNow #ACR24 abs1535 https://t.co/5MovzPJoFc
Mrinalini Dey
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Ab1676 discussed an intervention to change patient mindsets about side-effects of #methotrexate. Watch my video for @RheumNow on this abstract here:
https://t.co/NxuxQ5wYda
#ACR24
Adela Castro
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How do you manage skin in Sscl?
-RNA pol III + high risk for skin progression.
-Limited+ low risk + stable Sscl no need for immunesuppresors.
-Look for EF in pts with generalized morphea.
-Ttnt of skin depending on other organ involvements.
-If no Raynaud’s/hands spared think of… https://t.co/HBjO5eQfjT https://t.co/oS1ZmkanGA
Janet Pope
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Sarilumab is better than #MTX in #PMR
Reminder #RCT of #MTX in #PMR was a NEGATIVE #trial #1697
60 % #sarilumab in #RWE could d/c
#Prednisone after failure of initial #pred #Rx >1yr pred prior vs 40% MTX
Comparative effectiveness sari v MTX
#1700 #ACR24 @ACRheum @RheumNow https://t.co/4YXIBz0OK7
Richard Conway
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Bolhuis et al. PMR MODE study. MTX 25mg/week in recently diagnosed PMR. 52 weeks. 56 patients. Nada, zip, no effect. GC free remission 67% vs 68%. No difference in any secondary outcome. @RheumNow #ACR24 Abstr#1697 #ACRbest https://t.co/Mb909u1zFT https://t.co/dShyBF4WST
Janet Pope
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When you stop 🛑 #TCZ #tocilizumab at
6 months of #Rx in #PMR
RELAPSES are V high
DON’T stop #Toci in PMR too
Early
Rapid and frequent flares
#ACR24 @RheumNow @ACRheum #1698 https://t.co/IX5EJOcIY5
Janet Pope
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This will change my practice!
#RCT #MMF + #MTX
superior to
#Cyclophosphamide then #Azathioprine
In
#Tayakasu’s #arteritis N=150
RCT ~1g BID #mycophenolate + 15mg/wk #Methotrexate
Vs #cyclo ➡️100mg #azathioprine
All got #glucocorticoids
#ACR24 @RheumNow @ACRheum #1696 https://t.co/OpRep1vsmx
