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ACR23 – Day 3 Report

Jack Cush, MD

These year’s annual ACR Convergence has been a success with the return of an insanely active Poster Hall! F2F learning amidst miles of research and many young talented aside wizened establish presenters is such a welcome return to ACR, the way it should be.

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Yes No

Should We Change How We Prescribe Methotrexate?

Robert Chao, MD

For as long as I can remember, methotrexate has been the anchor drug treatment of rheumatoid arthritis. We also know it has limited oral bioavailability at doses greater than 15mg. There are subcutaneous forms that offer better bioavailability, but its subcutaneous nature can sometimes sway patients away from trying it in addition to its higher cost. Split dosing of methotrexate can be a solution to attain higher bioavailability; however, its effect on clinical efficacy is unknown. 

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Day 2 Report - ACR Plenaries: Changing the Practice of Rheumatology

Kathryn H. Dao, M.D.

Over the years of navigating the annual meeting, I found the sessions with the most impact to my practice were the Plenary Sessions. During these sessions, the latest research is presented, new ideas are floated, and old myths debunked. Here are the top ACR2023 Plenary abstracts I found impactful for my practice.

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ACR Best

#ACRbest Abstracts – Day 2

Jack Cush, MD

Our reporters have been prolific in finding the hot abstracts, those that were most attended or those that are getting the most buzz on social media.  Here are RheumNow's #ACRbest abstract reports from Monday, November 13, 2023 at #ACR23, covering The Great Debate, SGLPT2 inhibitors in SLE, the SMART Study of MTX, TMP/SMX Prophylaxis, RA-ILD & TNF Inhibitors, cancer research and more. 

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Palliative Care & Rheum - #ACR23 @RheumNow Consider Pall Care for Serious Illness: "high mortality risk & negatively impacts function or QoL OR strains caregivers" - thats a lot of rheum pt @HopkinsBayview-led session, always pt-centric @kekuchinad @MymaAlbaydaMD @jhrheumatology https://t.co/1j4lrkb5Ra
Eric Dein  ( View Tweet)
Clinical Year in Review at #ACR23 By @philseo (@jhrheumatology) Review some of the most impactful scientific studies in #Rheumatology in the past year! 🍕 https://t.co/ystEjzrU8u
Mithu Maheswaranathan, MD  ( View Tweet)
Daily Recap - TUESDAY https://t.co/Vq5BSHmPsv

Links:

Dr. John Cush RheumNow ( View Tweet)

ARTIC REWIND RCT 3 yrs csDMARD withdrawal 38% 3yrs csDMARDs free remission vs. 80% stable dose gpe 75% recovery after restart Rx progression 19% in half dose gpe More use bioDMARDs (18%) & GCs (50%) withdraw gpe Trends towards lower infections @RheumNow #ACR23 #ACRBest https://t.co/jhOINV7LLS
Aurelie Najm  ( View Tweet)
Tapering ABA vs. stable dose ABA in RA No diff in DAS28 remission at 2 years But… Only in patients receiving concomitant MTX Those tapering ABA mono also experience higher functional important Of note: not an RCT @RheumNow #ACR23 ABST2542 https://t.co/yycCDTnRiF
Aurelie Najm  ( View Tweet)
Rheumatologist - pharmacist co-management of MTX initiators @GeisingerHealth Philadelphia Having the dual skill set actually helped with adherence to guidelines vs standard care. Would be great to see how this works with implementation in RA clinics #ACR23 ABST2484 @RheumNow https://t.co/88R1BYzYn5
David Liew drdavidliew ( View Tweet)
Complements & HCQ? (Prof Petri et al) Significant ⬆️ in C3 (p=0.022) & C4 (p=0.003) levels with HCQ whole blood levels >50 ng/mL Increasing blood levels of HCQ significantly assocd w/⬆️prob of achieving normal C4 Improving C3,C4; addtl benefit of HCQ? #ACR23 ABST2327 @RheumNow https://t.co/5ucpXq9ngb
sheila  ( View Tweet)
TM83 #ACR23 @RheumNow 45yo M b/l sacroiliitis, Rx MTX -> ADA -> MTX + Tofa. No improv Low Ca, & Phos, ALP 239. Nml Vit D, High PTH. DEXA: Osteoporosis FGF23 high PET/CT showed soft tissue density in nasal septum, few cortical breaks Dx: oncogenic osteomalacia 2/2 malignancy https://t.co/EOcYNtovBy
Eric Dein  ( View Tweet)
Extended-Release Fluticasone Propionate for Injectable Suspension - EP-104IAR Phase 2 Randomized (1:1), Double-blind, Vehicle-Controlled Trial 318 pts, 57% F, age 64, Clinically and statistically significant pain relief for 14 weeks compared to vehicle @RheumNow #ACR23 #abstL04

Bella Mehta bella_mehta ( View Tweet)

If we're to summarize the challenges to making for CAR-T therapy work in a given disease, this is it: Dr. Chyi-Song Hsieh ⁦@WUSTL #ACR23 @RheumNow https://t.co/raoHtrJ25S
David Liew drdavidliew ( View Tweet)
Great summary of the big takeaways yesterday at #ACR23. Always love talking to @KDAO2011 @EBRheum @RheumNow We get into the use of MTX, the safety on TNFs and what is in the purview of rheumatology practice https://t.co/jm0a8ndrsi

Eric Dein  ( View Tweet)

Read my article on ACR Plenaries: Changing the Practice of Rheumatology #ACR23 @ACRheum @RheumNow @uptoTate @Yuz6Yusof @ericdeinmd https://t.co/ql851dVzAk

TheDaoIndex KDAO2011 ( View Tweet)

1-PJP prophylaxis or not in ANCA? 2-MTX single dose or split dose? 3-IL6 blocker early on in GCA/PMR? 4-SGLT2 in DM/Lupus nephritis? 5-Cervical cancer screening in Lupus? 6-TNF induced ILD? https://t.co/mzGXajmQqE @RheumNow , Daily recap #ACR23

Nouf Al hemmadi  ( View Tweet)

2 RA cohorts w/Breast Cancer 17% TNFi within 1yr after surgery No diff in overall survival at 5 yr w/ TNFi or csDMARD Trend towards better BC specific survival w/ TNFi vs. csDMARD only Worst survival for GC>7.5mg/day Only 2 yrs follow up @RheumNow #ACR23 ABST1675 https://t.co/ekKlJ2dP5i
Aurelie Najm  ( View Tweet)
Does TNFi use in pts with RA and early breast cancer affect survival? TNFi did not affect overall survival or breast cancer specific survival compared to cDMARDs Steroids did increase mortality @RheumNow #ACR23 Abs#1675

Robert B Chao, MD  ( View Tweet)

No significant difference in overall survival in early stage breast cancer (BC) patients treated with TNFi (alone -/+ cDMARDs, in 1st year of BC) and cDMARDs in RA. Those on glucocorticoids had worse survival. Suarez-Almazor M, Abst#1675 #ACR23 @RheumNow https://t.co/lnZx3OpuN5

Dr. Antoni Chan  ( View Tweet)

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