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Dr Hebing on s/c vs oral methotrexate. erythrocyte methotrexate polyglutamates significantly higher with s/c administration. s/c consistently seems to be the better option, better efficacy, less side effects. Abstr#1695 #ACR21 @RheumNow https://t.co/kLGr6pVnxQ
Richard Conway RichardPAConway ( View Tweet)
No significant difference in enthesitis activity in PsA pts taking csDMARD vs. TNFi vs. IL-17i
⭐️Age, duration of disease, physician global were main differences in TNFi and IL-17i vs. cDMARD
⭐️no specific clustering noted
Abs#1782
#ACR21 @RheumNow
https://t.co/AH33ZjHUa1 https://t.co/Gb2zKMBUqo
Links:
Robert B Chao, MD doctorRBC ( View Tweet)
#ACR21 Abs#1677. Effects of bDMARD on Lipids:
⬆️ HDL from 62 -> 66 in 1yr (p=0.013)
❌ No signif change in LDL or LDL-C/HDL-C ratios
@Rheumnow
https://t.co/uMsXKwwqvW https://t.co/fhCbDoa3px
Links:
Eric Dein ericdeinmd ( View Tweet)
SELECT-EARLY results for #upadacitinib in #RA
👉🏼UPA better than MTX for clinical response and remission
👉🏼⬆️rates of HZ, neutropenia, CPK elevations
👉🏼No new safety risks identified
Abs#1692 #ACR21 @RheumNow
https://t.co/wJy7MK4pyF https://t.co/YNpE1Axiw0
Mrinalini Dey DrMiniDey ( View Tweet)
ACR21 Best Abstracts We Saw - Day 3 (Monday)
The third day of ACR 2021 took a big leap in online content. Here is a compilation (with links) of presentations were the “ACRBest” as seen by our RheumNow faculty.
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Day 2 Report from ACR21
This report highlights the VITAL trial; the ORAL Surveillance Study; and the Microbiome study of monozygotic psoriasis patients.
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Methotrexate and hepatic fibrosis: we must be doing something right
Methotrexate may be a rheumatologist’s best friend, but a key part of counselling any patient about its use has always been the risk of hepatotoxicity.
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#ACR21 Year In Review: Factors associated with #COVID deaths in pts with #RMD:
⛔️age, male, HTN/CVD, lung disease, steroid>10mg/d, ⬆️disease activity
⛔️RTX (OR: 4), SFZ (3.6), other IS (2.2), No DMARDs (2.1) vs MTX monotherapy as reference @RheumNow https://t.co/Zd6qXCtGLk https://t.co/YHBEelLqKB
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Infxn risk of 1st year on rituximab for mod to severe SLE vs standard-of-care
🔹Most common SoC Rx: MMF, Aza, and/or cyclophosphamide
🔹🚫significant diff
🔹RTX pts = ⬆️dz duration, ⬆️# of prior meds, ⬇️maintenance steroid dose
https://t.co/AYQFXqlubl
#ACR21 Abst1288 @RheumNow
Pedro Castillo _Castillo_Pedro ( View Tweet)
#ACR21 #Abstr1462 More case against Low dose Hydroxychloroquine as could ⬆️ risk of #lupus flares. Adjusted risk as below:
Weight =>80kg, <400mg/d dose (OR 8.3)
Weight <80kg, <300mg/d dose (OR 2.6) @RheumNow https://t.co/bTRMJDoSoI https://t.co/yzopiO3Kbo
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Alcohol and MTX don't go along!
In a cohort of 1000+ early RA
Factors associated w/
1️⃣Nausea
Female OR 2
🍺 Alcohol OR 1.44
DAS28CRP OR 1.16
2️⃣Alopecia
Age OR 4.87
🍺 Alcohol OR 1.98
HAQ score OR 1.62
#Abst1444 #ACR21 @RheumNow https://t.co/zZG6aFR1SX
Aurelie Najm AurelieRheumo ( View Tweet)
👉HCQ dose < 400 mg/d are assc with SLE flare. Lower doses of HCQ may decrease risk of retinopathy. 👉For >80 kg (176 lbs), any dose < 400 mg/day is assc with increased odds of flare
(HCQ blood levels not measured)
Abst#1462 #ACR21 @rheumnow https://t.co/5tx3kruT8W
TheDaoIndex KDAO2011 ( View Tweet)
@ericdeinmd Although the MTX/alopecia - nausea poster was interesting. Abst#1444 #ACR21
Factors assc w/MTX- nausea/alopecia:
👉female sex
👉EtOH use
👉higher disease activity
👉belief that the med will cause it
(older age assc w/⬇️risk of nausea) https://t.co/XDKFhvN0V1
@rheumnow
TheDaoIndex KDAO2011 ( View Tweet)
#ACR21 Ab#1444 @AhmadSherbini. Factors ass w/ nausea & alopecia in MTX
⭐️Nausea & alopecia: ♀️, 🥃, activity score are risk factors
▶️EtOH highlights importance of folic acid in these pts!
@Rheumnow https://t.co/6UNUVh5ZW8 https://t.co/lxB2z2lXtu
Links:
Eric Dein ericdeinmd ( View Tweet)
Love-hate relationship with #methotrexate. Side effects are common ex nausea/GI in 1/3 and alopecia in women. ?if you ask do you get more AES. Tough to treat especially SEs are early. ?Coach pt to help w persistence abst1444# @RheumNow #ACR21 https://t.co/NDQDVz8lk2
Janet Pope Janetbirdope ( View Tweet)
Abst1344 #ACR21 @RheumNow observational study of pts w/PsA treated w/b&tsDMARD:pts who achieve MDA (22.8% of pts at 6 mo) more likely to maintain the initiated bDMARD or tsDMARD Rx & less likely to switch from the initiated bDMARD/tsDMARD https://t.co/egFDHV3eQs
Olga Petryna DrPetryna ( View Tweet)
#volcosporin good ~lupus nephritis added to #MMF but underbelly - side effects like but ?less than #cyclosporin. #FDA update - ⬆️hypertension and nephrotoxicity, infection #ACR21 @RheumNow https://t.co/w5nLLSTlrB
Janet Pope Janetbirdope ( View Tweet)
"Baseline and routine EKGS are NOT required for SLE patients just because they are on HCQ!" - Dr. HM Belmont. "The drug has been demonized due to its use in COVID patients. We don't need to hold HCQ for EMR alerts (e.g, with cipro, SSRIs, etc)." Abstr#1743 #ACR21 @rheumnow https://t.co/5Bxavo6dRg
TheDaoIndex KDAO2011 ( View Tweet)
Post-hoc analysis of Deucravacitinib (TYK2i) for tx of PsA showed similar efficacy in pts with and without background csDMARD use.
⭐️>60% w/ background csDMARD use, majority of which was MTX
⭐️no difference in AE
#ACR21
Abs#1352
@RheumNow
https://t.co/nIJT7rNkJP https://t.co/bq0x1Ywguo
Robert B Chao, MD doctorRBC ( View Tweet)
What predicts response to MTX in RA?
👉🏼DAS28-ESR
👉🏼RA duration
👉🏼Pt global assessment
👉🏼Swollen joint count
Abs#1227 #ACR21 @RheumNow
https://t.co/s942zvFiZ1
Mrinalini Dey DrMiniDey ( View Tweet)