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#ACR21 Abst#0836. TCZ switch from IV▶️SC in RA
⭐️11/37 ineffective on SC (30%)
⭐️TCZ IV >8mg/kg, no MTX, h/o ABA failure ass w/ risk of flare on SQ switch
🔥Very relevant w shortages, want more data re: confounders (adherence, disease control)
https://t.co/E9pD4SrXqz @Rheumnow
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Eric Dein ericdeinmd ( View Tweet)
Another benefit of DMARD use in RA. Dr Sood reports lower risk of long term opioid use. Very important given the harm of opioids Abstr#587 #ACR21 @RheumNow https://t.co/d1Dharf5jZ
Richard Conway RichardPAConway ( View Tweet)
#ACR21 Abs#0825
Early RA -Rx-naive: 48 wk, csDMARD+GC vs. 3 bDMARD+MTX (CZP/ABA/TCZ)
⭐️Superiority for ABA+MTX and CZP+MTX vs. to csDMARD+GC, not in TCZ+MTX
⭐️ Radiographic progression low in all
▶️ Short study w very aggressive 1st line combo Rx
https://t.co/TJPZkqmN8z @Rheumnow
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Eric Dein ericdeinmd ( View Tweet)
Dr Exarchou presents incidence of PsA in Sweden. 22/100000. 75% received DMARDs within 2 years, which seems high, so perhaps this is tip of iceberg with milder cases undiagnosed. Abstr#0571 #ACR21 @RheumNow https://t.co/kANG6KBnOd
Richard Conway RichardPAConway ( View Tweet)
For rheumatologists, instinct says in RA everything’s better with MTX. For tofacitinib, where immunogenicity not an issue, is that actually true?
Canadian registry data: maybe no
after 36m, low no. ?valid, markups mine
Need to see more of this!
#ACR21 ABST0827 @RheumNow https://t.co/VVwd4SZgVx
David Liew drdavidliew ( View Tweet)
MTX and liver: FibroScan scores compatible with liver fibrosis are significantly correlated w/ several parameters
-BMI
-waist circumference
-male gender
-age
but NOT MTX cumulative dose in a cohort of 500+ patients.
#Abst0786 @RheumNow #ACR21 https://t.co/RkSpVqN4qF https://t.co/9TENaR0WZ3
Aurelie Najm AurelieRheumo ( View Tweet)
Dr. R Thomas: current studies on prevention of RA:
👉oral DMARDS (MTX, HCQ)
👉biologics (RTX, abatacept)
👉 studies regulating T cells to restore tolerance
👉biomarkers of tolerant state & look at people who don't develop RA
👉 imaging as window of subclin dz. #ACR21 @rheumnow https://t.co/5bsu5459az
TheDaoIndex KDAO2011 ( View Tweet)
#ACR21 Abst#0786. Fibroscan screening for liver injury in pts on MTX:
▶️No significant correlation between cumulative MTX dose and liver stiffness by fibroscan, even at high dose MTX.
⭐️Age, sex, waist circumference, BMI are risks
@Rheumnow https://t.co/IhcNr9fhEh https://t.co/c7TUoGrNZ7
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Eric Dein ericdeinmd ( View Tweet)
Opening Day Report
The opening of ACR2 Convergence was a hit for all who signed up and viewed in. The day included the presidential address by outgoing president Dr. David Karp (UT Southwestern) and a keynote talk and interview with Dr. Seema Yasmin (Stanford).
Read Article
Blurred line btwn RA, preRA & RA prevention which makes interpretation of RCTs problematic. I’ve learned that if pt has RA not meeting criteria, some Rx ⬇️chance of RA over time-MTX, now #Abatacept but was it RA anyway AND what happens when you stop Rx? #ACR21 @RheumNow abst#0505 https://t.co/HwivsITvCQ
Janet Pope Janetbirdope ( View Tweet)
#ACR21 #Abstr0261 In stable Non sJIA, is it safe to taper or stop MTX? Of 375 pts in CARRA registry, 24% tapered and 14% stopped MTX. No diff in flare rates btw those continued vs tapered/stopped. Sustained remission was in ⬆️tapered vs stopped @RheumNow https://t.co/Mm1yfzRBQz https://t.co/rkHvXWj2oO
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#GreatDebate: add belimumab (BLMB) vs. voclosporin (VCS) to MMF for lupus nephritis (LN)
Dr. Petri argues for BLMB b/c: (1/2)
👉improvement in LN
👉improvement in non-renal lupus
👉decrease lupus renal mortality
👉**prevent GFR reduction **
👉long term efficacy
#ACR21 @rheumnow
TheDaoIndex KDAO2011 ( View Tweet)
Dr B Bermas noted AAP guidelines say avoid MTX while breastfeeding, but the literature show very little MTX crosses breast milk. Dr Sammaritano stated that is true, but we don’t know how much MTX accumulates,though. #acr21 @rheumnow @UTSWRheum https://t.co/9I7HszorEO
TheDaoIndex KDAO2011 ( View Tweet)
Would you allow a pt to continue MTX while breastfeeding? #acr21 @rheumnow
TheDaoIndex KDAO2011 ( View Tweet)
#ACR21 The Great Debate: Belimumab vs Voclosporin as Add-On Therapy in #LupusNephritis | Dr. Petri & Dr. Rovin
Audience Vote 🗳: What would you add to mycophenolate first?
Belimumab 71%, Voclosporin 29%
#ACRAmbassador @ACRheum
Summary of Pros & Cons of Each⬇️ https://t.co/OtLxs8IYr9
Mithu Maheswaranathan, MD MithuRheum ( View Tweet)
Prolonging the Controversy of Hydroxychloroquine
Dr. Kathryn Dao (@KDAO2011 ) shares several abstracts from #ACR21 that addressed the topic of HCQ and cardiovascular safety.
https://t.co/J6sVzYJkUZ https://t.co/dBZmtwQ927
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Dr. John Cush RheumNow ( View Tweet)
COVaRiPad study - Immunosuppression affects COVID-19 vax Ab levels. 247 pts, 90% seroconverted but @ reduced (3.4 fold) titers. Lowest w/ MMF (21x) and B cell Rx vs MTX/AZA (3-4x). Pts on B cell therapy should wait 6 mos to recv vax #ACR21 Abstr# 0457 https://t.co/1gkCsJSDBk
Dr. John Cush RheumNow ( View Tweet)
KEEPsAKE trial 1 (DMARD-IR) and 2 (DMARD/biologic-IR) on risankizumab (IL23i) for PsA:
👉phase 3 DBRPCT 24 weeks
👉150 mg week 0,4, 16 weeks
👉improved ACR20,ACR50,ACR70
👉improved PASI90
👉improved HAQ-DI
👉no increased safety signals
#ACR21 Abstr#0438 #Plenary @rheumnow https://t.co/ioIBXgV4Hi
TheDaoIndex KDAO2011 ( View Tweet)
ARIAA study of abatacept in pre-RA. Abatacept ⬇️MRI inflammation and reduces progression to RA. Of course it does. Like all these studies, really not sure what this is telling us. Abstr#0455 #ACR21 @RheumNow https://t.co/yNVVZFBWDq
Richard Conway RichardPAConway ( View Tweet)
Prevention study using Abatacept in 100 patients with arthralgia is superior (61%) to placebo (31%) in improving subclinical inflammation in RA at-risk patients (ACPA+, MRI+, Arthralgia+) at 6 months. No new safety issue emerged @RheumNow #ACR21 Abst#0455 https://t.co/DoRItcHfBE
Dr. Antoni Chan synovialjoints ( View Tweet)