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Health Literacy: the forgotten social determinant of health?
Nine out of ten adults in the USA struggle to understand basic health-related information. Across the pond, in the UK, 7.1 million adults read at, or below, the level of a nine-year-old, with 60% unable to understand health information. An increasing body of research in rheumatic diseases has sought to understand the impact of health literacy, long neglected as a social determinant of health, on clinical and non-clinical outcomes. Several abstracts at this year’s ACR Convergence focus on this topic.
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Taking CAR-T for a Test Drive
When the ACR Convergence 2024 abstract site went live, the first query I typed into the search bar was, “CAR-T.” I consider myself a CAR-T skeptic and would be surprised if the magical results from this NEJM case series replicate at scale, but it seems likely that CAR-T will revolutionize the care for (some) patients with rheumatic diseases. What new data will be presented at ACR?
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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
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Adela Castro AdelaCastro222 ( View Tweet)
Sun et al. MMF+MTX vs CYC/AZA in Takayasu. Overall response rates week 28 58.1% vs 32.4%, week 52 55.4% vs 32.4%. So MMF+MTX>CYC/AZA. But I'm not sure what to do with these results. How does it compare to toc or ada? @RheumNow #ACR24 Abstr#1696 https://t.co/Jr6S2c6AKs https://t.co/L8pMFJ5hnj
Links:
Richard Conway RichardPAConway ( View Tweet)
Safer and less relapses in
#Takayasu’s #arteritis
In
#MTX + #MMF
Vs
#Cyclo ➡️ #azathioprine
@RheumNow #ACRBest @ACRheum abst#1696
WOW 😮 Amazing! https://t.co/y3BDjdAa6P
Janet Pope Janetbirdope ( View Tweet)
Study on severe lymphopenia in SLE:
- Assessed incidence, risk factors, and outcomes
- 11.52% of SLE patients experienced severe lymphopenia
- Higher infection rates during severe lymphopenia period
= No opportunistic infections observed #ACR24 abst#1519 @rheumnow @HSSProfEd
Bella Mehta bella_mehta ( View Tweet)
Study on cardiovascular deaths in SLE:
- Analyzed 1999-2020 data
- Overall decline in mortality rates, but recent increase since 2014
- Higher rates in women and African Americans
- Geographic disparities noted
#ACR24 abst#0998 @rheumnow https://t.co/dpjsl0gI0x
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Bella Mehta bella_mehta ( View Tweet)
Salivary glands in #Sjogens #Disease
Have persistent
#IFN signature
Abnormal morphology
⬇️ secretory ability
In
Differentiated salivary gland organoids
DSGO
May aid in drug screening
Would drugs that
⬇️ #interferon help #Sjogren’s
Abst#1406 @RheumNow @ACRheum #ACR24 https://t.co/dppp0tyFk5
Janet Pope Janetbirdope ( View Tweet)
The Joint Project is a community-based, barangay health worker-led screening program that aims to increase MSK dse awareness, timely referral & treatment or rehab.
The figure below illustrates the conceptual framework for the program
@RheumNow #ACR24 abs0979 https://t.co/yxXsASl2GJ
sheila RHEUMarampa ( View Tweet)
Ultrasound guided injections on cadavers improve rheumatology trainees ability to do
#joint #injections
17 trainees -a couple of hrs of cadaver inj
▶️ joint injection confidence improved esp uncommon / difficult areas
Elbow
Ankle
Wrist
@RheumNow #ACR24 @ACRheum abst#1310 https://t.co/ZcER4s8QcR
Janet Pope Janetbirdope ( View Tweet)
Harkins @DrTrishHarkins et al. PROs predict relapse in PMR. pVAS, HAQ health status, FACIT-F all positive predictors. Interestingly PHQ-9 negative predictor. @RheumNow #ACR24 Abstr#1238 https://t.co/kj4WgmI0oq https://t.co/xLDzRZvxoA
Links:
Richard Conway RichardPAConway ( View Tweet)
Cowley et al. US pattern in Subclinical GCA in PMR vs GCA. Subclinical GCA has more isolated axillary artery involvement. Severity of US inflammation significantly higher in GCA than subclincal GCA @RheumNow #ACR24 Abstr#1629 https://t.co/6Iyx76YgkS https://t.co/DxzTEwE5J5
Links:
Richard Conway RichardPAConway ( View Tweet)
Findings from Abstr#1436 reveal that cigarette smoking is not positively associated with radiographic progression in psoriatic arthritis (PsA). Current and past smokers showed a longer time to joint damage progression. This suggests a complex relationship that warrants further… https://t.co/ERsAKoivA4
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Late-onset asthma but earlier EGPA diagnosis?
Abstract 1604 used IQVIA data to develop a machine learning model for better EGPA dx. Key predictors included eosinophilia, asthma, chronic sinusitis, multiple CXRs, skin biopsies, and GC prescriptions. @RheumNow #ACR24
Akhil Sood MD AkhilSoodMD ( View Tweet)
At "Envisioning a Steroid Free Future" talk
Angelo Gaffo at the mic: "Are there any situations you would do induction therapy for AAV without steroid?"
John Stone: [pause] "No." 😄
#ACR24 @RheumNow
Mike Putman EBRheum ( View Tweet)
#1350
🔬 Microbiome & RA: Impact on Disease Activity & Vascular Function
➡️ Salivary microbiome a/w arterial stiffness (AIx)(p 0.019)
➡️ Stool microbiome a/w DAS28-CRP(p 0.027)
🔴Key taxa👇identified for each; no common taxa for both disease activity & AIx.
#ACR24 @RheumNow https://t.co/54Sumzzd27
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
What is the impact of social connections on lupus?
Abstract #1503: In an NYC SLE cohort, greater social integration and support correlated with less pain, depression, disability, and frailty, while loneliness was linked to worse outcomes.
@RheumNow #ACR24 #SDoH https://t.co/5OCCExee06
Akhil Sood MD AkhilSoodMD ( View Tweet)
Reason for consult: aortitis- evaluate for systemic causes
Abstract 1638: Kmetova et al highlight the promising clinical utility of calprotectin as a marker for clinically isolated aortitis
@RheumNow #ACR24 https://t.co/2qPaAqWswG
Akhil Sood MD AkhilSoodMD ( View Tweet)
What is Osteoarthritis? A downloadable patient education page from JAMA. https://t.co/pQgGfI0boe https://t.co/pd3kygUxkH
Dr. John Cush RheumNow ( View Tweet)
🫁RP-ILD a/w high morbidity and mortality
How to Predict RP-ILD Development?
➡️AutoAb: anti-MDA5, anti-ARS, anti-Ro52
➡️Biomarkers: CRP, LD, Ferritin, KL-6
➡️CT: Lower consolidation/GGO
#ACR24 @RheumNow https://t.co/OIrHfVTZcM
Links:
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
