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Systemic Sclerosis and Physical Therapy
Systemic sclerosis (SSc) is a chronic fibrosing disease currently with no available cure.
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”Somatic mutation (in UBA1) may account for a significant fraction of adult-onset inflammatory disease” says Dr. Dan Kastner. Have you seen VEXAS in your clinic? #ACR20
Dr. Rachel Tate uptoTate ( View Tweet)
Reflecting on my first @ACRheum Congress- it wasn’t how I expected my first ACR to be. But #ACR20 was brilliant given the circumstances!
Easily one of the best virtual events I’ve attended- smooth platform, huge variety of sessions and efficient on-demand service.
@RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
Spot diagnosis @RheumNow @CRASCRRheum #ACR20 hint this woman has 2 rheumatic diseases https://t.co/kEu9COJY3B
Janet Pope Janetbirdope ( View Tweet)
#ACR20 Closing Session: really poignant words from Dr Diane Kamen:
"This meeting...allowed people to 'go to the microphones'...people who wouldn't normally get up and ask questions during the sessions...allowed for a lot more exchange of ideas."
Couldn't agree more!
@RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
What would you use in multidrug failure RA pt from last tweet +RF nodules & keratitis failed 2 TNFi & 2 JAKi @RheumNow #ACR20 @CRASCRRheum
Janet Pope Janetbirdope ( View Tweet)
Low-dose steroids in RA: what's the harm, right?
(You probably know where I'm going with this)
ESPOIR 10y data: total events, and severe infections worse with dose and time
(cumulative 8.4g ≡ 5mg/d)
No doubt some residual confounding, but real risk!
#ACR20 ABST1998 @RheumNow https://t.co/BAQmOR1ped
David Liew drdavidliew ( View Tweet)
What would you use next? sero+ RA new keratitis requiring prednisone and now also 20 SJC. New rheumatoid nodules. Pt has been on triple csDMARDs + Leflunomide, then 2 JAKi and 2 TNFi also with MTX each time. All Rx works for 6 months then relapse. @RheumNow @CRASCRRheum https://t.co/9cTS1tNE42
Janet Pope Janetbirdope ( View Tweet)
Filgo decreased MRI inflammation of many structures early in Rx in SpA which seems novel says w Maksymowych 5M015 @RheumNow #ACR20 @CRASCRRheum #ACRbest https://t.co/LOOOn7Hjvp
Janet Pope Janetbirdope ( View Tweet)
Inadequate response to MTX, what next?
“Are you forward thinking or are you stuck in the past? Conceptually it is just amazing that you can take a PO tablet as potent as a TNF or IL6 blocker... & the side effects are not so appalling.”—Dr. GreggSilverman. @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Summary of #ACR20 part C:
- A must see talk was the avacopan story
- IVIG for myositis does work! More than just anecdotal evidence now
- DIET is key to helping improve autoimmune dz!
- low dz activity RA pts should taper off of MTX 1st when also on TNFi @jeffsparks @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
@RheumNow #ACR20 abs1923 prosp cohort study of angiographic lesions in Takayasu’ &GCA: although infrequent new angio lesions more likely in TAK. Improvement is possible in both conditions, more likely to occur in TAK. Change in the branch arteries more dynamic than in the aorta https://t.co/2KsZ6o3vtP
Olga Petryna DrPetryna ( View Tweet)
When do you think we are going to get a DMARD for OA? 50% or more over age 60 will have osteoarthritis, yet we are yet to discover a promising disease modifying therapy. #ACR20 @RheumNow @ElaineHusniMD
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
“We are giving autoimmune diseases to ourselves through bad diet.” — Dr. Gregg Silverman, #ACR20 @RheumNow @drnatalietv
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
@RheumNow #ACR20 abs1921 single center baseline & follow-up PET/CT scan study in pts w/ refractory LVV-GCA on TCZ: while 83.33%pts achieved clincial remission only 10% experiences normalization of Total vascular score. https://t.co/sQK4L7Zu76
Olga Petryna DrPetryna ( View Tweet)
“Avacopan is the little train that could that will eat the antibodies lunch!” - Dr. Gregg Silverman #ACR20 @RheumNow @petermerkel @LCalabreseDO @philseo @AdamJBrownMD
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
As #ACR20 is wrapping up, are you are planning to see the conference lectures after the meeting is over? @RheumNow
Bella Mehta bella_mehta ( View Tweet)
Dr Lillegraven presents a randomized open-label phase 4, non-Inferiority trial of TNFi tapering in RA patients in sustained remission. 63% of tapered patients flared over 12 months vs 5% of maintained. Good response to reintroduction of TNFi @rheumnow #ACR20 Abstr#2010 https://t.co/Ki7PTsetbH
Richard Conway RichardPAConway ( View Tweet)
@rheumnow #ACR20 abs1535 retrospective study of SI MRI reveals 20% pts w/out spondyloarthritis have BME on an MRI, predominantly in the antero-middle quadrant. Erosions were seen in 31% of healthy patients and in 61% of patients with spondyloarthritis
Olga Petryna DrPetryna ( View Tweet)
Summary of #ACR20 part B:
- The future is bright with many trainees producing great research per Dr. Diane Karen
- Belimumab (phase III) reduced proteinuria, improved renal for, and helped w/ tapering of GC in pts w/ lupus nephritis but more infect in GC group @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)