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You have a patient with RA on 25 mg MTX SQ, tolerating well without side effects. They have moderate disease activity. Your next step: @Rheumnow. #ACR20
Eric Dein ejdein1 ( View Tweet)
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New #ACR RA guidelines is cost conscious:
1. DMARD naive: Preferred MTX over LEF>HCQ/SSZ and preferred MTX over biologic/tsDMARD
2. DMARD naive low DAS: HCQ or SSZ preferred >MTX>LEF
3. T2T goal LDA/remission
@rheumnow (thread)
k dao KDAO2011 ( View Tweet)
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Hepatitis B infexn in RA? Below is the ACR 2020 draft treatment guidelines in this patient population: @RheumNow #ACR20 https://t.co/C3zw4TWOpg
sheila RHEUMarampa ( View Tweet)
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Here is rationale for this recommendation away from triple therapy even though it has not shown to be inferior treatment, but works better/better adherence #ACR20 @Rheumnow. https://t.co/fQPOjLEjoA https://t.co/XrimgQW7oH
Eric Dein ejdein1 ( View Tweet)
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Switching or adding a DMARD in pts w/ moderate-high dz RA activity & hx of previous serious infection w/in the past 12 mos as opposed to starting/increasing GCs is conditionally recommended per draft recs of new ACR RA treatment guidelines. #ACR20 @rheumnow @CCalabreseDO
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
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Draft #ACR20 Rx Recs for RA: MTX is conditionally recommended with NORMAL LFTs and no advanced fibrosis. Role of HCQ for NALFD has been suggested at ACR, but not enough for mod-high disease activity @RheumNow. https://t.co/QFF3BK1NF0
Eric Dein ejdein1 ( View Tweet)
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New #ACR20 draft guidelines for RA treatment @RheumNow https://t.co/j8jUdgM4dD
Dr. Rachel Tate uptoTate ( View Tweet)
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Draft #ACR20 Rx Recs for RA: Treatment recommendations for Hepatitis B - highest risk is for RTX for reactivation! @RheumNow. https://t.co/2KX99yf8pD
Eric Dein ejdein1 ( View Tweet)
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Conditional recommendation to add bDMARD or tsDMARD in RA pts on maximally tolerated dose of MTX over adding HCQ+SSZ (triple therapy) per draft recommendation of new ACR RA treatment guidelines. #ACR20 @RheumNow @ElaineHusniMD https://t.co/MW0fOAeK09
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
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Study on #telehealth in #rheumatology patients in the US finds those with #comorbidities and high disease activity are most likely to take up remote consults.
Abs#1962 #ACR20 @RheumNow
https://t.co/aHiuoY507p https://t.co/8ScM9pkTZE
Mrinalini Dey DrMiniDey ( View Tweet)
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#ACR20 RA treatment recommendations:
On administration of MTX 👇@Rheumnow https://t.co/XPXx8dq8gY
sheila RHEUMarampa ( View Tweet)
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Draft #ACR20 Rx Recs for RA: discontinue MTX over biologic or tsDMARD in "patients that strongly want to discontinue", conditional recommendation supported by SEAM-RA Abst#939 @RheumNow https://t.co/U7cDhHIYzA
Eric Dein ejdein1 ( View Tweet)
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Draft #ACR20 Rx Recs for RA: on max tolerated MTX - add bio or tsDMARD conditional recommendation over triple therapy (MTX, HCQ, SSZ). @RheumNow. https://t.co/s6fKEW8czc
Eric Dein ejdein1 ( View Tweet)
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Draft #ACR20 Rx Recs for RA: Use MTX, starting oral but remember MTX tricks to maximize success. Folic acid, split dosing, SubQ all keys per Dr. O'Dell to maximize @RheumNow. https://t.co/8K9BjotZha
Eric Dein ejdein1 ( View Tweet)
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Novel predictors of early mortality in a cohort of GCA pts from Portugal:
🚩Older age at dx
🚩Tongue claudication
🚩Prior tx w/ anticoag
BP treatment at dx - predictor of early survival. @RheumNow #ACR20 abs1935 https://t.co/TGJNnZ8vTQ
sheila RHEUMarampa ( View Tweet)
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Draft #ACR20 Rx Recommendations for RA: MTX monotherapy conditionally rec over csDMARD dual or triple Rx, MTX+TNFi @RheumNow https://t.co/jyjRD5aadN
Eric Dein ejdein1 ( View Tweet)
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Rituximab in AAV: how to dose?
Should we be giving:
- 'haem dosing': 375mg/m2 x4 doses
- 'RA dosing': 1000mg x2 doses
Systematic review says: no difference
Reassuring given the variation in practice in real life!
#ACR20 ABST2048 @RheumNow https://t.co/Jf4Ue6HRRL
David Liew drdavidliew ( View Tweet)
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#ACR20 @RheumNow https://t.co/Duu2VK7Yes
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
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Prelim. results: Immunogenicity of adjuvanted #HerpesZoster subunit #vaccine in #RheumatoidArthritis patients taking #JAKinhibitors
- Most RA pts on JAKi have sufficient antibody response to HZ vaccine
- Acceptable safety profile
Abs#1997 #ACR20 @RheumNow
https://t.co/8HWAIwOATD
Mrinalini Dey DrMiniDey ( View Tweet)
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Rheumatology reimbursement by CMS:
"If all goes well, in a few months, you will see a 16% increase in rheumatology."
- From ACR Advocacy Updates
@RheumNow #ACR20 Abs#5M017
Robert B Chao, MD doctorRBC ( View Tweet)