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13S150. Draft ACR/EULAR APLS Classif Crit #ACR22
Entry: Clinical & +aPL w/in 3 yr
Then: Additive crit
-Don't count other cause
Clinical Domains: Macrovasc VTE, Macrovasc AT, Microvasc, Obst, Cardiac, Hematology
Lab: +LA, aCL/B2GP IgM/IgG/titer
Total: 3+ clin, 3+ lab
@RheumNow https://t.co/YeKW0orjZC
Eric Dein ericdeinmd ( View Tweet)
Plenary:
Tyrosine kinase 2 (TYK2)
◦ Mediates signaling of Type I IFNs, IL-23, and IL-12
◦ Key cytokines involved in lupus pathogenesis
◦ Deucravacitinib oral TYK2 inhibitor
◦ Phase 2 RCT in SLE showed efficacy
Pike M Abs1117 https://t.co/eJhNsM02Vl #ACR22 @RheumNow https://t.co/C6JQqR1DLj
Dr. Antoni Chan synovialjoints ( View Tweet)
Carter et al. Case series showing rapid effect of anifrolumab in refractory discoid lupus and SCLE. @RheumNow #ACR22 Abstr#0974 https://t.co/RjnNxjGJoP…
Richard Conway RichardPAConway ( View Tweet)
Are preexisting autoimmune dx pts okay for
PD-1i/CTLA-4i combo immunoRx
(vs PD-1i single agent)?
Common question in practice for your rheum pts who get cancer
Combo ICI means:
de novo irAE: double risk
flares: same risk
Give our pts what they need!
ABST0757 #ACR22 @RheumNow https://t.co/Vs1AoM54Ut
David Liew drdavidliew ( View Tweet)
Zheng et al. Celiac disease more common in SLE aOR 2.88 (95%CI 2.60 –3.31). More common in white females. Assoc higher hospitalization cost and increased LOS @RheumNow #ACR22 Abstr#1192 https://t.co/kdwLmpIxNN https://t.co/ZdQJQn3QIF
Richard Conway RichardPAConway ( View Tweet)
Phase 2 efficacy and safety of deucravaticinib (TYK2i) in mod-severe SLE. Met primary endpoint (SRI4) for 3mg and 6mg doses (but not 12mg). No signal for HZ but increased oral herpes. Bigger numbers will be helpful.
@RheumNow #ACR22 #plenary #ACRBest https://t.co/SjW1OSQzdM
Julian Segan JulianSegan ( View Tweet)
DEUC showed statistically significant and sustained clinical efficacy in SRI(4) responses versus PBO and was well tolerated in SLE. Plenary Abs 1117 #ACR22 @RheumNow https://t.co/iHPiA8FCwO https://t.co/A0FQ7zwL64
Dr. Rachel Tate uptoTate ( View Tweet)
#ACR22 Plenary II Abstr#1117 Phase 2 results +ve in #lupus! Patients (65% White) on Deucravacitinib, TYK2-i had more SRI-4 response rates vs PBO. PBO:34.4%; DEUC 3 mg BID:58.2%, DEUC 6 mg BID:49.5%, DEUC 12 mg QD:44.9%. No major safety, slight increase in oral herpes @RheumNow https://t.co/QIJfoeP4dg
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Costenbader @karen_kc123 7 year results VITAL. 2000iu vitamin D reduced autoimmune disease over 5 years; after trial end, effect dissipated and no longer overall significant. No change in borderline effect of 1000 mg/day omega3. @RheumNow #ACR22 Abstr#1200 https://t.co/lebdzWIO4n https://t.co/HKbHwLihrI
Richard Conway RichardPAConway ( View Tweet)
Inverse association between average yearly HCQ dose and CV damage in cohort of SLE pts from Abs 0982 #ACR22 @RheumNow https://t.co/sfB6ONgwOa https://t.co/FAUGAVe2mB
Dr. Rachel Tate uptoTate ( View Tweet)
Ab1115 #ACR22 Rx Co-Pay affects Rx Adherence in SLE
Higher copays associated w/:
💊39% lower odds of HCQ adherence
💊56% lower AZA adherence
💊32% lower MMF adherence
Need better $$ and transparency into costs. Screen for determinants of health affecting affordability!
@Rheumnow https://t.co/1NdBb3GLzL
Eric Dein ericdeinmd ( View Tweet)
Serum AMH reduced in adolescents w/ rheumatic disease compared to menstrual-age matched, healthy controls. UCTD and SLE higher disease activity assoc'd w/ dec AMH levels, suggesting dz activity and dz may affect ovarian reserve. Abs 0942 #ACR22 @RheumNow https://t.co/xSZ85ipFSD https://t.co/tsaWBdrQcb
Dr. Rachel Tate uptoTate ( View Tweet)
Excllent plenary, medication copay modifies treatment adherence in SLE
>$10 copay reduced adherence for HCQ (39%), AZA (56%), MMF (32%)
Easy to imagine that all our innovation cannot overcome access & barriers
Should be priority to fix
#ACR22 @RheumNow #ACRBest Abstr#1115 https://t.co/BPfr9mCVgy
Mike Putman EBRheum ( View Tweet)
Combined estrogen-progestin contraception in SLE patients with positive aPL conferred an increased risk of thrombosis relative to progestin-only contraception. Abs 0943 #ACR22 @RheumNow https://t.co/B2Wmhlz6at https://t.co/YlvqoYY8FN
Dr. Rachel Tate uptoTate ( View Tweet)
Ab1117 #ACR22 Deucravacitinib: TYK2 inhibitor in active SLE?
363 pt P2, double-blind PBO-controlled 48 wk study
DEUC 3 mg BID, 6 BID, 12 QB vs PBO:
At 32wk: DEUC 3BID & 6BID > PBO, sustained across all groups at 48wk.
AEs: similar bw PBO and DEUC. No VTE
@RheumNow #ACRBest https://t.co/uamJe05odq
Eric Dein ericdeinmd ( View Tweet)
Interstitial inflammation in the entire cortical parenchyma in areas w/ and w/o fibrosis identifies at risk SLE pts for CKD progression. Abs 0634 #ACR22 @RheumNow https://t.co/3iBYHPyYXL https://t.co/iSwblT2Amm
Dr. Rachel Tate uptoTate ( View Tweet)
Most rheums round down on dosing because of the weight based recc's, but hydroxychloroquine dosing less than 5 Mg/kg/day leads to increased hospitalizations for #SLE flares abst#1654 #ACR22 #PressConference @rheumnow https://t.co/GGnnl14cy9
TheDaoIndex KDAO2011 ( View Tweet)
Stop repeating the #ANA test!
46% of all ANA tests were repeat tests in this study. #HealthCareCost #NoUtility #ChooseWisely abst#1278 @rheumnow #ACR22 https://t.co/K7oyqJYvi9
TheDaoIndex KDAO2011 ( View Tweet)
Favorable kidney outcomes observed for BEL vs PBO in pts with SLE, including fewer kidney flares, greater kidney improvement (SELENA-SLEDAI), less kidney worsening (BILAG), and improved eGFR. Abs 0352 #ACR22 @RheumNow https://t.co/w50uEYVDup https://t.co/JyKZEZG6DZ
Dr. Rachel Tate uptoTate ( View Tweet)
I questioned HCQ dose reducing in my recent newsletter & podcast; more evidence!
Receiving less HCQ = more damage and more CVD
Observational, not clearly causal, but should make you wonder...
Are we sure we should be shooting for <5mg/kg/day?
#ACR22 @RheumNow #0982 https://t.co/SuAwSumgu1
Mike Putman EBRheum ( View Tweet)
