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Top 5 Clinical Pearls in RA Management
RheumNow Live 2024 provided a wealth of clinical insights, particularly in the realm of rheumatoid arthritis (RA) management. Here are the top five clinical pearls from the event's opening session, "Success in Rheumatoid Arthritis."
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APIPPRA Trial: Abatacept in at-risk rheumatoid arthritis patients
Abatacept has been studied in seropositive clinically suspect arthralgia patients (at risk for rheumatoid arthritis) and shows the potential to delay or prevent the disease.
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VITAL Info on Autoimmune Disease (2.9.2024)
Dr. Jack Cush reviews the journal reports from the past week on RheumNow.com. Highlights are summarized by three songs: "Stairway to Heaven", "You're No Good", and "How Long (has this been going on)".
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Poly-Refractory Rheumatoid Arthritis
Refractory of difficult to treat (D2T-RA) rheumatoid arthritis (RA) comprises a minority of patients that can be categorized by clinical and imaging parameters to formulate a better therapeutic approach.
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Inflammatory Arthritis in Systemic Sclerosis is Problematic
Inflammatory arthritis (IA) is a common manifestation in systemic sclerosis (SSc), affecting nearly one-third of patients.
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Steroids are associated with MACE events in RA. #RWCS24 @RheumNow @RWCSmtg https://t.co/U6ssALNspe
Dr. Rachel Tate uptoTate ( View Tweet)
Who do you watch closely for developing RA? @RheumNow and @RWCSmtg suggest additional risk factors for ratcheting closer to RA. #RWCS24 https://t.co/lV3I5emn72
Dr. Rachel Tate uptoTate ( View Tweet)
Mayo study of 1643 #RA pts (Dzduration 7 yrs) found 4 clusters based on # of comorbidities (Cluster 1 [42%] few comorbidities & cluster 4 [7%] > 10). Cluster 1 w/ good prog/survival; but cluster 4 was older, less DMARDs/biologics https://t.co/qAWZoXVWlv https://t.co/g3gMsNj848
Dr. John Cush RheumNow ( View Tweet)
Obesity is assoc w higher CRP.
Losing weight lowers CRP RWCS24 https://t.co/Gc6TKtmOgI
Dr. John Cush RheumNow ( View Tweet)
Higher adipose in RA linked to atherosclerosis but protects against erosions RWCS24 https://t.co/qsFMhj4LyZ
Dr. John Cush RheumNow ( View Tweet)
Microbiome study (stool- & saliva) in 144 DMARD-naïve RA pts. Samples 6 wks after DMARD Rx. In those achieving MCID, stool microbes decreased (Prevotella, Streptococcus). Baseline microbiota in DMARD-naïve pts indicated future response https://t.co/PQJEp3bNBE https://t.co/jV5SeNd21z
Dr. John Cush RheumNow ( View Tweet)
14d study of 30 #RA pts collected data from iPhone + Apple smartwatch +PROs showed that AI analysis of sensor data augmented PRO data (by 10%) regarding RA status & severity. Sensor + PRO correlated well w/ RAPID3 status (r2, 0.692) https://t.co/3izpHiqRHG https://t.co/vMvtqOZCjF
Dr. John Cush RheumNow ( View Tweet)
Brazilian registry of 1316 RA pts on bDMARDs or JAKi-Added use of antimalarials reduced SAEs & total AEs, & incr survival. 19% were on HCQ, & had signif less SAEs (mIRR: 0.49); AEs (0.68); serious infections (0.53); hepatic AEs (0.21); & mortality (P=.003) https://t.co/cOeg3KL8Z3 https://t.co/pPRqD7PkXB
Dr. John Cush RheumNow ( View Tweet)
Poly-Refractory Rheumatoid Arthritis
Refractory of difficult to treat (D2T-RA) rheumatoid arthritis (RA) comprises a minority of patients that can be categorized by clinical and imaging parameters to formulate a better therapeutic approach.
https://t.co/IKAojQFdaw https://t.co/paBwWw2nmh
Dr. John Cush RheumNow ( View Tweet)
Full read overview of SJOGRENS SYNDROME, which can be Primary SS or Secondary (15% in SLE, 20% RA, & 30% systemic sclerosis). SS Organ involvement:
- CNS 2-17%
- Renal <=10%
- ILD 10-20%
-MSK 45-56%
https://t.co/RElOFfP2xr https://t.co/aJI041VCuE
Dr. John Cush RheumNow ( View Tweet)
Danish registries study shows maternal Autoimmune Dzs (all) were assoc w/ incr risk of childhood cancers (OR=1.25, 95% CI 1.06, 1.47), acute lymphoblastic leukemia (OR =1.52), Burkitt lymphoma (OR=2.6) & CNS tumors (OR=1.45); same seen for RA mothers https://t.co/HQO972ch9R https://t.co/dDEJUo8unq
Dr. John Cush RheumNow ( View Tweet)
Resolvin (RvT)4 - orchestrates macrophage responses to limit atherosclerosis during inflammatory arthritis. (RvT)4 negatively correlates w/ vascular lipid load in inflammatory arthritis; RvT4 can be used to reduce blood vessel inflammation. https://t.co/H38cFvDcvE https://t.co/ptZpjWf1F6
Dr. John Cush RheumNow ( View Tweet)
VITAL Study - Autoimmune Prevention Requires Continued Supplements
https://t.co/jXTq11R8fE https://t.co/QaCGBdAMAj
Dr. John Cush RheumNow ( View Tweet)
Many #RA pts remain on Steroids despite b/tsDMARD use! Study 228 #RA pts, 68% Rx low-dose GCs (32% no GCs). After 3 yrsof b/tsDMARDs, 32% still on GCs, 23% D/C GCs, & 20% go on & off, 25% never took GCs. GCs use assoc w/ HTN (20 v 11%) & MI (2.3% vs 0) https://t.co/lWVfvJrAyp https://t.co/uTIWqDAjRG
Dr. John Cush RheumNow ( View Tweet)
649 # RA pts (291 ACPA+) from the Leiden Early Arthritis Clinic shows Disease activity incr by:
- Obesity: + 0.32 higher DAS
- Obese + ACPA+: + 0.43 DAS
- ACPA+ RA: SJC incr 60%, TJC 55%, CRP + 3.7 mg/L https://t.co/WH0tpybe4a https://t.co/jkgDLQdfRH
Dr. John Cush RheumNow ( View Tweet)
