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Mitigating Immunogenicity When Using Uricase Therapies as ULT
ACR20 convergence highlights a shift in gout management and uric acid lowering therapy (ULT). The new biologics pegdriticase and pegloticase are associated with risk of immunogenicity and loss of biological effects.
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Thanks @EBRheum for a great rundown of how to keep up with the #rheumatology literature- particularly liked the reminder to use tech & @Twitter as well as reading.
"#RheumTwitter is fun, it's collaborative, it's full of doughnuts."
Proud to be a rheum trainee!😄
#ACR20 @RheumNow https://t.co/V1zaUD1KCJ
Mrinalini Dey DrMiniDey ( View Tweet)
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Should ARBs be adjunct Rx in GCA?
Plausible target:
- previous pharmacoepi
- ATII expressed in GCA inflamm lesions
- ATII induced pro-inflamm in PBMC/co-cultured VSMC
- steroids modulate ATII expression in GCA TA ex vivo
Maybe worth testing?
Cid et al #ACR20 ABST0510 @RheumNow https://t.co/mNNzZVYe7g
David Liew drdavidliew ( View Tweet)
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@RheumNow #acr20 abs0622 infection induced MPO anca vasc: most common triggers viruses(35.2%), mycobacterial (29.4%)& bacterial inf (29.4%). Onset 3 mo post inf. (70.5%) renal involvement, w/ biopsy-proven GN in 53%. 17.6%died. Rx steroids+abx, CYC in 47%.
Olga Petryna DrPetryna ( View Tweet)
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We have great options all around! Both are efficacious in biologic (TNFi) failures for RA patients.
Comparative Clinical Efficacy of Sarilumab versus Upadacitinib over 12 Weeks: Matching-Adjusted Indirect Comparison Analysis Abst#0827 #ACR20 @RheumNow
https://t.co/1SsL9qLJD3
k dao KDAO2011 ( View Tweet)
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Is diet important in gout control? #ACR20 @rheumnow
Richard Conway RichardPAConway ( View Tweet)
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EQUATOR2 52wk extension trial - Filgotinib on enthesitis in PsA pts
1️⃣Clinical resolution of enthesitis at 52wks 77% by LEI and SPARCC
2️⃣Pts who did not respond by wk 16➡️77% and 81% resolution enthesitis by LEI and SPARCC
@RheumNow #ACR20 Abs#0910 https://t.co/mCe32rrAcc
Robert B Chao, MD doctorRBC ( View Tweet)
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@RheumNow #acr20 abs0665 claim based database stdy of pegloticase/immunomodulation coadministration trends: use of co-immunomodulation ⬆️ from 1.2%-3.9% 2015- 2018 to 15.0% in 2019. 86%start immunomodulator within 30 days of first peg infusion. MTX most commonly used
Olga Petryna DrPetryna ( View Tweet)
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When you counsel patients w/RA, do you warn them that during times of dz flare, their ability to drive may be affected? ...maybe you should based on Abstr#0198
#ACR20 @rheumnow
k dao KDAO2011 ( View Tweet)
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@RheumNow #ACR20 abs0710 early biologic therapy (BT) in JIA: Early BT=better outcome ( 81.8% on TNFi). BT start after 7,5mo from Dx correlates w/higher probability of active disease at 2 yrs (S=0,67 E=0,63). In active group at 2y 75% arthritis, 16,7% uveitis& 8,3% both. #ACRbest
Olga Petryna DrPetryna ( View Tweet)
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Nice insights into RA-ILD from @jeffsparks:
- assoc (in Medicare): male, smoker, asthma/COPD, b/tsDMARDs, steroids
- mortality risk? Yes, esp resp (sdHR 4.4), cancer
- ACPA/lung inflamm related to RA-ILD? Yes, esp anti-filaggrin (aOR 3.08/log unit)
#ACR20 ABST0489/0490 @RheumNow https://t.co/DGkNNPOcbd
David Liew drdavidliew ( View Tweet)
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@Janetbirdope @RheumNow @CRASCRRheum This study is a follow-on to an existing body of evidence re: vitamin K-dependent proteins ("Gla" proteins) in #OA, as well as warfarin VK antagonist effects, and agnostic discovery in a GWAS. The findings hold including in studies unrelated to access to care and a small RCT.
Tuhina Neogi, MD, PhD Tuhina_Neogi ( View Tweet)
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Be sure to check this session with @CCalabreseDO and Dr. Gordon Lam on the role of IL6 in inflammation, RA, and CRS at 2 pm EST today! #ACR20 @RheumNow https://t.co/c4oX1tNeId
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
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Dr Sammy Zakaria said we need close communication with cardiologist in myocarditis related to myositis. #ACR20 @RheumNow https://t.co/kTAZKWpw0S
Sole RetamozoSole ( View Tweet)
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Did you know? ADA was initially named "Eric" after the fierce soccer star "Eric Daniel Pierre Cantona"! @RheumNow #ACR20 https://t.co/5WvA5Ov3Fu
sheila RHEUMarampa ( View Tweet)
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HCQ might decrease risk for NAFLD!
Restrospective study of 5600 pts noted patients on HCQ (despite having more metabolic syndrome, HTN, DM) had 24% less incidence of NAFLD compared to pts not on HCQ
Abstr#0177 #ACR20 @rheumnow
https://t.co/ZoK2aC0ZQR
k dao KDAO2011 ( View Tweet)
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Myositis:getting to the Heart. #ACR20 Prof Chung @RheumNow https://t.co/pj9rzmRgyx
Sole RetamozoSole ( View Tweet)
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Coding 101 pearls! Under coding is considered fraud per Dr. Vladimir Liarski @vladml @RheumNow #ACR20 https://t.co/idkPJeUzvu
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
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Taking a break at the #ACR20? Visit https://t.co/KmscOUu8MO and access our online library of the the latest video abstracts, as well as extensive author interviews hosted by our editor. https://t.co/iRxroN2YWN
The Journal of Rheumatology jrheum ( View Tweet)
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Can’t a clinician usually differentiate dermatomysitis skin changes from cutaneous lupus and if not would it affect your Rx of the skin involvement - HCQ, MMF, MTX, Aza & topicals. IL18 sigatures. But I get it. Impt for pathogenesis! @RheumNow #ACR2020 @CRASCRRheum https://t.co/RJh7fEVo4O
Janet Pope Janetbirdope ( View Tweet)