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Diagnosis in GCA is changing.
Some questions from these nice Olmsted County data:
- why are dx in women declining?
- in the past, without imaging, were we missing GCA diagnoses?
It's easy to forget how far we've come in GCA!
@MayoClinic @MdWarrington #ACR20 ABST0517 @RheumNow https://t.co/QsW8BSsf1a
David Liew drdavidliew ( View Tweet)
@RheumNow #acr20 abs0063 in silico, in vitro &clinical study: Amitriptyline, naloxone& thalidomide prevent NOS2, IL6, IL1B, MMP9 release, inhibits NLRP3 inflammasome pathway> decreased colchicine consumption in gout pts using above meds for other indications #acrbest #different https://t.co/cz3htmtBU0
Olga Petryna DrPetryna ( View Tweet)
GCA phenotypic differences clearer again -
Large vessel involvement (on USS) in GCA are a/w:
- higher steroid burden
- first relapses occur later
- relapses harder to diagnose (symptoms less classical), but were a/w an IMT increase of about 25% (0.18mm)
#ACR20 ABST0518 @RheumNow https://t.co/87zVjAm9eU
David Liew drdavidliew ( View Tweet)
VA Population study shows that incident RA was less common in persons w/ HIV (PWH)(matched w/ uninfected). Only 21 RA pts in 56K PWH. PWH+/RA+ have lower autoantibodies and less likely to get DMARDs. #ACR20 Abstr#0195 https://t.co/rERJVQfq7a https://t.co/g5lATtxqOM
Dr. John Cush RheumNow ( View Tweet)
An emerging change in diagnostic (dx) modalities used in GCA? Although the leading dx modality remains a temporal a bx at 67% from 2010-2018, this is a decrease from 84% (1950-2009). Imaging is being used 19% of the time from 2010-2018 per data from Mayo Clinic. @RheumNow #ACR20 https://t.co/J97oVAGObj
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
ILD in SSc has grave consequences. Abstr#393 Claims database in Ontario shows relevant Scleroderma ILD occurred in 17% of >3000 pts with nearly double the mortality #ACR20 @RheumNow @CRASCRRheum #bestinclass https://t.co/K3UXvuxBcp
Janet Pope Janetbirdope ( View Tweet)
Shoutout to @SattuiSEMD and @NavarroMillanMD showing #dementia is lower in #RA pts on bDMARDs compared to csDMARDs using CMS data #ACR20 ABS#0488 @RADoctor @RheumNow https://t.co/1XOV2zqKko
Bella Mehta bella_mehta ( View Tweet)
Great talk by @rheumcat @rheum_covid on COVID-19 impact on rheumatology. Talk to pts re: what to do with rheum rx... they haven't read guidelines and may make their own changes! Prepare them for exposure/ifn! #ACR20 @Rheumnow 2F042 https://t.co/HkxbkYjEm3
Eric Dein ejdein1 ( View Tweet)
@RheumNow #acr20 abs0405 RELIF ph3 rct: pts w/Behcets who achieve Full resolution of OUs w/Apremilast by wk6+ 6wks of sustained response also report better improvement in BSAS, OU pain, overall Dis activity& QoL. Only 29.8% were able to achieve 6+6 though, while 70.2% did not https://t.co/8roaO5YPM6
Olga Petryna DrPetryna ( View Tweet)
Dr Garvey presenting on trends in GCA incidence in Olmstead County. Becoming less common year on year there. Not my experience in Ireland #ACR20 Abstr#517
@rheumnow @Sarah_L_Mackie https://t.co/3O963l6UXG
Richard Conway RichardPAConway ( View Tweet)
NEMO Deleted Exon 5 Autoinflammatory Syndrome (NDAS) is a new immunodeficiency syndr (Autosomal dom), GOF w/ paniculitis, CNS, HSM, Cytopenias, hypogamm & autoAbs. 12 described cases. Linked to upregulation of NFKB and IFN signature. #ACR20 Abst #0176 https://t.co/1k1tFbFKu1
Dr. John Cush RheumNow ( View Tweet)
Amazing table by Dr. Arthur Kavanaugh that is jam-packed with a gold mine of information reviewing therapies for RA, PsA, AxSpa, IBD, & autoinflammatory dz in a concise, high yield fashion #ACRbest #rheumtwearls #ACR20 @RheumNow https://t.co/pVaxye42jX https://t.co/z4HRtU4tmt
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
#ACR20 2F042 Dr. Grainger on COVID around the world. 1) Control disease 2) Limit steroids 3) Keep studying 4) Address disparities and 5) Advocate for your pts! @RheumNow We can get under control like in Dr Grainger's home of NZ! https://t.co/YSFxXGAiRY
Eric Dein ejdein1 ( View Tweet)
Rx in RA should be for LONG term #bestinclass #ACR20 abstr#222 shows in both bionaive & bioexperienced in 5471 pts #JAKi had more pts continuing Rx than #TNFi and other bDMARDs Not RCT & Longer durability data are needed @RheumNow @CRASCRRheum https://t.co/Uo4p5zo6gT
Janet Pope Janetbirdope ( View Tweet)
56 systemic JIA pts treated with anakinra (2.5mg/Kg/d). Pts were genotyped for 6 SNPs (from untranscribed reg IL1RN). Homozygotes >=1 SNPs associated with higher IL-1RN levels and 6 fold risk of anakinra nonresponse. #ACR20 Abst 172 https://t.co/0UU3gDfHvE
Dr. John Cush RheumNow ( View Tweet)
FAT is OK!
Abstr#0485 #ACR20 @rheumnow PROTECT-RA
150 pts cardiac CTA study:
nonobese low LDL (<70) had ⬆️plaque burden, ⬆️ LDL oxidation compared to obese low LDL pts
nonobese low LDL compared to nl LDL had 8X risk for CVD. not seen w/obese pts
DAS28 scores make no difference https://t.co/gDIS7fEY6Y
k dao KDAO2011 ( View Tweet)
Dr Christ reports on GUSTO study showing that 13/18 GCA patients treated with tocilizumab and only 3 days of steroid maintained remission at 24 weeks. @rheumnow #ACR20 Abstr#515 #ACRbest https://t.co/VLgXEUIi1c
Richard Conway RichardPAConway ( View Tweet)
Which has better durability in RA? @RheumNow @CRASCRRheum #ACR20 abstr#222
Janet Pope Janetbirdope ( View Tweet)
If the presence of fibromyalgia correlates with clinical outcome scores in psoriatic arthritis (PsA), how do you differentiate between fibromyalgia and PsA disease activity? @RheumNow #ACR20
Dr. Antoni Chan synovialjoints ( View Tweet)
Looking forward to the "#COVID19 Around the World: Impact on #Rheumatology" session over the next hour- amazing to be reminded that @rheum_covid Global Rheumatology Alliance started with a tweet! 😀
#ACR20 @RheumNow https://t.co/t2yPfkz2Cb
Mrinalini Dey DrMiniDey ( View Tweet)