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Lianne Gensler presenting "Exercise Strategies for Ankylosing Spondylitis". Not all physical activity is similarly beneficial. Learn more now by attending her session at #ACR21!
@CherylKoehn @ArthritisNetwrk @EIM_Canada @exerciseworks @PhysioKTBroker @jwhittak_physio @JasminKMa https://t.co/rER3EdCohO
JointHealth ACEJointHealth ( View Tweet)
@LianneGensler Is exercise anti-inflammatory?
In this study, healthy volunteers were infused with E coli endotoxin 😲 and their TNF levels measured. TNF levels were compared between groups at rest and groups exercising.
TNF levels were ⬇ by exercise.
#ACR21 https://t.co/Ylw7SQX32y
Rheum Cat rheum_cat ( View Tweet)
Physical exercise did not increase BME disease in SIJ and spine in PsA. The risk of increased BME after 11 weeks of HIIT was not higher compared to controls in a cohort of PsA patients with low to moderate disease activity @RheumNow #ACR21 Abst#1362 https://t.co/DHj4D5Ojb1 https://t.co/J4KV5zdpey
Dr. Antoni Chan synovialjoints ( View Tweet)
Waist:Hip ratio may be better than BMI in screening for obesity in #axSpA accdg to this study by @Sineadm15 & colleagues
👉⬆ prevalence of abdominal obesity in axSpA esp among ♀️
@RheumNow #ACR21 abs1322 https://t.co/UB3K7xR9kG
sheila RHEUMarampa ( View Tweet)
ACR21 Best Abstracts - Day 2
The RheumNow faculty reporters have been scouring and reporting on the best abstracts from the ACR. Here is a sampling of their choice abstract presentations reported during ACR 2020 Day 2 (#ACRbest).
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The Influence of Obesity on Choice of Biologic Agent in Rheumatoid Arthritis
In rheumatoid arthritis we have a wide range of options available to us when we progress to a biologic treatment option. We have little to differentiate between these agents based on the clinical trials.
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#ACR21 #Abstr0864 How does obesity (BMI=/>30) affect #lupus outcomes? Data from Toronto showed:
💠⬆️hs-CRP
💠No in disease activity over 3yrs
💠⬆️CV events (combination of low grade inflammation + hypertension)
@RheumNow https://t.co/IBu8uNSAJi https://t.co/2aqz5e3rwi
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
🌞😎🍣 Vitamin D and Omega-3 FA ⬇️ Risk of developing autoimmune disease
1st prospective, randomized, double blind, placebo controlled trial
Vit D 2000IU and/or Omega 3-FA 1000mg ⬇️autoimmune disease by 25-30%
#ACR21 #ACRBest @RheumNow
Abs#957
https://t.co/7dODuplg7e https://t.co/GUKhYXbSXU
Robert B Chao, MD doctorRBC ( View Tweet)
To add numbers to this - using ARR because it's easiest:
Vitamin D: 123/12,937 = 0.95% rheum dx
Placebo: 155/12,937 = 1.20% rheum dx
ARR = 0.25% or NNT of 400 to prevent 1 case of rheum dx
Better get prescribing ASAP!
Mike Putman EBRheum ( View Tweet)
#ACR21 #ACRAmbassador
Fascinating analysis of rheum dx from the (negative!) VITAL study (https://t.co/aMtMCIf1F1)
Very few pts 278/25,871 (1.1%) but HR 0.78, p = 0.045 for vitamin D preventing autoimmune disease
Do you believe it? If so, what's your public policy advice? https://t.co/ZkO5nHAJz9
Mike Putman EBRheum ( View Tweet)
Supplementation for 5 years with vitamin D3 +/- n-3 fatty acids reduced incident autoimmune disease by 25-30% in older adults vs. those who received neither supplement. The effect of vitamin D3 appeared stronger after 2 years @RheumNow #ACR21 Abst#0957 https://t.co/uOwNyjxEoG https://t.co/S5kIM4kj6L
Dr. Antoni Chan synovialjoints ( View Tweet)
Can vit D, omega-3 fatty acids prevent autoimmune dx development, even in non-deficient people?
(some plausibility, no other meds can)
vit D *might* have an effect, esp post-2y
cautious interest seems okay!
extension worth looking at
VITAL trial add-on #ACR21 ABST0957 @RheumNow https://t.co/H5aF8Vl79u
David Liew drdavidliew ( View Tweet)
I honestly find Vit D literature confusing! VITAL RCT omega3 and vit D in preventing autoimmune diseases. They seems to work?🧐The confidence intervals just shy of 1.00...I am still skeptical..but keeping vit D normal doesnt hurt I guess....#ACR21 @rheumnow abst#0957 https://t.co/QFcz2zK4Ic
Bella Mehta bella_mehta ( View Tweet)
Always one of my favourite sessions at #ACR21- #Rheumatology #SecretsAndPearls
Dr Kolfenbach reminds us of the importance of discussing #lifestyle, #smoking and #diet with our patients in clinic.
@RheumNow #InflammatoryArthritis #RheumatoidArthritis #PsA https://t.co/2gadRBLCTb
Mrinalini Dey DrMiniDey ( View Tweet)
VITAL RCT of Omega-3 and Vit D in preventing autoimmune diseases in 25,871 individuals. They both work! Reducing incident autoimmune disease by 25-30%. This is game-changing! Abstr#0957 #ACR21 @RheumNow #ACRBest https://t.co/BaeZDTTnQf
Richard Conway RichardPAConway ( View Tweet)
Obesity does not affect #SLE disease activity despite persistent ⬆️in CRP. From Toronto #lupus database #ACR21 abst#0864 @RheumNow https://t.co/4ZpAMaU0jk
Janet Pope Janetbirdope ( View Tweet)
How to improve clinical care for knee OA? stepped exercise program helps WOMAC self reported pain outcomes in Knee OA Important RCT #ACR21 year in review by @karen_kc123 @RheumNow
@AnnalsofIM here is a paper https://t.co/RGIjBL9TuZ
Links:
Bella Mehta bella_mehta ( View Tweet)
Systematic review of dietary interventions for RA - 30 RCTs, 1063 pts; Pain was most reported outcome, sporadic studies showed occ. lowering of ESR, CRP, TNF, Plts, Igs, etc. Few studies show Anti-inflammatory diets may effective lowering DAS in RA https://t.co/B46NrVkwcK
Links:
Dr. John Cush RheumNow ( View Tweet)
Large GWAS Study Reveals Genetic Basis for Osteoarthritis Phenotypes
Cell has published the results of a multinational, GWAS meta-analyses of 826,690 individuals that included 177,517 osteoarthritis patients, finding 52 previously unknown osteoarthritis (OA) genetic risk variants and linking OA genetic risks with joint distribution and pain
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New Hope for NonAlcoholic Fatty Liver Disease
The current issue of the NEJM has two articles on nonalcoholic fatty liver disease (NAFLD also called NASH - nonalcoholic steatohepatitis), one dealing with the prognoses, outcomes and mortality of NAFLD and another prospective and promising interventional trial in NASH patients.
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