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A#1744 AI for RA to improve scheduling in UK
39% pts meet quality metric for early intervention
Input: RF, CRP, CCP, gender, age -> 51% accuracy (compare to first appt clinical accur 46%)
Focusing on highest risk -> 88% accuracy -> 50% wait time for high-risk pts
#ACR24 @RheumNow
Eric Dein ericdeinmd ( View Tweet)
Strive for remission (CDAI ≤2.8) to achieve better functional outcomes in RA
#ACR24 @RheumNow ABST#1743 https://t.co/qpsTF54rmW
Jiha Lee JihaRheum ( View Tweet)
In a cohort of >17,000 European pts w/ axSpA:
-bDMARD naïve pts starting TNFi or IL-17Ai were more likely to achieve LDA than TNF-experienced.
-Higher time to achieve LDA and shorter durability in pts with prior TNFi use.
Abst#1756 #ACR24 @RheumNow
Adela Castro AdelaCastro222 ( View Tweet)
A#1743
Are there benefits of getting LDA to remission?
Remission CDAI <2.8, VLDA 2.8-6, LDA 6-10
After 1 yr f/u of LDA, 45% Rem, 40 VLDA, 16 LDA
Not in remiss - higher BMI, longer duration, higher resource utilization, worse PRO
No clear diff bw remission & VLDA
#ACR24 @RheumNow https://t.co/ut7c52JVDr
Eric Dein ericdeinmd ( View Tweet)
A#1694
To get one or two lungs for lung transplant? 🫁
Autoimmune related ILD transplant outcomes?
145 single (SLT), 461 double (DLT)
Similar 1 yr mortality - HR SLT 1.19 unadjusted, 1.49 adj - not statistically significance
@RheumNow #ACR24 https://t.co/uo8WbrNFAm
Eric Dein ericdeinmd ( View Tweet)
Chevet et al. What happens when you withdraw tocilizumab after 6 months in PMR? Follow up of SEMAPHORE study. 80.8% relapsed! Median time to relapse 15 weeks. @RheumNow #ACR24 Abstr#1698 https://t.co/9pJ88C05V2
Richard Conway RichardPAConway ( View Tweet)
#Gout attack is assoc w 1.5 X MI, MACE in next 30 days
@ACRheum @RheumNow #ACR24 https://t.co/7IeFbW6xW8
Janet Pope Janetbirdope ( View Tweet)
A#1693
Change in FVC @ W12 or 24 has progn value @ w52 in AI-ILD
Study SENSCIS (SSc) & INBUILD (SARD) trial PBO gps
SENSCIS: OR for ILD progression 1.9 @ w12, 2.5 @ w24
INBUILD: OR 2.2 @ w12 & w24
Early PFTs predict outcomes @ 1 yr, short trials may be feasible
#ACR24 @RheumNow https://t.co/8cICAeG0nr
Eric Dein ericdeinmd ( View Tweet)
Sarilumab is better than #MTX in #PMR
Reminder #RCT of #MTX in #PMR was a NEGATIVE #trial #1697
60 % #sarilumab in #RWE could d/c
#Prednisone after failure of initial #pred #Rx >1yr pred prior vs 40% MTX
Comparative effectiveness sari v MTX
#1700 #ACR24 @ACRheum @RheumNow https://t.co/4YXIBz0OK7
Janet Pope Janetbirdope ( View Tweet)
Bolhuis et al. PMR MODE study. MTX 25mg/week in recently diagnosed PMR. 52 weeks. 56 patients. Nada, zip, no effect. GC free remission 67% vs 68%. No difference in any secondary outcome. @RheumNow #ACR24 Abstr#1697 #ACRbest https://t.co/Mb909u1zFT https://t.co/dShyBF4WST
Richard Conway RichardPAConway ( View Tweet)
Bolhuis et al. PMR MODE study. MTX 25mg/week in recently diagnosed PMR. 52 weeks. 56 patients. Nada, zip, no effect. GC free remission 67% vs 68%. No difference in any secondary outcome. @RheumNow #ACR24 Abstr#1697 #ACRbest https://t.co/Mb909u1zFT https://t.co/dShyBF4WST
Richard Conway RichardPAConway ( View Tweet)
Subgroup data from SELECT GCA, overall reinforces overall message
I was curious to see pts previously treated with TCZ; wonder if that selects for refractory phenotype - seems not to be the case
Take home: encouraging data, no subgroup issues
#ACR24 @RheumNow Abstr#1695 https://t.co/5iCLE6T4u3
Mike Putman EBRheum ( View Tweet)
Sun et al. MMF+MTX vs CYC/AZA in Takayasu. Overall response rates week 28 58.1% vs 32.4%, week 52 55.4% vs 32.4%. So MMF+MTX>CYC/AZA. But I'm not sure what to do with these results. How does it compare to toc or ada? @RheumNow #ACR24 Abstr#1696 https://t.co/Jr6S2c6AKs https://t.co/L8pMFJ5hnj
Richard Conway RichardPAConway ( View Tweet)
Sun et al. MMF+MTX vs CYC/AZA in Takayasu. Overall response rates week 28 58.1% vs 32.4%, week 52 55.4% vs 32.4%. So MMF+MTX>CYC/AZA. But I'm not sure what to do with these results. How does it compare to toc or ada? @RheumNow #ACR24 Abstr#1696 https://t.co/Jr6S2c6AKs https://t.co/L8pMFJ5hnj
Richard Conway RichardPAConway ( View Tweet)
A#1691
Biomarkers for Rx response SSc ILD?
92 SSc-ILD pts, 19 had progressive pulm fibrosis (PPF)
KL-6 - incr in PPF, decr in those w/o PPF
CXCL-4 decr across cohort - non-signif trend for more w/o PPF
Specifically in MMF: CRP, KL6, CXCL4 are predictive
#ACR24 @RheumNow https://t.co/9fG6atcLmK
Eric Dein ericdeinmd ( View Tweet)
@kekuchinad A#1689 PFT ref equations -> inequities in SSc ILD Predict FVC uses age, ht, sex & race - higher % pred values -> underdx Race-specific v neutral equations: More black pts meet trial eligibility (69/57%), immunos (56/40), lung t, (14/9) @RheumNow #ACR24 #ACRBest https://t.co/40PFmdk3Xv
Eric Dein ericdeinmd ( View Tweet)
Will my patient with lupus nephritis respond well to induction therapy?
Abstract 1685: Aundhia et al demonstrate the promising utility of RAIL to predict complete renal response in patients with lupus nephritis (Class III or IV +/- V)
@RheumNow #ACR24 https://t.co/JBldrrwUhN
Akhil Sood MD AkhilSoodMD ( View Tweet)
#1689: race-neutral 🫁 function equations in SSc improve equity:
🔹 Race-specific equations underestimate disease severity in Black patients.
🔹 Switching to race-neutral reclassified 45% of Black patients to more severe, 16% of White patients to less severe
@RheumNow #acr24 https://t.co/BfK2PsCMX5
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Low uptake of SGLT2i in Lupus nephritis
SGLT2i users had similar adverse event rates as ACEi/ARB users
SGLT2i users experienced more weight loss
#ACR24 @rheumnow abst#1534 https://t.co/tB5o7tyhu5
Bella Mehta bella_mehta ( View Tweet)
Study on SLE and NMO overlap:
Higher risk of acute cystitis & severe sepsis in hospitalized patients
SLE/NMO overlap patients 3x more likely to develop acute cystitis
2x more likely to develop severe sepsis #ACR24 @RheumNow abst#1529
Bella Mehta bella_mehta ( View Tweet)