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Abst0327 #ACR22 SMART-SLE Monitoring
Some SLE patients with +dsDNA have persistent positivity, others have fluctuations
Anti-dsDNA in persistently positive HR 1.56 for flare risk
Change (up or down!) in dsDNA more than 2x prior visit for fluctuating patients: HR 1.43
@RheumNow https://t.co/YwDPTYWPLu
Eric Dein ericdeinmd ( View Tweet)
Abst0326 #ACR22 Anti-Mitochondrial Ab in SLE
Whole mitochondrial (AwMA), AmtDNA or AmtRNA - higher in SLE compared to controls
AwMA predictive of death, AmtDNA and AmtRNA predictive of nephritis
@Rheumnow https://t.co/d98HSHnJVE
Eric Dein ericdeinmd ( View Tweet)
Abst0328 #ACR22. Predicting UCTD to CTD Meta-Analysis
Factors for SLE transition: younger age, serositis, dsDNA
SSc transition: puffy finger, NFC, or SSc antibodies
No studies wo moderate or high risk of bias
Limited studies on biomarkers for SLE, need more studies
@Rheumnow https://t.co/GofGF8TkCx
Eric Dein ericdeinmd ( View Tweet)
Is channelling bias a risk, because of treating clinicians 'protecting' pre-existing autoimmune dx pts: maybe?
Certainly in practice, these pts might get less combo immunoRx; this @mcgillu data would suggest so
Much more to understand across tumor streams
ABST0760 #ACR22 https://t.co/z1rhAJZ9gj
David Liew drdavidliew ( View Tweet)
Only 4 minutes to discuss adherence in #SLE. Implementation of discussion if <80% of meds filled. Academic docs - 20/24 used + reinforcement, validated in 17 Pts, 11/24 asked open ended ?s. Pts thought it was right timing. ?does it change behaviour- ? Abst0063 @RheumNow #ACR22 https://t.co/UQbRgw5Emj
Janet Pope Janetbirdope ( View Tweet)
Pike et al. Deucravactinib (TYK2i) in SLE. + on SRI(4) week 32. + SRI(4),BICLA, LLDAS, CLASI-50, swollen and tender joint counts week 48. Strange, the lowest dose (3mg bd) seems best. @RheumNow #ACR22 Abstr#1117 #ACRbest https://t.co/o4902tvZs8 https://t.co/t8oeMRGUS7
Richard Conway RichardPAConway ( View Tweet)
2000 IU/day vitamin D led to significantly reduced incidence of autoimmune diseases in Abs 1200 over 5.3 years, but after trial termination, protective effects dissipated and were no longer significant. #ACR22 @RheumNow https://t.co/sLwoxeCR3y https://t.co/47wpWXF1W7
Dr. Rachel Tate uptoTate ( View Tweet)
13S150. Draft ACR/EULAR APLS Classif Crit #ACR22
Entry: Clinical & +aPL w/in 3 yr
Then: Additive crit
-Don't count other cause
Clinical Domains: Macrovasc VTE, Macrovasc AT, Microvasc, Obst, Cardiac, Hematology
Lab: +LA, aCL/B2GP IgM/IgG/titer
Total: 3+ clin, 3+ lab
@RheumNow https://t.co/YeKW0orjZC
Eric Dein ericdeinmd ( View Tweet)
Plenary:
Tyrosine kinase 2 (TYK2)
◦ Mediates signaling of Type I IFNs, IL-23, and IL-12
◦ Key cytokines involved in lupus pathogenesis
◦ Deucravacitinib oral TYK2 inhibitor
◦ Phase 2 RCT in SLE showed efficacy
Pike M Abs1117 https://t.co/eJhNsM02Vl #ACR22 @RheumNow https://t.co/C6JQqR1DLj
Dr. Antoni Chan synovialjoints ( View Tweet)
Carter et al. Case series showing rapid effect of anifrolumab in refractory discoid lupus and SCLE. @RheumNow #ACR22 Abstr#0974 https://t.co/RjnNxjGJoP…
Richard Conway RichardPAConway ( View Tweet)
Are preexisting autoimmune dx pts okay for
PD-1i/CTLA-4i combo immunoRx
(vs PD-1i single agent)?
Common question in practice for your rheum pts who get cancer
Combo ICI means:
de novo irAE: double risk
flares: same risk
Give our pts what they need!
ABST0757 #ACR22 @RheumNow https://t.co/Vs1AoM54Ut
David Liew drdavidliew ( View Tweet)
Zheng et al. Celiac disease more common in SLE aOR 2.88 (95%CI 2.60 –3.31). More common in white females. Assoc higher hospitalization cost and increased LOS @RheumNow #ACR22 Abstr#1192 https://t.co/kdwLmpIxNN https://t.co/ZdQJQn3QIF
Richard Conway RichardPAConway ( View Tweet)
Phase 2 efficacy and safety of deucravaticinib (TYK2i) in mod-severe SLE. Met primary endpoint (SRI4) for 3mg and 6mg doses (but not 12mg). No signal for HZ but increased oral herpes. Bigger numbers will be helpful.
@RheumNow #ACR22 #plenary #ACRBest https://t.co/SjW1OSQzdM
Julian Segan JulianSegan ( View Tweet)
DEUC showed statistically significant and sustained clinical efficacy in SRI(4) responses versus PBO and was well tolerated in SLE. Plenary Abs 1117 #ACR22 @RheumNow https://t.co/iHPiA8FCwO https://t.co/A0FQ7zwL64
Dr. Rachel Tate uptoTate ( View Tweet)
#ACR22 Plenary II Abstr#1117 Phase 2 results +ve in #lupus! Patients (65% White) on Deucravacitinib, TYK2-i had more SRI-4 response rates vs PBO. PBO:34.4%; DEUC 3 mg BID:58.2%, DEUC 6 mg BID:49.5%, DEUC 12 mg QD:44.9%. No major safety, slight increase in oral herpes @RheumNow https://t.co/QIJfoeP4dg
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Costenbader @karen_kc123 7 year results VITAL. 2000iu vitamin D reduced autoimmune disease over 5 years; after trial end, effect dissipated and no longer overall significant. No change in borderline effect of 1000 mg/day omega3. @RheumNow #ACR22 Abstr#1200 https://t.co/lebdzWIO4n https://t.co/HKbHwLihrI
Richard Conway RichardPAConway ( View Tweet)
Inverse association between average yearly HCQ dose and CV damage in cohort of SLE pts from Abs 0982 #ACR22 @RheumNow https://t.co/sfB6ONgwOa https://t.co/FAUGAVe2mB
Dr. Rachel Tate uptoTate ( View Tweet)
Ab1115 #ACR22 Rx Co-Pay affects Rx Adherence in SLE
Higher copays associated w/:
💊39% lower odds of HCQ adherence
💊56% lower AZA adherence
💊32% lower MMF adherence
Need better $$ and transparency into costs. Screen for determinants of health affecting affordability!
@Rheumnow https://t.co/1NdBb3GLzL
Eric Dein ericdeinmd ( View Tweet)
Serum AMH reduced in adolescents w/ rheumatic disease compared to menstrual-age matched, healthy controls. UCTD and SLE higher disease activity assoc'd w/ dec AMH levels, suggesting dz activity and dz may affect ovarian reserve. Abs 0942 #ACR22 @RheumNow https://t.co/xSZ85ipFSD https://t.co/tsaWBdrQcb
Dr. Rachel Tate uptoTate ( View Tweet)
Excllent plenary, medication copay modifies treatment adherence in SLE
>$10 copay reduced adherence for HCQ (39%), AZA (56%), MMF (32%)
Easy to imagine that all our innovation cannot overcome access & barriers
Should be priority to fix
#ACR22 @RheumNow #ACRBest Abstr#1115 https://t.co/BPfr9mCVgy
Mike Putman EBRheum ( View Tweet)
