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#EULAR2020 THU0260 LESS IS BEST when it comes to steroids: Singapore 10 yr retrospect SLE study noted GCs dose is an independent predictor of mortality for hospitalized infection even when adjusted for disease activity.
k dao KDAO2011 ( View Tweet)
#tacrolimus #prograf is non inferior to #MMF #cellcept in #lupus #nephritis induction. We’ve been doing it for years but great to see some solid RCT data behind this. #rheumatology #SLE #autoimmune https://t.co/CblD4GaXCp
Mohammad A. Ursani MD, RhMSUS DrMAUrsani ( View Tweet)
Updated #EULAR2020 guidelines on management of #lupus #nephritis #SLE #rheumatology #autoimmune #SLE https://t.co/zk2QXXRvTy
Mohammad A. Ursani MD, RhMSUS DrMAUrsani ( View Tweet)
#EULAR2020 THU0268 Neuro-develp't in 60 children w/ SLE +APS mothers (n=38):
25% ADHD
93% recent memory delay (assc w/⬆️tetrahydrobiopterin level. p=0.01)
40% speech delay
39.4% maternal APS assc w/special needs education in offsprings age >2 yrs, p<0.05
@rheumnow
k dao KDAO2011 ( View Tweet)
#EULAR2020 Dr. V Ritschl:EULAR Task Force on Patient Adherance: 30-80% of pts do not adhere to Rx. resulting in ⬆️dz severity, pain, fatigue, depression, decreased in function, physical activity. HCPs should discuss adherance reg. & explore factors affecting adherance. @RheumNow
k dao KDAO2011 ( View Tweet)
ENbrel works in long term for the few people left on the drug at 10 yrs with SpA. Enormous dropout. If you are still on Rx for a decade you are in the minority. Drop out of TNFi in SpA mirrors RA & PsA @RheumNow @eular_org @CRASCRRheum @earlyarthritis #EULAR2020 https://t.co/dLS2fw5uRP
Janet Pope Janetbirdope ( View Tweet)
#EULAR2020 THU0225 Results of a Retrospect UK study: Monitor SLE patients with Sm+Ro+RNP autoAb combo closely; these patients have a higher rate (90.6%) of developing LN within 5 years of diagnosis compared to those w/o Ab (55.8%), p=0.002. @RheumNow
k dao KDAO2011 ( View Tweet)
Can you classify SLE by labs only but should you? Serology is part of criteria but why dx with only +ANA, +antiDNA and no other CTD characteristics. Would need cytopenias & RBC casts to think of lab dx of SLE OP0094 @LupusCanada @RheumNow @eular_org #EULAR2020 @CRASCRRheum https://t.co/Jr6SRr3HR1
Janet Pope Janetbirdope ( View Tweet)
Avacopan is as effective as steroids in ANCA Assoc Vasculitis – 330 pt RCT AAV Rx w/ RTX or CTX but randomized to prednisone or avacopan (C5aR antagonist). Avacopan=prednisone remission rates same (72% vs 70%) wk 26 & wk 52 (66% vs 55%). #EULAR2020 #OP0011 https://t.co/WIXJCYkxSb
Links:
Dr. John Cush RheumNow ( View Tweet)
#EULAR2020 OP0096 Dr. L Chatzis study on Sjogren:
1. 2nd most common autoimm dz in women
2. women:men ratio 20:1 (not 9:1)
3. 2 types Ro-Ab: nuc. Ro60 (assc w/La)and cytopls. Ro52 (assc w/ILD/myositis)
4. Seroneg. Sjogren's (neg Ro/La/RF) good prognosis:⬇️lymphoma
@RheumNow https://t.co/fV3ltQqnkf
k dao KDAO2011 ( View Tweet)
NPSLE is more than a headache! probs with dx, uncertain Rx, overlap with common probs - infection, pain, fibromyalgia, drug side effects, etc. Spectrum in NPSLE just like SLE has a spectrum of cutaneous findings T Huizanga discusses @eular_org #EULAR2020 @RheumNow @CRASCRRheum https://t.co/sdw0xavWBq
Janet Pope Janetbirdope ( View Tweet)
When making a dx of neuropsychiatric SLE I order labs AND @RheumNow @eular_org @CRASCRRheum @earlyarthritis #EULAR2020
Janet Pope Janetbirdope ( View Tweet)
MTX in GCA (+/- TCZ): can GiACTA data provide insights?
MTX didn't add anything from data provided, but channelling bias a definite issue (note PNL numerically higher in non-MTX).
MTX as adjunct/cover post-TCZ? We'll need to test for it properly
FRI0220 #EULAR2020 @RheumNow https://t.co/BCsEKqqaMh
David Liew drdavidliew ( View Tweet)
I've heard people say FDG uptake on PET/CT in PMR/GCA is just a correlate of systemic inflamm.
Look at the uptake intensity (SUVmax) vs inflamm markers in n=65 PET/CT in GCA. There's no pattern whatsoever.
Not just an expensive ESR!
@FreemanHospital SAT0272 #EULAR2020 @RheumNow https://t.co/D4xAZC7KmO
David Liew drdavidliew ( View Tweet)
To truly address adherence, you need to understand what is impairing it, and tailor an approach to overcome those barriers.
Great to see this articulated in EULAR recommendations re: non-adherence - a big factor in our therapeutic outcomes!
EULAR projects #EULAR2020 @RheumNow https://t.co/0pazcDFTuV
David Liew drdavidliew ( View Tweet)
Is there subclinical GCA in PMR pts?
50 consecutive PMR pts had vascular USS. 27/50 had GCA vascular uptake, of which 10 had no GCA symptoms at all.
Is PMR sometimes just the tip of the GCA iceberg? Do the aSx USS+ pts get GCA Sx eventually?
Bonn SAT0254 #EULAR2020 @RheumNow https://t.co/UmsixY29Qh
David Liew drdavidliew ( View Tweet)
GCA and cancer: it's been hard to tease apart, lots of cofounders. We've needed large cohorts with comparators & detail.
Large Israeli database says there are links
(EMR/claims/prescribing combined, n = 4.4m w validated incident GCA set). If so, why?
OP0143 #EULAR2020 @RheumNow https://t.co/kSPGnxNjah
David Liew drdavidliew ( View Tweet)
#EULAR2020 Prof. T Domer: baricitinib show promise in phase II trial for SLE: Microarray analysis noted reduction in IFN signature; however, the reduction did not correlate w/SLEDAI-2K or SRI4 clinical response @RheumNow https://t.co/cW4egzSnAs
k dao KDAO2011 ( View Tweet)
#EULAR2020 Most innovative! Vaccination with IFNa-kinoid to induce anti-IFNa antibodies to treat SLE (results of phase IIb trial). https://t.co/rM0z23ieQW @RheumNow https://t.co/OYMdDZl6sb
k dao KDAO2011 ( View Tweet)
#EULAR2020 OP0160 Prospective study of Hopkins Lupus Cohort: HCQ blood levels can predict risk for thrombotic events in SLE. Dr. M Petri advocates this is another reason for monitoring HCQ whole blood levels. Goal HCQ whole blood level should be 1000-1500 ng/mL @rheumnow https://t.co/mM6jsJ2Qmf
k dao KDAO2011 ( View Tweet)