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Health Literacy: the forgotten social determinant of health?

Mrinalini Dey, MBBChir, MA(Hons) Cantab., MRCP, FHEA

Nine out of ten adults in the USA struggle to understand basic health-related information. Across the pond, in the UK, 7.1 million adults read at, or below, the level of a nine-year-old, with 60% unable to understand health information. An increasing body of research in rheumatic diseases has sought to understand the impact of health literacy, long neglected as a social determinant of health, on clinical and non-clinical outcomes. Several abstracts at this year’s ACR Convergence focus on this topic.

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CAR-T

Taking CAR-T for a Test Drive

Michael Putman, MD, MSCI

When the ACR Convergence 2024 abstract site went live, the first query I typed into the search bar was, “CAR-T.” I consider myself a CAR-T skeptic and would be surprised if the magical results from this NEJM case series replicate at scale, but it seems likely that CAR-T will revolutionize the care for (some) patients with rheumatic diseases. What new data will be presented at ACR?

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Are Emulation Trials a Fantasy?

Janet Pope, MD, MPH, FRCPC

Are emulation ‘trials’ helpful, despite the biases that occur with observational data, or do they truly mimic the results of randomized controlled trials (RCTs)?

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#1350 🔬 Microbiome & RA: Impact on Disease Activity & Vascular Function ➡️ Salivary microbiome a/w arterial stiffness (AIx)(p 0.019) ➡️ Stool microbiome a/w DAS28-CRP(p 0.027) 🔴Key taxa👇identified for each; no common taxa for both disease activity & AIx. #ACR24 @RheumNow https://t.co/54Sumzzd27

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Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
What is the impact of social connections on lupus? Abstract #1503: In an NYC SLE cohort, greater social integration and support correlated with less pain, depression, disability, and frailty, while loneliness was linked to worse outcomes. @RheumNow #ACR24 #SDoH https://t.co/5OCCExee06

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Akhil Sood MD AkhilSoodMD ( View Tweet)
Reason for consult: aortitis- evaluate for systemic causes Abstract 1638: Kmetova et al highlight the promising clinical utility of calprotectin as a marker for clinically isolated aortitis @RheumNow #ACR24 https://t.co/2qPaAqWswG

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Akhil Sood MD AkhilSoodMD ( View Tweet)
What is Osteoarthritis? A downloadable patient education page from JAMA. https://t.co/pQgGfI0boe https://t.co/pd3kygUxkH

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Dr. John Cush RheumNow ( View Tweet)
🫁RP-ILD a/w high morbidity and mortality How to Predict RP-ILD Development? ➡️AutoAb: anti-MDA5, anti-ARS, anti-Ro52 ➡️Biomarkers: CRP, LD, Ferritin, KL-6 ➡️CT: Lower consolidation/GGO #ACR24 @RheumNow https://t.co/OIrHfVTZcM

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Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Remote monitoring SHOULD increasingly be part of our care. BUT I don't think it neccessarily will. Just like with conferences reverting to non-virtual when facilitating virtual is logical from a learning perspective. There are other limiting interests in play #ACR24 @RheumNow https://t.co/UN3jGa7jVZ

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Richard Conway RichardPAConway ( View Tweet)

"Do not fear RPF." - John Stone Retroperitoneal fibrosis certainly feels challenging at times, and radiologic features might stay even after functional improvement but we've come a long way (although, despite B cell depletion, there's plenty more to do) #ACR24 16S26 @RheumNow https://t.co/2Y3buXrAFY

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David Liew drdavidliew ( View Tweet)
Abstract 333 showed that in a cohort of patients with IIM-ILD increased age, PH, FVC decline at 1 yr, SOB at 2 years were predictors for mortality and lung transplant ! #ACR24 @RheumNow https://t.co/NgOj7WKeE3

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Gabriela Martinez Zayas, MD MartinezZayasMd ( View Tweet)
@abdelhamed012 @RheumNow Same https://t.co/uScez6UwBp

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Richard Conway RichardPAConway ( View Tweet)
Systematic review suggests (although not provn) that audiovestibular dysfunction may be from APS. Anti-phospholipid & HSP-70 Abs found 25-33% w/idiopathic sudden sensorineural hearing loss,. ACL Abs seen in up to 27% w/ sensorineural hearing loss https://t.co/WcmeCP0ryq https://t.co/DiYX57R0uG

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Dr. John Cush RheumNow ( View Tweet)
Stone et al. Phase 3 RCT B-cell depletion with CD19 targeting agent Inebilizumab in IgG4-RD. HR 0.13 (0.06, 0.28) for flare. @RheumNow #ACR24 Abstr#0775 https://t.co/Kd4Xmoc5e6 https://t.co/Al6gOA1F8K

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Richard Conway RichardPAConway ( View Tweet)
Cannabis in Pain: CBD can help with nociceptive pain THC better for neuropathic, centralized pain Perhaps a role in helping decrease other medications like opiates Clauw 16S18 #ACR24 @RheumNow https://t.co/kaQXrD4GAn

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Eric Dein ericdeinmd ( View Tweet)
How often should #scleroderma #ILD pts have #PFTs? 🤷‍♂️ Data from SENCIS RCT of SSc-ILD 25% worsened FVC by 6/12 Are we UNDER a ordering PFTs in an ILD #SSc population 👇 Because if worsening we would consider a change in background #immunesuppression @RheumNow #ACR24 #678 https://t.co/a9ybO3FwDd

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Janet Pope Janetbirdope ( View Tweet)
More steroid-sparing options for #IgG4RD! Abstract 0775: In pts w/ IgG4: - Inebilizumab (CD19-monoclonal ab) vs placebo associated with reduced risk of flare (HR 0.13; 95% CI 0.06, 0.28) AEs: infections, infusion reactions, lymphopenia #ACR24 @RheumNow https://t.co/Vr5hcd2E7E

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Akhil Sood MD AkhilSoodMD ( View Tweet)
Researchers developed a digital messaging program to reduce fatigue in SLE - Grounded in social cognitive and self-determination theories - Reviewed 148 messages, refined based on patient feedback - High patient ratings, future will see more of these #ACR24 abst#0362 @RheumNow

Bella Mehta bella_mehta ( View Tweet)

Ab#0427 #ACR24 HSS: menopause & systemic rheum disease severity 1/3 women report worse disease associated w menopause Reported more flares, menopausal symptoms Findings were similar between SLE and RA, but SLE patients were >2x more likely to discuss w their rheum @RheumNow

Eric Dein ericdeinmd ( View Tweet)

Nationwide US study -Prevalence of HLH in SLE: 0.13% -Higher risk in younger, female, and racial minority patients - Strong association with high mortality #ACR24 abst#0619 @RheumNow

Bella Mehta bella_mehta ( View Tweet)

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