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Effective Treatments for Rheumatoid Arthritis ILD
The American College of Rheumatology guidelines for the diagnosis and management of interstitial lung disease, which includes rheumatoid arthritis interstitial lung disease (RA-ILD), has been one of the most controversial topics in the runup to ACR Convergence.
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#ACRBest https://t.co/nx3bzhmeBW
Aurelie Najm ( View Tweet)
There is a dose, duration and recency-dependent relationship between previous GC use and MACE. GC doses 5mg/day, durations of 30 days, and use one year prior to MACE were all associated with an increased risk of MACE, Wallace B Abst#2430 #ACR23 #ACRBest https://t.co/2ExboBvo2W https://t.co/FuqXdFFwqP
Dr. Antoni Chan ( View Tweet)
Synovial tissue histology correlates w/ several clinical parameters in early naive RA
Combination ohigh CD68 infiltrate
Fibrinoid Necrosis in tissue asso w/
-better DA reduction
-higher EULAR moderate/good resp
Included in a prediction model (AUC0.7)
@RheumNow #ACR23 ABST2483 https://t.co/2jCMSzV7ak
Aurelie Najm ( View Tweet)
Body mass is associated w/ ttmt response in RA
Data from RACAT & TEAR studies
TNFi > triple th in underweight gpe but not in overweight gpe
Similar result in gpe w/ low leptin levels
& low adipokine scores
True biology or confounding bias?
@RheumNow #ACR23 ABST2541 https://t.co/OhKj6QNaSa
Aurelie Najm ( View Tweet)
Who uses #cannabis in #rheumatic #diseases? Those who smoke, have higher pain, more anxiety, poor sleep are more likely to have used cannabis for their rheumatic disease. Half of the >2900 respondents have tried #cannabis. Use of #biologics reduced use. #980 @RheumNow @ACRheum https://t.co/DQDRQN40zR
Janet Pope ( View Tweet)
Wouldn’t it be great to be able to predict which women with RA would improve during pregnancy, & which would worsen? We’d be able to adjust DMARDs accordingly.
Gene expression signatures might tell us more - one key cluster here was 21x predictive.
#ACR23 ABST2481 @RheumNow https://t.co/OiDV5sUiYC
David Liew drdavidliew ( View Tweet)
Erosive hand #OA may be more painful than treated #RA patients. The burden of OA is often not alked about, and this study highlights it! @RheumNow #ACR23 https://t.co/jLbvtMmgE0
Bella Mehta bella_mehta ( View Tweet)
Gene signature predicts RA trajectory during pregnancy:
Blood RNAseq *before* pregnancy
🚺 improve during preg: Strong Neutrophil signature
🚺 experience dis worsening:
Strong B cell signature
Needs replication but could have major implications!
@RheumNow #ACR23 ABST2481 https://t.co/gOHwEvOOM6
Aurelie Najm ( View Tweet)
Anti-fibrotics in RA-ILD
Retro analysis of 74 pts
AEs frequent 55% and discontinuation in 46% (more than in initial RCTs)
No diff between AF
FCV trajectory mildly improved
ABST2479 @RheumNow @Juge_P_A @PhilippeDieude #ACR23 https://t.co/GqsHxkIFgD
Aurelie Najm ( View Tweet)
GCs on MACE in RA in VA
A#2430 #ACR23 @RheumNow
Not just ongoing steroid usage, also prior usage 1 year ago
5 mg use for 30 days one year ago - increases MACE events by 3%
5 mg use for 90 days one year ago - increases MACE events by 9%
Eric Dein ( View Tweet)
Wallace et al. Dose, duration, recency dependent relationship between GC and MACE. Even 5mg/day, 30 day use, and use 1 year prior associated with risk. 5mg, 7.5mg, 10mg pred for 90 days - 13%, 19%, 27% MACE increase Abstr#2430 #ACR23 #ACRbest @RheumNow https://t.co/50B5nGqxu9 https://t.co/lNrUbZOm0o
Richard Conway ( View Tweet)
Even low doses of steroids associated with major adverse cardiovascular events!
Large VA database - >18k RA pts
Dose as low as 5mg/day prednisone for 30 days, 1 year prior to event, associated with increased MACE
@RheumNow #ACR23 Abs#2430 https://t.co/JjeoBi7YTD
Robert B Chao, MD ( View Tweet)
Lung cancer in RA. @NamrataRheum et al. 26,625 RA HR for lung cancer for b/tsDMARDs vs csDMARDS 1.07 (0.91-1.26) Abstr#0453 #ACR23 @RheumNow https://t.co/NLNtyYoaoH https://t.co/tRpt62n62X
Richard Conway ( View Tweet)
Antifibrotics in RA-ILD @Juge_P_A Discontinuation in 46% (Mainly GI). Improved FVC trajectory - almost stops decline. Abstr#2479 #ACR23 #ACRbest @RheumNow https://t.co/nZW6TVKefL https://t.co/5BX3PhFhOK
Richard Conway ( View Tweet)
Real-world tolerability of anti-fibrotics (nintedanib, pirfenidone) in RA-ILD @BrighamWomens:
patients do drop out because of AEs, but a decent chunk are okay and do get modest benefit
@Juge_P_A @jeffsparks #ACR23 ABST2479 @RheumNow https://t.co/BpM14eizmF
David Liew drdavidliew ( View Tweet)
Merging field moving forward - cardio-rheumatology collaboration imp!
Calcium scores in older patients with #RA may be the one take away! Very important to risk predict and mitigate CV events .
Ofcourse history taking still remains key! session 14T118 #ACR23 @RheumNow https://t.co/xoldFlA8EW
Bella Mehta bella_mehta ( View Tweet)
Speaking of real RA drugs for RA-ILD... large multicenter study finds 4 in 5 patients who received ABA had lung stabilization
Nice to see observational data; this would be an amazing opportunity for a pragmatic open label RCT
@RheumNow #ACR23 Abstr 2165 https://t.co/LTpfjTVAur
Mike Putman EBRheum ( View Tweet)
Always refreshing to hear from another specialist's point of view
Cardiologist @Bweber04 on CVD and rheumatologic diseases
Increased risk of death, MI and HF exacerbation in our pt population
Increased all cause mortality
@RheumNow #ACR23 https://t.co/yOkPOmxU4N
Robert B Chao, MD ( View Tweet)
#ACR23 Late-Breaking Abstr#L09 In a crowded market, you’ve got to stand out. Phase 2 RCT of LNK01001, a highly selective JAK1-i in China: improvement in ACR 20,50,70 vs PBO at WK12. Those in PBO who didn’t meet ACR20 improved after receiving Tx. Very low infections @RheumNow https://t.co/ZbJFNHOtFT
Md Yuzaiful Md Yusof ( View Tweet)
