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In rheumatoid arthritis we have a wide range of options available to us when we progress to a biologic treatment option. We have little to differentiate between these agents based on the clinical trials.
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Richard Conway
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MUC5B and RA-ILD. Dr McDermott @jeffsparks show that MUC5B is associated with RA-ILD, older age at RA diagnosis, and ILD within 5 years of RA onset. Is this a different disease to other RA or modulation by the promotor variant? Abstr#0576 #ACR21 @RheumNow https://t.co/r2fQqxVY6N
Dr. John Cush
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RheumNow’s expanded coverage of the #ACR21 Annual meeting is sponsored in part by @Novartis. All content chosen by RheumNow & its Faculty.
sheila
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Interesting study by @DrPoddubnyy et al. looking into the efficacy of SEC on HLAB27 subtypes (post hoc analysis of SKIPPAIN trial)
➡ SEC effective for both HLAB27+ and - grps
➡ Significant response seen among HLAB27+ and HLAB27 homozygous pts
@RheumNow #ACR21 abs0917 https://t.co/St37kdGY65
Richard Conway
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And here is ORAL-Surveillance, small increase in MACE and malignancy with tofacitinib vs TNFi. 1 extra MACE per 319-567 patient years, 1 extra malignancy per 275 patient years. Abstr#0831 #ACR21 @RheumNow https://t.co/wMJnspTTBy
David Liew
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For rheumatologists, instinct says in RA everything’s better with MTX. For tofacitinib, where immunogenicity not an issue, is that actually true?
Canadian registry data: maybe no
after 36m, low no. ?valid, markups mine
Need to see more of this!
#ACR21 ABST0827 @RheumNow https://t.co/VVwd4SZgVx
sheila
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Factors associated w/ poor COVID19 outcomes in #SLE from the GRA @rheum_covid
📌Demographics - age, sex, region
📌Glucocorticoid use
📌 Comorbids - renal, CV
📌Untreated/active dse
❗Very important msg here: Control dse, manage comorbids & avoid GCs
@RheumNow #ACR21 abs0866 https://t.co/eXR3KqGrJa
TheDaoIndex
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Dr. Thomas reviews risk for progression to RA
👉+ACPA (9% risk)
👉1st degree relative 3-9X risk
👉70% risk in 5 years of both are true!👈
#ACR21 @rheumnow https://t.co/y5eUyacBFT
Dr. Antoni Chan
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Radiographic progression in AS is greatest between ages 30-39. The presence of preexisting structural damage starts to accelerate it from earlier ages. Data from 1125 patients followed from 2001-2018 @RheumNow #ACR21 Abst#0897 https://t.co/g0t45R0lOd https://t.co/RvlO9EcMIX
Richard Conway
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3 year results of SELECT-COMPARE study of upadacitinib. No evidence of a signal in cardiovascular events or cancer. Reassuring, but really need an ORAL-Surveillance style study of upadacitinib to be confident. Abstr#0828 #ACR21 @RheumNow
Aurelie Najm
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An important message from Dr Ranjeny Thomas on #RA #disease control: "Patients can have a significant impact on the control of their disease, and the interventions we recommend need to be personalised to their resilience ability." #ACR21 @RheumNow https://t.co/h63uz5kfU8
Robert B Chao, MD
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Gender differences in secukinumab treatment of AS?
⭐️improved disease activity, global function, depression in men and women
⭐️women ⬆️disease burden
⭐️high retention rates irrespective of gender
Abs#909
#ACR21 @RheumNow
https://t.co/L6mCxuSMo1 https://t.co/pR3OBoXqaT
David Liew
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Booking regular clinic visits for controlled RA pts - can we be more efficient?
12m RCT
Self-monitoring app, supported self-initiated care
only one scheduled follow-up visit
controlled RA pts
DAS28/pt satisfaction same
visits/y: 1.7 vs 3.0
@reade_020 #ACR21 ABST0830 @RheumNow https://t.co/600XTKo9GM
TheDaoIndex
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Risks for RA:
- chromosome 6 has HLA risk genes encoding HLA-I and -II
- HLA-DRB1 *04:01 and *04:04 stonrgly assc w/ RA in white Americans/Europeans
- the Shared epitope increase risk for RA & severe disease; high assc with ACPA+
Protective➡️HLA-DRB1*13:01 @rheumnow #ACR21 2/2
TheDaoIndex
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Chances for RA if a family member has RA?
Dr. B Masri reviews familial studies:
👉person w/1st degree relative w/ RA has 2-4 X risk
👉Multigen study standard incidence ratios: 3.02 child, 4.64 siblings, 9.31 in multiplex family, 6.48 twins, 1.17 in spouses #ACR21 @rheumnow 1/
TheDaoIndex
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Dr. Ranjeny Thomas on preventing RA:
👉60% genetics/immunopathogenesis (noncontrollable factors)
👉40% lifestyle modifications: healthy diet, healthy weight, avoiding tobacco, reduce occupational exposure, improve exercise/sleep, decrease stress.
#ACR21 @rheumnow 1/2 https://t.co/eoh3kcekR8
Md Yuzaiful Md Yusof
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Don't forget to catch up with our @RheumNow Faculty Panel discussion on What's Hot and Not Daily Recap for Saturday #ACR21 @RichardPAConway @AurelieRheumo @bella_mehta @_Castillo_Pedro https://t.co/x2xu6k2h9x
Aurelie Najm
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MTX and liver: FibroScan scores compatible with liver fibrosis are significantly correlated w/ several parameters
-BMI
-waist circumference
-male gender
-age
but NOT MTX cumulative dose in a cohort of 500+ patients.
#Abst0786 @RheumNow #ACR21 https://t.co/RkSpVqN4qF https://t.co/9TENaR0WZ3
Robert B Chao, MD
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Drug retention of TNFi vs. secukinumab in AxSpA pts
Abs#911
⭐️46% discontinued either treatment
⭐️TNFi with slightly better drug retention
⭐️Age, BASDAI, BMI did not favor any group
⭐️inefficacy - main reason
#ACR21 @RheumNow https://t.co/ynoomYrTvX
swethaann23
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Detecting inflammation in SIJ for axSpA is by MRI but Artificial intelligence convolutional network aids this:
-In the Validation set: Trained CNN ▶️91.8% accuracy; Sens 88.9% Sp 93.5%
- Holdout set: 81.5% accuracy; Sens 67%; Sp 84.5%.
Abst# 0905 #ACR21 #ACRBest @RheumNow https://t.co/qmOxk9JQOC
