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Hand movement video: more promising than photos as a computer vision concept for remote monitoring of RA disease activity.
Of course: validation, training, clinical evaluation all must happen before it is ready for your clinic
https://t.co/HyN6ElKF0F #ACR23 ABST1293 @RheumNow https://t.co/DltI9HFiFE
David Liew drdavidliew ( View Tweet)
Fatigue 😴 in RA & synovial biology
In DAS LDA pts Fatigue asso w/
-female sex
-synovial lymphocytic inflammation
In DAS moderate DA:
-female sex
-synovial lining layer
-Anxiety
Limitations: arthroplasty tissue, small sample size, no Immunohisto
@RheumNow #ACR23 ABST1630 https://t.co/4vhzvdPgyd
Aurelie Najm ( View Tweet)
Fisher et al. In high disease activity, fatigue associates anxiety and synovial lining hyperplasia, 1.57[1.01,2.5]; p=0.047) In LDA, fatigue associates chronic lymphocytic synovial inflammation, 1.92[1.09,3.57]; p=0.024) Abstr#1630 #ACR23 @RheumNow https://t.co/Gev6pU3srq https://t.co/Ys8etP36ir
Richard Conway ( View Tweet)
Do we miss RA activity in obese pts?
Pre-clinical trial entry MSK USS:
similar DAS28
but lower SJC/US scores in obese
Is it because, in obese RA patients:
we underdetect on exam?
we undertreat?
higher risk, so lower penetrance of severe dx endotypes?
#ACR23 ABST1287 @RheumNow https://t.co/3FFPdBJOpz
David Liew drdavidliew ( View Tweet)
Multimorbidity in #RA - VARA registry data- looking at 61 different biomarkers and 44 comorbidities
Chronic pain in 44%
Specific biomarkers seen in different morbidities
@rheumnow #ACR23 session#13M148 https://t.co/l6FU1ELKD3
Bella Mehta bella_mehta ( View Tweet)
Peyton et al.: 4 multimorbidity patterns in RA
-Mental health and subst abuse
-Metabolic
-CV
-Chronic pain
All associated with different sets of biomarkers.
Some are very specific of one profile while others are widespread across profiles.
@RheumNow #ACR23 ABST1631 https://t.co/VqCrLI3oyy
Aurelie Najm ( View Tweet)
In PS-matched study, no significant difference in respiratory hospitalisation or death between RA-ILD patients on non-TNFi/JAKi vs. TNFi. This finding does not support systematic avoidance of TNFi in RA-ILD, England B Abst#1582 #ACR23 #ACRBest @RheumNow https://t.co/1zVjMWNZZS https://t.co/d8TRIvGaIe
Dr. Antoni Chan ( View Tweet)
Abst#1583 SMART study: Split dose qwk MTX (10 mg QAM, 15 mg QPM) may have better efficacy compared to 25 mg single dose qwk MTX. RCT 253 RA patients: split dose had better DAS score, less likely to add other DMARDS, but slight⬆️in LFTs. #Plenary #ACR23 @rheumnow #ACRbest
TheDaoIndex KDAO2011 ( View Tweet)
It's OK to use TNFi in RA-ILD!
VA study 1000+ pts using Target Trial Emulation framework: TNFi vs nonTNFi biologics/JAKi followed for 3 years. NO differences in respiratory hospitalizations or deaths or all cause mortality. abst#1582 #ACR23 #ACRbest @rheumnow https://t.co/aI2SmMrLPE
TheDaoIndex KDAO2011 ( View Tweet)
Factors predicting fatigue in RA differ by disease activity.
Synovial lining hyperplasia and synovial lymphocytic inflammation on histology were key factors.
@rheumnow #ACR23 session 13M148 https://t.co/yPBZX2Rxft
Bella Mehta bella_mehta ( View Tweet)
RA-ILD: the study that exonerates TNFi ?
TNFi vs. other BioDMARDs/JAK do not increase risk of death or hospitalization over 1 and 3 yrs follow up.
No subgroups stand out
VHA cohort, 50% smokers
No info on ILD patterns or disease trajectory
ABST1582 @RheumNow #ACR23 https://t.co/frv16oRLqv
Aurelie Najm ( View Tweet)
Lovering et al. Synergestic effect of RA and CVD on dementia risk. 35% increased risk RA, 89% increased risk RA+CVD. Abstr#1628 #ACR23 @RheumNow https://t.co/Brj8XrG2o4
Richard Conway ( View Tweet)
#ClinicalPearl or #pathology pearl? Using synovial #biopsies to guide therapy in #RA #RCTs is a reality. But likely #fibrotic #phenotype won’t respond and #lympho_myeloid has more RA damage. #ACR23 session 13M140 #Precision #medicine #ACRbest @ACRheum @RheumNow https://t.co/DmI9dNpu8w
Janet Pope ( View Tweet)
@Dr_K presenting long COVID data from FORWARD RA.
These pts had some symtoms before COVID!- More comorbidites, depression patient reported scores, fibromyalgia but no different DMRD use.
PHQ8 and wodepread paid were the most important PROMs @RheumNow
#ACR23 https://t.co/JaWc4oDnaI
Bella Mehta bella_mehta ( View Tweet)
#Precision #Medicine in RA RCTs. Treat w right drug at right time?
Possible problems -sample variation on synovial #bx, some won’t respond ex fibrotic phenotype variable drug distribution/resistance. AI is helping to separate Pts #ACR23 @ACRheum @RheumNow 13M140 https://t.co/D7NxpM4YNw
Janet Pope ( View Tweet)
Michaud et al. RA patients with long COVID had more fibromyalgia pre-COVID (41% vs 13%), higher rates of pain, depression, and worse PROs pre-COVID. Authors suggest long COVID may partially reflect pre-existing illness Abstr#1629 #ACR23 #ACRbest @RheumNow https://t.co/mrcGWrSD6c https://t.co/YiGCbvBDtn
Richard Conway ( View Tweet)
Do you discuss HPV vax & cervical CA screening w/SLE & RA pts?
In this study, more women w/SLE discussed cervical CA screening w/their rheums(33.3% vs. 11.4% p<0.01) & more likely to have persistent abn paps on ffup
Similar HPV vax status for both grps
#ACR23 ABST1356 @RheumNow https://t.co/Vbu8hbZ1uh
sheila ( View Tweet)
Karpouzas et al. MTX reduces IHD in males but not females with RA. 4362 patients. 66% lower risk MACE and 55% lower risk any ischaemic CVE. Abstr#1627 #ACR23 @RheumNow https://t.co/MC4W0dinUv https://t.co/1hkBoawt4b
Richard Conway ( View Tweet)
RA males 81% increase MACE & 58% ischemic CVE
2 folds Males>Females in MTX non users
Makes MTX users reduction 66% & 55% risk MACE & ischemic CVE and no diff w/ females
MTX use not assoc w/ reduction MACE in females
@RheumNow #ACR23 ABST1627 https://t.co/qbAc2bWdcM
Aurelie Najm ( View Tweet)
SMART study in RA, splitting MTX
Split dosing better at wk 16 but ~similar at wk 24
Caveat: wonky design from wk16-wk24 makes it hard to interpret?
Surprsingly, adverse events ~similar but smallish sample
Mostly supports my practice of splitting?
@RheumNow #ACR23 #ACRBest https://t.co/g7s4EUHeCW
Mike Putman EBRheum ( View Tweet)
