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Day 2 Report - ACR Plenaries: Changing the Practice of Rheumatology
Over the years of navigating the annual meeting, I found the sessions with the most impact to my practice were the Plenary Sessions. During these sessions, the latest research is presented, new ideas are floated, and old myths debunked. Here are the top ACR2023 Plenary abstracts I found impactful for my practice.
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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)
ARTIC REWIND: To taper or not?
A#L07 #ACR23 @RheumNow
RA pts taper TNFi in stable remission
No taper group: 85% flare free in 3 yrs
Taper grp: only 25%
Lower Boolean 2.0 Remission rates
Don't taper off a good thing! https://t.co/KnJrEfVFkV
Eric Dein ( View Tweet)
Excellent session: Navigating CV risk for #inflammatory #arthritis - view from #cardiology #ACR23 14T118 @RheumNow @ACRheum https://t.co/WKhh0TonE8
Janet Pope ( View Tweet)
Is #cardiology now a specialty like #rheumatology with bDMARDs? Many pathways discussed for CVD in #rheumatoid #arthritis. And biologics for lowering lipids too! #ACR23 @ACRheum @RheumNow 14T118. More overlap of pts over time! https://t.co/blv5GmHTGe
Janet Pope ( View Tweet)
I continue to be underwhelmed by nintedanib, esp in RA-ILD
Data from INBUILD-ON, f/u study to the INBUILD basket trial
Persistent loss of FVC... wonder how pts would have done had they received an RA-active DMARD?
Need H2H vs TNFs & real DMARDs
@RheumNow #ACR23 Abstr 2158 https://t.co/56PgC6Uc67
Mike Putman EBRheum ( View Tweet)
Phase 2 RCT. Selective JAK1i LNK01001 in RA. 156 patients, 24 week (12 week PBO controlled). Abstr#L09 #ACR23 @RheumNow https://t.co/hHjL1yFH0H https://t.co/Qls4zRrRGH
Richard Conway ( View Tweet)
The Fallacy of Biologic Treatment to Prevent RA
It is time to stop fooling ourselves that we can prevent RA with our existing biologic agents. #ACR23
https://t.co/qHMW4HGkk2 https://t.co/l2Tn7hGtY3
Dr. John Cush RheumNow ( View Tweet)
Summary of diet effects in RA and SLE patients 👇
Dr. Sarah Patterson also shared nutrition resources for pts and clinicians
https://t.co/ae6nLrLXca
#ACR23 @Rheumnow @rheumarhyme @GerRheumDoc @doktora_ging https://t.co/8HhCHCTGLh
sheila ( View Tweet)
Great summary of the big takeaways yesterday at #ACR23. Always love talking to @KDAO2011 @EBRheum @RheumNow
We get into the use of MTX, the safety on TNFs and what is in the purview of rheumatology practice https://t.co/jm0a8ndrsi
Eric Dein ( View Tweet)
Excellent pragmatic RCT, TNF withdrawal in RA
Almost 2/3 flared by 1 yr; at 3 years up to 3 in 4
Supports my practice of generally continuing TNFs long term
Also highlights importance of pt preferences; 1 in 4 may do well if they wish to discontinue
@RheumNow #ACR23 #ACRBest https://t.co/G4l0DgBP2Z
Mike Putman EBRheum ( View Tweet)
In case you missed it! Watch our ACR Monday Recap of the meeting with me, @RheumNow @EBRheum and @ericdeinmd. #ACR23 @uptoTate https://t.co/GpMdev0Yk7
TheDaoIndex KDAO2011 ( View Tweet)
