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Does VTE increase risk of subsequent MACE (cardiac events ie MI). National Data Bank excluded pts with past CV events. 2X risk of future CVE post VTE. Strange as risks are a bit different #ACRbest #ACR19 @RheumNow abst196 https://t.co/XoSkow7AAQ
Janet Pope Janetbirdope ( View Tweet)
Efficacy and Safety of Upadacitinib in a
Randomized, Double-Blind, Placebo-Controlled,
Multicenter Phase 2/3 Clinical Study of Patients With Active AS
• Onset of response to upadacitinib 15 mg QD tx was rapid
• AEs similar between upadacitinib and placebo
#ACR19 @RheumNow
Kanika Monga, MD DrKanikaMonga ( View Tweet)
Abstr#2273: higher placental transfer antiTNFs=ADA,IFX,GOL. Less transfer=CTZ,ETN. No ⬆️ in infxns in offspring, even with 3rd tri exposure. Potential trend for ⬆️ in serious infxns (>/=1 hosp adm 1st yr of life) with high placental transfer antiTNFs, not sig. #ACR2019 @RheumNow https://t.co/qEIl9lxlv1
Maeve Gamble MaeveGamble ( View Tweet)
Secukinumab: a human IgG1κ monoclonal antibody that binds to IL-17A
ASAS40: a composite measure including patient global, pain, function, and inflammation
In patients with nr-AxSpA, secukinumab improved ASAS40 through week 52, compared to placebo
Dr. Deodhar #ACR19 @RheumNow https://t.co/yLwt47w2wr
Jonathan Hausmann MD hausmannMD ( View Tweet)
MYTH: Tocilizumab should be reserved for GCA patients whom prednisone has failed
#PearlsAndMyths Dr. John Stone #ACR19 @RheumNow https://t.co/tVrC5XP0ot
Kanika Monga, MD DrKanikaMonga ( View Tweet)
Interesting withdrawal study of tofacitinib in children with JIA showed that drug was better than placebo at preventing disease flares. #pedirheum #ACR19 @RheumNow https://t.co/lHWNJGmmtF
Jonathan Hausmann MD hausmannMD ( View Tweet)
NEW ANCA Associated Vasculitis Guidelines - discussed at #ACR19
1. Rituxan > cytoxan
2. Reduced steroid regimen!
3. Rec against PLEX
4. Rec FOR scheduled RTX over ANCA+B cell guided
5. MTX for limited dx
Well done everyone - very reasonable and evidence based!
@RheumNow https://t.co/oX6qEJDQON
Mike Putman EBRheum ( View Tweet)
NEW Draft Guidelines for EGPA presented at #ACR19 @RheumNow
1. TTE and FFS to guide tx
2. GC plus cytoxan or rituxan for active/severe dx
3. Imuran/MMF/MTX for maintenance after severe dx
4. Mepo for non-severe over csDMARDs
Larger role for RTX than expected, overall reasonable https://t.co/MEb10n5Mzd
Mike Putman EBRheum ( View Tweet)
Video from @gensler_MD on AS and nr-axSpA studies presented at #ACR19 @rheumnow https://t.co/fcn9zCxouU via @YouTube
Philip Robinson philipcrobinson ( View Tweet)
Pregnancy outcome in the DESIR cohort (SpA cohort) #ACR19 @RheumNow https://t.co/PcwR6rrMRw
Philip Robinson philipcrobinson ( View Tweet)
The bit I particularly like out of this: you get *at least* another 10% from going back for more slices from your temporal artery biopsy. Please, sir, may I have some more (slices)?
Reggio Emilia #ACR19 ABST2648 @RheumNow
David Liew drdavidliew ( View Tweet)
The more we know, the more we learn we struggle to predict GCA flares.
Model based on three large GCA cohorts (total n=778) could pick some factors (headaches, limb claudication, aortitis, CRP) but couldn't discriminate well. Other variables important?
#ACR19 ABST2650 @RheumNow
David Liew drdavidliew ( View Tweet)
In case we needed more reassurance: ANCA positivity on IF without a MPO or PR3 rarely leads to ANCA-associated vasculitis.
Maybe if the pathology report had that info attached, it would help reassure our generalist colleagues?
@ShaareZedekMed #ACR19 ABST2642 @RheumNow
David Liew drdavidliew ( View Tweet)
MGUS is really common in the general population. Therefore, it’s going to be really common in our rheumatic patient population
#acr19 https://t.co/9HIWvDm20n
Dr Irwin Lim _connectedcare ( View Tweet)
Here’s the risk stratification for MGUS
#ACR19 @rheumnow 5T064 https://t.co/fKeJu8n5DI
Dr Irwin Lim _connectedcare ( View Tweet)
Do you routinely consider ACPA status in your choice of Biologic MOA?
Olga Petryna DrPetryna ( View Tweet)
#ACR19 @rheumnow L20 head-to-head IXE vs ADA PSA 52wk trial: IXE shows significantly ⬆️ response than ADA for simultaneous ACR50 + PASI100 through Wk 52.TEAEs in 73.9% IXE &68.6% ADA pts. sAEs in 4.2% IXE&12.4% ADA pts, and d/c 2/2 AEs in 4.2% IXE & 7.4% ADApts; no deaths https://t.co/WeGdmu0vh6
Olga Petryna DrPetryna ( View Tweet)
#ACR19 RITAZAREM RCT rituxan vs imuran, AAV maintenance
RTX superior to imuran w/HR 0.36 and relapse rate at 24 months (13% vs 38% imuran, NNT=4). Hypogam risk only 4% higher vs imuran (NNH~25) and non-severe infections similar
Supports guideline recs from this AM!
@RheumNow https://t.co/m9FkJ7d7I9
Mike Putman EBRheum ( View Tweet)
#ACR19 @RheumNow
FINCH1 results for filgotinib in RA w/MTX inadequate response
Good efficacy over PLBO for ACR50 at 24 wks (NNT~4), somewhat less impressive than UPA against TNF (NNT~20, not superior)
Lower rates of HSV! Also, like UPA there is (as yet) no VTE signal https://t.co/1HjFgfXvlX
Mike Putman EBRheum ( View Tweet)
J Stone IgG4-RD pearl: If elevated at baseline the serum IgG4 is a good biomarker for IgG4-RD.
If very high, IgG4, can be a marker for recurrent disease. Hypocomplementemia implies renal involvement. #ACR2018 @RheumNow
Maeve Gamble MaeveGamble ( View Tweet)