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38yo F with seroneg RA on 3x therapy with synovitis. What tx do you choose?
-Bathon: Confirm dx, use biologic, avoid ritux
-Bykerk: Ask about JIA, use TNF, JAK, IL-6
-Emery: Not ritux. Use steroids, consider TNFi, urgent tx is not needed
-Mikuls: Agree with above
#ACR19 @RheumNow
Jonathan Hausmann MD hausmannMD ( View Tweet)
@RheumNow Should note this was not the first JAKi in this space; similar trial using tofacitinib in 2017 https://t.co/NrEul0wLp9
Mike Putman EBRheum ( View Tweet)
#ACR19 Abst#2728 Plenary: Upadacitinib RCT in AnkSpa
Improved ASAS40 at wk14 (52% v 26% PLBO, NNT~4) and SPARCC MRI Scores.
Good safety profile but too small a trial to assess properly
Overall an encouraging result, JAKi impacting yet another disease!
@RheumNow https://t.co/GtB9wHuoNp
Mike Putman EBRheum ( View Tweet)
Upadacitinib in AS
Nice to the rapid response
#ACR19 @rheumnow Abst2728 https://t.co/woAZbdb5QY
Dr Irwin Lim _connectedcare ( View Tweet)
What's your option for RA patients with MTX failure?
-Bathon: Triple therapy vs. biologic (etanercept or adalimumab)
-Bykerk: Maximize MTX to 25mg SQ
-Emery: Adalimumab is our cheapest and most effective therapy
-Mikuls: Usually TNFi, typically etanercept
#ACR19 @RheumNow
Jonathan Hausmann MD hausmannMD ( View Tweet)
Do you hold MTX in men who want to conceive? #ACR19 @RheumNow
Maeve Gamble MaeveGamble ( View Tweet)
Upadacitinib in AS
And here’s the Safety Slide
#ACR19 @rheumnow Abst2728 https://t.co/fpjhrjGp0N
Dr Irwin Lim _connectedcare ( View Tweet)
Looking forward to this PsA panel talk #ACR2019 https://t.co/pCMaqQCMsJ
Dr. John Cush RheumNow ( View Tweet)
For new diagnosis of RA: How often do you bridge with prednisone?
#ACR19 @RheumNow
Maeve Gamble MaeveGamble ( View Tweet)
Not what I was expecting:
patients reporting a diagnosis of ANCA-associated vasculitis are overwhelmingly correct, and are correct about GPA vs MPA.
If only we could say the same about lupus!
Tanaz Kermani, Jason Springer, Peter Merkel et al #ACR19 ABST2635/2641 @RheumNow https://t.co/APcqg0e5fw
David Liew drdavidliew ( View Tweet)
Quote of the day from David Borenstein at #ACR19 “Low back and neck pain are second only to the cold the most common affliction for mankind” @RheumNow https://t.co/MAX0TCXnqK
Dr. Antoni Chan synovialjoints ( View Tweet)
EAMs: I know there's published data but among Axial SpA patients you actually see, what is the most common EAM?
@rheumnow #ACR19
Dr Irwin Lim _connectedcare ( View Tweet)
A 55-year-old female found to have seropositive RA. Do you ever start a biologic first?
-Emory: we would if we could get it approved for patients predicted to have severe erosive dz
-Bathon: in women planning to become pregnant
-Mikuls: not really
@rheumnow #ACR19 https://t.co/UyeJKFTBJS
Jonathan Hausmann MD hausmannMD ( View Tweet)
What happens to PET/CT after six months of steroids in GCA? Reduction in vascular uptake, but remnant uptake didn't correlate with future clinical flares. Role of serial PET/CT in GCA yet to be determined...
@tonysammel @earlyARA #ACR19 2671 @RheumNow https://t.co/OwiqD9yMij
David Liew drdavidliew ( View Tweet)
Do you add steroids to the initial treatment of patients with RA?
-Bathon: in severe disease
-Mikuls: a conversation you should have with your patients, depending on their goals
@rheumnow #ACR19
Jonathan Hausmann MD hausmannMD ( View Tweet)
We've been asking what happens intravascularly in GCA pts on TCZ.
Five GCA pts with aortic complications on TCZ doesn't answer it, but just a reminder: TCZ is steroid-sparing, not disease-modifying. Don't take your eyes off the road!
@KantonsspitalSG #ACR19 ABST2666 @RheumNow https://t.co/G9JM4QLXSH
David Liew drdavidliew ( View Tweet)
Influenza vaccine highlights #ACR19 #whyivaccinate @RheumNow #cleclinicrheum https://t.co/NX4227Gmo9. https://t.co/iqljjr20nw
Cassandra Calabrese CCalabreseDO ( View Tweet)
Vaccination is the best mode of infection prevention. decrease frequency and severity in our patients who are at increased risk, yet vaccination rates remain so low! @LCalabreseDO @RheumNow #ACR19 #whyivaccinate
Cassandra Calabrese CCalabreseDO ( View Tweet)
Abstr#1805 per-operative csDMARD or bDMARDs not associated with 30-day post-op infection, more studies needed to determine if we truly need to hold biologics for joint replacement surgery #ACR19 @RheumNow
Cassandra Calabrese CCalabreseDO ( View Tweet)
What do you do when a patient with gout you are treating with allopurinol develops a typical allopurinol rash? #ACR19 @RheumNow
Philip Robinson philipcrobinson ( View Tweet)