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retrospective study using Medicare claims data demonstrates lower risk of infection-related hospitalization with abatacept compared to other biologics, in RA patients previously exposed to TNFi. Abstr#1801 #ACR19 @RheumNow
Cassandra Calabrese CCalabreseDO ( View Tweet)
ICIR data showing Checkpoint inhibitor-related Sjogrens is different! More men, older patients, seronegative. Dry mouth >>dry eyes. Abstr#1905 #ACR19 @RheumNow @LCalabreseDO #cleclinicrheum
Cassandra Calabrese CCalabreseDO ( View Tweet)
PREVENT trial of Secukinumabnr-axSpA. SEC 150 mg loading and no loading dose provided significant improvement in signs and symptoms of nr-axSpA through Wk 16. The safety profile of SEC was consistent with the established safety profile across indications #L2 #ACR19 @RheumNow
Dr. Antoni Chan synovialjoints ( View Tweet)
The cytokine storm syndromes including MAS, HLH, autoinflammatory disease. Cron R #ACR19 #acrbest @RheumNow https://t.co/oy2QPHk8jh
Dr. Antoni Chan synovialjoints ( View Tweet)
Immune-mediated causes of uveitis
• Behcet’s disease
• Cogan’s syndrome
• IBD
• TINU
• JIA
• Multiple sclerosis
• Psoriatic arthritis/ AS/ Reactive Arthritis
• Relapsing polychondritis
• Sarcoidosis
• SLE
• Vasculitis
• Vogt-Koyanagi-Harada Syndrome
#ACR19 @RheumNow
Kanika Monga, MD DrKanikaMonga ( View Tweet)
MTX v. Mycophenolate – FAST uveitis trial
– 265 adults with non-infectious uveitis
– Oral MTX 25 mg v. MMF 3 grams daily
– MTX non-inferior to mycophenolate
Ophthalmology, 2018. 125(2):193.
JAMA, 2019. 322(10):936.
#ACR19 @RheumNow
Kanika Monga, MD DrKanikaMonga ( View Tweet)
Abstract #0626
Are there really differences between non-radiographic and radiographic axial spondyloarthritis? Data from the Spanish Atlas
#ACR19 @RheumNow https://t.co/hg3U2QjpFp
Kanika Monga, MD DrKanikaMonga ( View Tweet)
More than half of rheums who tweet and answer polls at #acr19 don’t look at synovial fluid anymore (maybe even more don’t in the real world) due to time constraints— your thoughts? @Rheumnow https://t.co/78d6MwbsXB
k dao KDAO2011 ( View Tweet)
Poor prognostic factors for MDA-5 ILD:
- Ferritin > 1000 ng/mL prior Rx
- GCO or consolidations in all lung fields
- Worsening of lung consolidations during Rx
#ACR19 @RheumNow
Kanika Monga, MD DrKanikaMonga ( View Tweet)
Myositis -- Ask for muscle biopsy when:
- high clinical suspicion w/ negative myositis specific antibodies
- high clinical suspicion of inherited muscle disease
- isolated elevated CPK
- recalcitrant to treatment
- atypical presentation
#ACR19 @RheumNow
Kanika Monga, MD DrKanikaMonga ( View Tweet)
Sjogrens RCT of Tocilizumab showed no benefit. Wonder re outcomes and pt selection. Maybe pick early pts with high inflammatory markers or other organ involvement #ACR @RheumNow #Sjogrens abstr1904
Janet Pope Janetbirdope ( View Tweet)
Tofacitinib works in Polyarticular JIA. Maybe new hope for kids with JIA and benefits of oral medication #ACR #ACR19 #JIA @RheumNow L23.
Janet Pope Janetbirdope ( View Tweet)
Myositis-specific autoantibodies (MSA): an important tool to support the diagnosis of myositis
#ACR19 @RheumNow https://t.co/vgW2wxkemr
Kanika Monga, MD DrKanikaMonga ( View Tweet)
Certrolizumab pegol decreases uveitis in open label study of SpA with past uveitis and HLAB27 group enriched for recurrence. Pre and post Rx rates of uveitis were compared. 80% reduction of uveitis but uncontrolled and unblinded. #ACR #ACR19 @RheumNow
Janet Pope Janetbirdope ( View Tweet)
1/3 of pts using apremilast with PsA/SpA from Corrona data base are using it in combination with bDMARDs. Not sure how they get reimbursement #ACR #ACR19 #psoriaticarthritis @RheumNow abstract 1481
Janet Pope Janetbirdope ( View Tweet)
2020 Gout Clinical Practice Guideline
❕Regardless of disease activity, conditionally recommend
- limit alcohol intake
- limit purine intake
- limit high-fructose corn syrup
- if overweight/obese, recommend weight loss
- against adding vitamin C supplementation
#ACR19 @RheumNow
Kanika Monga, MD DrKanikaMonga ( View Tweet)
@RheumNow 2020 Gout Clinical Practice Guideline
‼️ For allopurinol and febuxostat, strongly recommend starting at low dose with subsequent dose titration to target over starting at higher dose ( ≤ 100 mg/d for allopurinol, ≤ 40 mg/d for febuxostat)
#ACR19 @RheumNow
Kanika Monga, MD DrKanikaMonga ( View Tweet)
Gout guidelines make total clinical sense. Congrats ACR and Goit me@bers for a monumental job #ACR @RheumNow https://t.co/A0iwU0WPlZ
Janet Pope Janetbirdope ( View Tweet)
All the NEW Clinical Practice Guidelines for GOUT!
1. Allopurinol is 1st line
2. Start ULT during flare!
3. No tx for asymptomatic hyperuricemia
Seems pretty reasonable - surprised no rec for MTX w/pegloticase
#ACR19 @RheumNow Thank you to @philipcrobinson for posting slides! https://t.co/riwHGYNZ8T
Mike Putman EBRheum ( View Tweet)
2020 Gout Clinical Practice Guideline
42 recommendations (16 strong)
- 27 ULT management (13 strong)
- 5 Gout Flares (3 strong)
- 5 Lifestyle recommendations
- 4 Management of other medications
- 1 Asymptomatic Hyperuricemia #ACR19 @RheumNow
Kanika Monga, MD DrKanikaMonga ( View Tweet)