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ACR23 – Day 3 Report
These year’s annual ACR Convergence has been a success with the return of an insanely active Poster Hall! F2F learning amidst miles of research and many young talented aside wizened establish presenters is such a welcome return to ACR, the way it should be.
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Peng et al. 146 IgG4-RD in remission on immunomodulators+GC. 18 month follow-up. Withdraw IM+GC - 52% flare. Withdraw GC + continue IM 14.2% flare. Continue both 12.2% flare. Clear message that ongoing IM is the way Abstr#L16 #ACR23 #ACRbest @RheumNow https://t.co/3CAQhyTYqq https://t.co/qr1GOSvJYg
Richard Conway ( View Tweet)
What happens when you stop #steroids and/ immunosuppressive Rx in Pts in remission for at least 1 yr in #IgG4 disease?
You are likely guessing correctly
Pts flare! Don’t stop Rx
?taper 🤷♀️
Like RA Rx - if stop Rx = flares
Large RCT from China L16 #ACR23 @RheumNow @RheumNow
Janet Pope ( View Tweet)
Effective Treatments for Rheumatoid Arthritis ILD
The American College of Rheumatology guidelines for the diagnosis and management of interstitial lung disease, which includes rheumatoid arthritis interstitial lung disease (RA-ILD), has been one of the most controversial topics in the runup to ACR Convergence.
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Clinical Year in Review at #ACR23
By @philseo (@jhrheumatology)
Review some of the most impactful scientific studies in #Rheumatology in the past year! 🍕 https://t.co/ystEjzrU8u
Mithu Maheswaranathan, MD ( View Tweet)
ARTIC REWIND RCT 3 yrs csDMARD withdrawal
38% 3yrs csDMARDs free remission vs. 80% stable dose gpe
75% recovery after restart
Rx progression 19% in half dose gpe
More use bioDMARDs (18%) & GCs (50%) withdraw gpe
Trends towards lower infections
@RheumNow #ACR23 #ACRBest https://t.co/jhOINV7LLS
Aurelie Najm ( View Tweet)
Low dose #prednisone has (bad) brain effects. An argument to use steroid sparing drugs in #PMR @philseo @ACRheum @RheumNow #ACR23 THINK about steroid sparing Rx in ?all pts with #PMR #Great #debate https://t.co/usQJRNUN8B
Janet Pope ( View Tweet)
#CAR T cells #ACR23
🔥Back to back Sessions on one of the most avidly researched area in Rheum!
💡Check out these slides to understand:
☣️Toxicities and Limitations of CAR T therapy
🆕 Novel CAR designs
⚡️CAR cell sources
❓Research Questions to ponder!
#ACRambassador https://t.co/6sOn4rjqY3
debaditya_roy ( View Tweet)
Toxicities and limitations of CAR therapy:
the other side of its incredibly exciting, boundless potential
@Michel_Sadelain @MSKCancerCenter #ACR23 @RheumNow https://t.co/L1UIqqlOdC
David Liew drdavidliew ( View Tweet)
Are all ICI-IA irAEs the same?
@cappelliMD @jhrheumatology presented lovely work: latent class analysis on her cohort data
She found two phenotypes - one with more persistent symptoms, & potentially a start in stratifying irAE therapy going forward.
#ACR23 ABST2513 @RheumNow https://t.co/roW00KwbVZ
David Liew drdavidliew ( View Tweet)
So great to see posters back at #ACR23 and interactions of #students and #mentors which can be career shaping. Data from #Alberta with a nearly 3K survey on #cannabis use in Pts with #rheumatic diseases studying the use as #Rx and #recreational @RheumNow #979, 980 https://t.co/xbVcK5HuRS
Janet Pope ( View Tweet)
Rx of #inflammatory #arthritis with #glucocorticoids doesn’t seem to affect outcomes in #malignancy treated with #checkpoint #inhibitors. Good news as new or flaring inflammatory arthritis as an irAE can be severe. #ACR23 @RheumNow @ACRheum #1055 @CanRIO_Tweets https://t.co/tFIPcQq2X6
Janet Pope ( View Tweet)
There is a dose, duration and recency-dependent relationship between previous GC use and MACE. GC doses 5mg/day, durations of 30 days, and use one year prior to MACE were all associated with an increased risk of MACE, Wallace B Abst#2430 #ACR23 #ACRBest https://t.co/2ExboBvo2W https://t.co/FuqXdFFwqP
Dr. Antoni Chan ( View Tweet)
After attaining #remission or #LLDAS after a flare - HALF flare over f/u esp if tapering pred to <7.5 or 5 mg. #HCQ was protective. 65% got LLDAs and 45% rem in 1/2 yr - longer time to get #remission #2553 #ACR23 @RheumNow @ACRheum #ACRbest Asian cohort of #SLE largest@in world https://t.co/yBBqYJZVOe
Janet Pope ( View Tweet)
Is rituximab still a problem with COVID - esp if our patients have been vaccinated pre-ritux?
Antibody titres better when not getting regular ritux around boosters
Maybe boosters 9mo (or so) gap after ritux helps immunogenicity
@TroldborgAnne et al #ACR23 ABST2511 @RheumNow https://t.co/dE0uC6B9hx
David Liew drdavidliew ( View Tweet)
Who uses #cannabis in #rheumatic #diseases? Those who smoke, have higher pain, more anxiety, poor sleep are more likely to have used cannabis for their rheumatic disease. Half of the >2900 respondents have tried #cannabis. Use of #biologics reduced use. #980 @RheumNow @ACRheum https://t.co/DQDRQN40zR
Janet Pope ( View Tweet)
HCQ and risk of retinopathy 👁️
DoD database HCQ 44000+ females & 10000+ males
Risk retinopathy HR 1.5
Variations according to diagnosis SLE higher risk vs. RA, more so in males HR 2, females HR 1.7
No adjustment on HCQ dose
@RheumNow #ACR23 ABST2452 https://t.co/TtTu6ixb45
Aurelie Najm ( View Tweet)
And to continue
B-SAFE Clinical risk score for HCQ retinopathy 👁️ 10 years
4000+ pts, 3% retinopathy over 5yrs
Predictors of HCQ retinopathy
-body weight
-sex
-age
-eGFR
-weight based dose mg/kg
-higher cumulative dose
Risk ranges 1% to >20%
@RheumNow #ACR23 ABST2453 https://t.co/h2tl6vH9M3 https://t.co/8iuRxoVaJ0
Aurelie Najm ( View Tweet)
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)
A#2429 #ACR23 @RheumNow
ROMO v DEN - 12 mo RCT 70 GIOP pts at high-risk
Mean prednisolone dose 6.6 mg
H/o fragility fx in 1/2 pts
12 mo: Increase in spine BMD- ROMO (+7) and DEN (+2)
Hip and Femoral neck improved both (1.6% both), not signif diff bw grps
AEs: incr injxn site rxn https://t.co/VueuZIjFfM
Eric Dein ( View Tweet)