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Sjogren's in a Plenary! Remibrutinib (BTKi) in SjS
Improved ESSDAI at wk 24, but NONE on ESSPRI (more patient-centric ie fatigue, dryness, joint pain)
Definitely helps w/lab abnormalities, but worried benefit for outcomes that matter may be limited
#ACR22 @RheumNow abstr#1113 https://t.co/GutY8KndbR
Mike Putman EBRheum ( View Tweet)
Initial Remibrutinib (oral, covalent, and highly specific inhibitor of Bruton’s tyrosine kinase (BTK)) data in SS shows good efficacy and safety. Plenary Abs 1113 #ACR22 @RheumNow https://t.co/5Zr0Y1ueAv https://t.co/Iy194YUWNC
Dr. Rachel Tate uptoTate ( View Tweet)
2nd Plenary Session!
Remibrutinib (BTK inhibitor) for treatment of Sjögren's syndrome (phase 2 study)
Improvement of ESSDAI, salivary flow and pathologically elevated Ig's
Abs#1113 @RheumNow #ACR22 https://t.co/vdgxBPe6qd
Robert B Chao, MD doctorRBC ( View Tweet)
Mimics of Sjogren’s Syndrome @RheumNow #ACR22 https://t.co/nEAXKb6qF0
Dr. Antoni Chan synovialjoints ( View Tweet)
Low dose IL-2 works in Primary Sjogrens Syndr (pSS)? RCT 60 pSS pts rx w/ PBO vs LD-IL-2; latter lower ESSDAI @wk 24 (67% vs 27%; P=.004) & less Sxs (dryness,fatigue) @wk12 and expansion of TREGs & CD24highCD27+ B cells. https://t.co/39U6WX7ceM https://t.co/i56XDSvGXs
Links:
Dr. John Cush RheumNow ( View Tweet)
Here's a nice slide comparing Sjogren's disease and Sarcoidosis:
#ACR22 @RheumNow #acrreview #MedTwitter https://t.co/MQQx3GBl5f
sheila RHEUMarampa ( View Tweet)
Sialadenosis is a mimic of #sjogren - it related to fatty infiltration/metabolic syndrome. Correct underlying issue and pts will improve - Dr S McCoy @rheumnow #acrreview #acr22 https://t.co/bZPj1LmERs
TheDaoIndex KDAO2011 ( View Tweet)
Wonderful slide by Dr. Sarah McCoy on #Sjogrens #ACR22 @RheumNow
Broad differential for these patients when they present in clinic:
📍Ask about:
🚬 habits
💊 meds
🍬 🩻history: #diabetes, past radiation exposure
🦠 infection (#HIV, #HCV)
🩸 #vitamin deficiency https://t.co/6Qo23lWBs4
Catherine Sims, MD DrCassySims ( View Tweet)
Sjogrens - Dx tips, myths & mistakes:
• SS not rare; affects 1 in 400
• 95% female, but SS is more severe in men
• African Americans have a severe systemic phenotype
• Asians report dryness Sxs
• Smoking & alcohol intake often avoided by SS pts
https://t.co/B2hR7z8H5Z https://t.co/g0FKhcmoXa
Links:
Dr. John Cush RheumNow ( View Tweet)
Multicentre matched control study looked at primary Sjogrens that developed lymphoma or NOT. Parotid swelling (PSW) is an early major predictor of non-Hodgkin lymphoma in pSS; esp if present before or dx, & w/ a longer duration of PSW https://t.co/QokXF6klEv https://t.co/YqFgAqt4ku
Links:
Dr. John Cush RheumNow ( View Tweet)
Mitochondria as Master Regulators of Inflammation
Mitochondrial constituents and metabolic products may give rise to immune activation; this is especially true for mitochondrial DNA, which can function as damage-associated molecular patterns (DAMPs) leading to inflammasome activation.
Read Article
🌏 Today is World Sjögren's Day!🌍
🩺 Sjögren's is not Just Dry eyes👁️ and Dry Mouth👅👄 - there's much more to it
There's still a lot about this 'invisible' #Autoimmune Disorder, we don't know
Clinical Features and Pathogenesis
#LetstalkaboutSjögrens
#MedTwitter
#RheumTwitter https://t.co/t9toed8MG7
EnvisionRheumat ERheumat ( View Tweet)
#EULAR2022 Prof Schulze-Koops highlighted a mechanistic study that baricitinib therapy ex vivo suppressed autophagy, increased apoptosis, and reduced expression of adhesion molecules in #sjogren salivary glands. Next step should be randomised controlled trial cc: @Yuz6Yusof https://t.co/1tDBNzTuwQ
Dr. John Cush RheumNow ( View Tweet)
Environmental articulate matter (PM2.5) levels can increase the odds of a systemic autoimmune rheumatic disease onset (OR 1.12; 1.08–1.15), , w/ no effect of ozone. Results not changed by controlling for smoking. https://t.co/7BGBh9h0lf https://t.co/LcUo4Lxzgx
Links:
Dr. John Cush RheumNow ( View Tweet)
#OP0236 #EULAR2022 Prof Schulze-Koops highlighted a mechanistic study that baricitinib therapy ex vivo suppressed autophagy, increased apoptosis, and reduced expression of adhesion molecules in #sjogren salivary glands. Next step should be randomised controlled trial @RheumNow https://t.co/dirmHY9cYJ
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#OP0286 #EULAR2022 With no licensed therapy, we need a better and responsive outcome measure. Using data-driven method, SJÖGREN’S TOOL FOR ASSESSING RESPONSE (STAR) has been developed. This will be evaluated in NECESSITY RCTs across Europe @RheumNow https://t.co/U5Aj6bwWBy
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Torgashina et al Rituximab in Sjogrens ILD. ILD first manifestation of Sjogrens in 26%. Rituximab improvement in 37% and stabilisation in 47%. @RheumNow #EULAR2022 POS0710 https://t.co/CCnPVrTGfI
Richard Conway RichardPAConway ( View Tweet)
New Tool! STAR (#Sjogren’s Tool for Assessing Response) was developed to assess treatment response in primary Sjogren’s and will be validated on 3 datasets #EULAR2022 @rheumnow OP0286 https://t.co/9tgVSWGxEc
TheDaoIndex KDAO2011 ( View Tweet)
Fonzetti et al. Isolated Ro-52 in pSS. 300 patients. Less inflammatory features but more fibrotic disease - ILD and PBC. @RheumNow #EULAR2022 OP0146 https://t.co/2WIAu8qKiH https://t.co/mspSBNxbx2
Links:
Richard Conway RichardPAConway ( View Tweet)
#POS0065 #EULAR2022 What is the nature of ILD progression in #Sjogren and is it mostly stable? A cohort study in Oslo (N=702) showed after 15 yrs follow-up, 45% had radiographic progression. Hence, need to monitor lung function test @RheumNow https://t.co/ga7qer27ks
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)