@_connectedcare @RheumNow @ACRheum My pearls (so far) 1. Use vitamin A to reduce SEs w MTX 2. Try doxycycline for refractory calcinosis in scleroderma 3. Use MTX with pegloticase to reduce infusion reactions 4. Anti-IL17 has activity in nr-axSpA 5. Patients think opiates are more effective than SNRIs or TCAs in FM

@RheumNow #ACR19 #acrbest abs2470 ⬆️serum calprotectin in PsA pts associated w/presence of carotid plaque, ⬆️intima-media thickness & ⬆️CRP. potential novel bio marker of CV disease in PsA https://t.co/ech3Ll8Nka

As I leave #acr19, time to reflect. My goal is to uncover pearls that change what I do in my next few clinics. 3 this time. How many such pearls did you find? @RheumNow @ACRheum

@rheumnow #ACR19 abs2854 internationPsART cohort data: age of onset defines if PSO or PSA starts first (PSO precedes in younger pts), Pustular PSO associated w/shorter time interval PSO to arthritis while nail involvement, plaque PSO & PSO family Hx associated w/ longer interval https://t.co/KtPXhYdbky

Do you still look at synovial fluid under the microscope? @rheumnow #acr19

Baricitinib additional improvement in pain vs ADA despite accounting for effect on disease activity https://t.co/zAjS2dOayF @RheumNow

• https://assets.ctfassets.net/mpejy6umgthp/1GddGCUl6UX0JRJSqYBpVW/59031ed6ebb6b6…

Claims data showing switching from ETN or ADA to Tofa had higher drug survival vs cycling to another TNF. Does not provide reason for discontinuation though https://t.co/yTNHkKanJA @RheumNow #ACR19

• american college of rheumatology acr 2019 arhp 2019 annual scientific meeti 57…

Weight loss in IgG4-RD NOT because of overwhelming systemic inflammation but from pancreatic involvement. Need pancreatic enzyme replacement. #ACR19 @RheumNow

Abstr#2729: 303 pts randomized. More pts achieved ASAS40 at Wk 16: IXE Q2W (40%), IXE Q4W (35%) vs PBO (19%, p< 0.01) and at Wk 52: IXE Q2W (31%), IXE Q4W (30%) vs PBO (13%, p< 0.01). Blocking IL-17A is a potential treatment option for patients with nr-axSpA. #ACR19 @RheumNow

Fantastic view of how specific defects in the immune system lead to various clinical presentations and laboratory abnormalities. Dr. Mahta Mortezavi #ACR19 @RheumNow https://t.co/ht7VBhDdpR

Drs. Davila and Solow say “No good data to suggest that biologic DMARDs contribute to progression of MGUS so okay to treat as you normally would.” #ACR19 @RheumNow https://t.co/5r2W4q1t5c

While immunoglobulin replacement for patients with CVID prevents infections, it does not correct any of the autoimmune features....keeping rheumatologists busy! Dr. Mahta Mortezavi #ACR19 @RheumNow

#acr19 ⁦@RheumNow⁩ Dr West’s Pearls: - at 40x magnification of synovial fluid, 1 WBC per hpf = 500 WBC/ uL (hence, 5 WBCs seen= 2500 WBC/uL which means the pt has an inflammatory fluid - you don’t have to wait for the lab results!) https://t.co/nChSnFq5NL

The updated ACR/NPF treatment recommendations for PsA were discussed by Dr. Mease and Dr. E. Husni at #ACR19. Will you start with a TNFi, as per these recommendations, over other medications for your tx naive patients? @RheumNow

Nice work showing PROs correlate with high disease activity in pts w/checkpoint inhibitor-related inflammatory arthritis abstr#2151 @cappelliMD @LCalabreseDO @RheumNow #ACR19 #cleclinicrheum https://t.co/Yi8LhNhA0v