#ACR21 Abst#0793. Japanese multicenter US cohort (KUDOS) study, looked at difficult to treat (D2T) RA pts ▶️ 1/5 pts are D2T (fail 2+ b/tsDMARD, mod disease or GCs) ⭐️ Contributors of good outcomes: IL-6i (OR 9.6), concomitant MTX (OR 7.1) @Rheumnow https://t.co/9YSa4ebQlR

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@benjaminsutu @RheumNow Always steroids first, we learned that the hard way in GUSTO - but yeah, probably something after that, and TCZ is our only b/tsDMARD choice... for the time being (at #ACR21 - mavrilimumab, baricitinib, secukinumab...)

Blurred line btwn RA, preRA & RA prevention which makes interpretation of RCTs problematic. I’ve learned that if pt has RA not meeting criteria, some Rx ⬇️chance of RA over time-MTX, now #Abatacept but was it RA anyway AND what happens when you stop Rx? #ACR21 @RheumNow abst#0505 https://t.co/HwivsITvCQ

• Aurelie Najm on Twitter: "Provocative study in pre-RA. SC Abatacept in pat…

#ACR21 #Abstr0437 OK, so RTX affects #COVID vaccine but some pts need RTX. Factors predicting response to vaccine: RA vs AAV/IIM Higher IgG Longer time-to-RTX Lower RTX courses Number. Prediction Calculator is developed but need ext. validation #RheumNow https://t.co/iXSaGQ76hS https://t.co/WQAV3GRPBz

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Role of anti-CK antibodies: 👉⬆️susceptibility to severe mycobacterial dz & opportunistic infx (similar to HIV) 👉causes an indeterminate quantiferon (no response to mitogen) 👉initiated by infx➡️anti-Noc2 Ab➡️cross react with IFN➡️IFN-Ab 👉⬆️severity of #COVID19 #ACR21 1/2 https://t.co/5NHQpwQw6X

#GreatDebate: add belimumab (BLMB) vs. voclosporin (VCS) to MMF for lupus nephritis (LN) Dr. Petri argues for BLMB b/c: (1/2) 👉improvement in LN 👉improvement in non-renal lupus 👉decrease lupus renal mortality 👉**prevent GFR reduction ** 👉long term efficacy #ACR21 @rheumnow