Split dose oral MTX (15/10mg) versus single dose (25mg) in RA RCT 250pts EULAR good resp 16wks 22 vs 10% (sig) 24wks 37 vs 28% (ns) 50% more addition of 2nd csDMARD in single dose #ACRBest @RheumNow #ACR23 ABST1583 For more thoughts, have a read https://t.co/urA6X4rY0D 👇🏼

SMART on MTX Ab#1583 @RheumNow #ACR23 Single dose MTX 25 mg v Split dose (same day 15/10 mg). FA 5 mg 2x/wk. 16w can add csDMARD Split 29% vs 22% - EULAR response improve - not signif. Better DAS28 Split: 35% added 2nd csDMARD vs. 54.5% in single dose No stat diff in sAE #ACRBest

Should Methotrexate be prescribed as split dosing? Multi-center, RCT of RA pts showed split dosing of 25mg MTX resulted in higher efficacy + reduced need for additional DMARDs, compared to single dose MTX @RheumNow #ACR23 Abs#1583 https://t.co/zjjnzWUl5E

SMART study #ACR23 Plenary abs #1583: po split-dose MTX (vs single dose) once weekly in RA pts had ^^ efficacy & reduced need for add'l DMARDs. No major AE, but slight increase in frequency of persistent transaminitis in split-dose group. https://t.co/wHzjpSnfuA @rheumnow https://t.co/0hNTMGbt47

The SMART study by Dhir et al: once-weekly, oral split-dose MTX (10mg/15mg) in RA pts had⬆️efficacy & ⬇️need for addtl DMARDs vs. once-weekly, single-dose MTX Reassuring. . . . In my practice, pts tolerate MTX split dosing better esp w/⬆️doses #ACR23 ABST1583 @RheumNow https://t.co/F8p2aKmmH4

Does NSAID use = CKD? Large Korean study on CKD in ankylosing spondylitis pts showed risk of CKD associated with comorbidities. Long term NSAID use not associated with increased risk of CKD. @RheumNow #ACR23 Abs#1394 https://t.co/m3kYI30gBc

Risk of CKD in AS patients was associated with comorbidities, not NSAID use. #ACR23 Abs #1394 https://t.co/cbOPvjOCyq @rheumnow https://t.co/O0rhbMFiOX

To remind us. Glory be! GLORIA a #RCT in elderly active #RA: MTX+10 mg daily #prednisolone which was better than MTX alone. But more infections and no comparison of inexpensive Rx such as adding #HCQ. Still debated as to benefit vs risk of this strategy @RheumNow #ACR23 @ACRheum https://t.co/slOmESbIOW

Interesting abstract re:dx trajectories, I have a counter-intuitive take I expect pts w/high dx activity to respond BETTER than pts w/LDA at diagnosis More autoimmunity + less fibro = higher chance to respond to DMARD? Anyone else feel that way? @RheumNow #ACR23 Abstr1426 https://t.co/D6GU7tMcY6

Towards Personalised Care in RA Since the millennium, we have seen an expansion in the number of advanced treatments both biologic and targeted synthetic disease modifying anti-rheumatic drugs (DMARDs) for rheumatoid arthritis (RA). #ACR23 https://t.co/SjyfMyPyGw https://t.co/uzG72vKSpd

• Towards Personalised Care in Rheumatoid Arthritis | RheumNow