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

#ACR23 Abstr# 2490 Data supporting aggressive early treatment in #SLE? Multicentre open label RCT in China showed low dose MMF + Pred 0.5mg/kg/d reduced severe flare & lupus nephritis cases vs HCQ + Pred in new onset SLE with high dsDNA but w/o major organ involvement @RheumNow https://t.co/oRlgCaOvXo

#ACR23 Abstr# 2487 How to reduce PBO response in #SLE trials? Try adding low dose GC as co-primary endpoint. Interim analysis of Phase 2 RCT: SRI-4 + sustained GC dose to ≤5mg/d or ≤BL from Wk16 to 28 was met more in Ianalumab (BAFF-R-i) vs PBO (44% vs 9%) @RheumNow https://t.co/JEnMWKilR6

Rashes in Rheumatology at #ACR23 Which disease entity are these palms pathognomonic for? @RheumNow https://t.co/NmT1LTzWmm

Therapeutic Ladder for Discoid Lupus: 1. Strict🌞protection, smoking avoidance 2. Antimalarials 3. Topicals/intralesional corticosteroids, topical CNI 4. Oral steroids, retinoids, MTX, MMF 5. Thalidomide, lenalidomide 6. IVIG, JAKi, Belimumab... BUT also Anifrolumab!… https://t.co/xSw0s12Uvk https://t.co/stIJ944d9A

#ACR23 Abstr# 2485 Belimumab therapy in RCT was associated with increased risk of psychiatric events inc suicidality vs PBO. When compared with standard immunosuppressant, real-world data using emulated trial design showed no increased risk @RheumNow https://t.co/Vqhc5yRsSA

Complements & HCQ? (Prof Petri et al) Significant ⬆️ in C3 (p=0.022) & C4 (p=0.003) levels with HCQ whole blood levels >50 ng/mL Increasing blood levels of HCQ significantly assocd w/⬆️prob of achieving normal C4 Improving C3,C4; addtl benefit of HCQ? #ACR23 ABST2327 @RheumNow https://t.co/5ucpXq9ngb

HCQ discontinuation in SLE? Why?! In this retro cohort of 42 pts Reasons: Retinal toxicity (57%) Self-discontinuation (17%) Factors strongly assoc'd w/ flares 1 yr after discontinuation - mean C3 and +dsDNA at index visit. #ACR23 ABST2343 @RheumNow https://t.co/BCO9N4gSkX

A#2427 #ACR23 @RheumNow PR3+ cell abundance higher in prolif LN, more than membranous. Mostly in tuberulointerstitium Density of PR3+ higher in glomueruli of prolif LN Correlates with activity, not chronicity Urinary PR3 predict renal fxn loss at 3y @jhrheumatology @andreafava https://t.co/vvC8lgZgWO

#ACR23 Abstr#2270 What are the causes of discordance btw #SLE patients and physicians pertaining to disease activity? Survey data from Global COVAD: 45% rate of discordance! Could be related to fatigue levels, pain, poor mental being & impaired physical function @RheumNow https://t.co/kVzGRJm2R8

Great research by @andreafava on urinary biomarkers for lupus nephritis A#0850 #ACR23 IL-17 and other biomarkers can predict renal fxn loss - better than proteinuria! Article on @RheumNow https://t.co/DeiWFKzNxC

#ACR23 Abstr#2334 Can we achieve #SLE DORIS remission with current therapy? Post-hoc analyses of 3 x RCTs + LTE over 4 years showed anifrolumab therapy was associated with more frequent and sustained remission vs PBO during the 4-year period. Good for long-term outcomes @RheumNow https://t.co/eq02yChTZr

Rashes in Rheumatology at #ACR23 Name the rash? @Rheumnow https://t.co/uFjXEOHczZ

• https://twitter.com/MeralElRamahiMD/status/1724549534309663000/photo/1

Review of rashes in SLE at #ACR23 by Dr. Katherine Shaw, MD ⭐️Important to recognize rashes of lupus b/c heterogeneity of cutaneous lupus erythematosus subtypes influences response to treatment. @RheumNow https://t.co/u7dwDe9kbt

⭐️Important to recognize rashes of lupus b/c heterogeneity of cutaneous lupus erythematosus subtypes influences response to treatment. 🚩Phase II trial of Iberdomide in SLE: ➡️ not associated w/ statistically significant improvement in CLASI-A when including ALL CLE subtypes… https://t.co/LHNqKMALzU https://t.co/K73sXjFTHM