Lupus

Drs. Jack Cush and Arthur Kavanaugh discuss highlights and key takeaways from ACR 23.

While there wasn’t much original new programming and research presented on the final day, that didn’t slow the RheumNow faculty from tweeting the noteworthy “Best of ACR” abstracts. Enjoy these below.

Since chronic kidney disease is one of the strongest CV risk factors, any new strategy to reduce proteinuria and avoid a decline in renal function may likely improve patient outcomes. In large cardiovascular outcome trials, the use of a fairly new-kid-on-the-block therapy, sodium–glucose cotransporter-2 inhibitors (SGLT2i) appear to be both cardio and renal-protective. Would the use of SGLT2i have the same impact in SLE?

The last day at ACR23 was a ghost town as most left, largely because there was limited programming on the fourth and final day. The main attraction on Day 4 was the late-breaking abstract – oral presentations.  Here’s a list of the late breakers; below, I provide commentary on the ones that caught my attention.

Should rheumatologists be counseling patients on cervical cancer prevention and screening? The data from Abstract #1479 at ACR Convergence 2023 suggests that this should be an important conversation with our female lupus patients.

Today was a big day for the Plenaries, Curbside Consults, ACR Business meeting (and induction of our new ACR President Dr. Deborah Desir) and Late-Breaking Posters. Our hot-button reporters have compiled these #ACRbest abstracts for you! (November 14, 2023 at #ACR23)

In Abstract 0850, Dr. Andrea Fava from Johns Hopkins presents research on the value of urinary biomarkers as measure of intrarenal inflammation.

Over the years of navigating the annual meeting, I found the sessions with the most impact to my practice were the Plenary Sessions. During these sessions, the latest research is presented, new ideas are floated, and old myths debunked. Here are the top ACR2023 Plenary abstracts I found impactful for my practice.

Inhibitors of SGLT2 have been shown to reduce MACE in patients with type 2 DM and established cardiovascular disease. In patients with chronic kidney disease at risk of progression, SGLT2 inhibitors have shown reduction in risk of eGFR decline and hospitalization. In SLE, clinical trials have yet to explore the possible role of SGLT2i in improving renal outcomes in lupus nephritis. A couple of abstracts presented during the meeting tackled the

Our reporters have been prolific in finding the hot abstracts, those that were most attended or those that are getting the most buzz on social media.  Here are RheumNow's #ACRbest abstract reports from Monday, November 13, 2023 at #ACR23, covering The Great Debate, SGLPT2 inhibitors in SLE, the SMART Study of MTX, TMP/SMX Prophylaxis, RA-ILD & TNF Inhibitors, cancer research and more. 

Pregnant women with autoimmune rheumatic diseases (ARDs) and antiphospholipid syndrome (APS) face significantly increased risks of cardiovascular events (CVEs). This increased risk is often attributed to ARDs, its medications or comorbidities associated with it.

Few people are aware of the EULAR recommendations for cardiovascular risk management in SLE published in 2022.  The recommendations had 4 overarching principles: increase awareness of elevated cardiovascular risk, need for regular cardiovascular screening, assess and manage modifiable risk factors, and patient education. During ACR 2023 Convergence, several abstracts were presented evaluating the prevalence of CV disease and exploring new

For over 70 years, glucocorticoids, (GC) have been a part of standard therapy in SLE. They are classically used to not only induce remission or treat an acute flare, but also as maintenance therapy. They are a valuable 'friend' if used wisely, and can become a 'foe' if used excessively.

ACR Convergence is truly drinking from the proverbial fire hose. It’s a beautiful mash-up of basic science and treatment updates meets guidelines, recommendations, and disease identification. My goal when attending any conference is to learn as much as I can, synthesize that information, and bring you clinically relevant morsels for you to consider for your practice. 

In a post hoc analysis of the phase 2 NOBILITY trial, researchers found that treatment with obinutuzumab—an antibody that targets a protein expressed on certain immune cells—was superior to placebo for preserving kidney function and preventing flares in patients with lupus nephritis, a kidney condition associated with the autoimmune disease lupus.