SMART study in RA, splitting MTX Split dosing better at wk 16 but ~similar at wk 24 Caveat: wonky design from wk16-wk24 makes it hard to interpret? Surprsingly, adverse events ~similar but smallish sample Mostly supports my practice of splitting? @RheumNow #ACR23 #ACRBest https://t.co/g7s4EUHeCW

SMART study - MTX split into morning and evening once weekly vs all together. 253 patients. Split dosing better efficacy (DAS28 4.1 vs 4.5, p=0.03), more LFT elevation but less neutropenia. Abstr#1583 #ACR23 @RheumNow https://t.co/tkrds4uqQP

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

What is frailty? How does it affect RA outcomes? Pop based cohort study 13000+ RA vs. 26000+ matched ctrl Over 2x more frailty 5.6% vs 2.6% OR frailty in RA 2.3 Adjusted for rurality, neighborhood income quartiles AND BL comorbidities index @RheumNow #ACR23 ABST1275 https://t.co/ZkOpgHPSE0

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

Large VA study of >1k RA-ILD pts No difference in risk of respiratory hospitalization or death in RA-ILD pts using TNFi vs. nonTNFi/JAKi Data does not support avoiding TNFi in RA-ILD @RheumNow #ACR23 Abs#1582 https://t.co/LTNLXEIAPo