Factors predicting fatigue in RA differ by disease activity. Synovial lining hyperplasia and synovial lymphocytic inflammation on histology were key factors. @rheumnow #ACR23 session 13M148 https://t.co/yPBZX2Rxft

RA-ILD: the study that exonerates TNFi ? TNFi vs. other BioDMARDs/JAK do not increase risk of death or hospitalization over 1 and 3 yrs follow up. No subgroups stand out VHA cohort, 50% smokers No info on ILD patterns or disease trajectory ABST1582 @RheumNow #ACR23 https://t.co/frv16oRLqv

Lovering et al. Synergestic effect of RA and CVD on dementia risk. 35% increased risk RA, 89% increased risk RA+CVD. Abstr#1628 #ACR23 @RheumNow https://t.co/Brj8XrG2o4

#ClinicalPearl or #pathology pearl? Using synovial #biopsies to guide therapy in #RA #RCTs is a reality. But likely #fibrotic #phenotype won’t respond and #lympho_myeloid has more RA damage. #ACR23 session 13M140 #Precision #medicine #ACRbest ⁦@ACRheum⁩ ⁦@RheumNow⁩ https://t.co/DmI9dNpu8w

@Dr_K presenting long COVID data from FORWARD RA. These pts had some symtoms before COVID!- More comorbidites, depression patient reported scores, fibromyalgia but no different DMRD use. PHQ8 and wodepread paid were the most important PROMs @RheumNow #ACR23 https://t.co/JaWc4oDnaI

#Precision #Medicine in RA RCTs. Treat w right drug at right time? Possible problems -sample variation on synovial #bx, some won’t respond ex fibrotic phenotype variable drug distribution/resistance. AI is helping to separate Pts #ACR23 ⁦@ACRheum⁩ ⁦@RheumNow⁩ 13M140 https://t.co/D7NxpM4YNw

Michaud et al. RA patients with long COVID had more fibromyalgia pre-COVID (41% vs 13%), higher rates of pain, depression, and worse PROs pre-COVID. Authors suggest long COVID may partially reflect pre-existing illness Abstr#1629 #ACR23 #ACRbest @RheumNow https://t.co/mrcGWrSD6c https://t.co/YiGCbvBDtn

Do you discuss HPV vax & cervical CA screening w/SLE & RA pts? In this study, more women w/SLE discussed cervical CA screening w/their rheums(33.3% vs. 11.4% p<0.01) & more likely to have persistent abn paps on ffup Similar HPV vax status for both grps #ACR23 ABST1356 @RheumNow https://t.co/Vbu8hbZ1uh

Karpouzas et al. MTX reduces IHD in males but not females with RA. 4362 patients. 66% lower risk MACE and 55% lower risk any ischaemic CVE. Abstr#1627 #ACR23 @RheumNow https://t.co/MC4W0dinUv https://t.co/1hkBoawt4b

RA males 81% increase MACE & 58% ischemic CVE 2 folds Males>Females in MTX non users Makes MTX users reduction 66% & 55% risk MACE & ischemic CVE and no diff w/ females MTX use not assoc w/ reduction MACE in females @RheumNow #ACR23 ABST1627 https://t.co/qbAc2bWdcM

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