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Dr. John Cush RheumNow
1 year ago
Glucocorticoids-free zone in SLE?
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. #ACR23
https://t.co/sfRhNj6OpZ https://t.co/k6VoG5lKO7
Janet Pope
1 year ago
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
Mike Putman EBRheum
1 year ago
Rather unsurprising finding at this point, but valuable nonetheless
Per usual, joint efficacy for bimekizumab (IL17i) ~similar to TNF
New twist; similar loss in efficacy over time. Nice to have another IL17i; not sure this is a "blockbuster"
@RheumNow #ACR23 Abstr1437 https://t.co/4sVfSz7ZnK
Dr. Antoni Chan
1 year ago
In axSpA, the mean and median progression were 0.54 and 0.38 points in mSASSS per year respectively, lower than what has been reported in similar cohorts, LBP before diagnosis was a strong predictor of progression, Granados R Abst#1389 #ACR23 @RheumNow https://t.co/fvkOzhUG97 https://t.co/k18HxWswbs
Robert B Chao, MD
1 year ago
Great Debate on the use of biologics in treatment of Giant Cell Arteritis and Polymyalgia Rheumatica!
Let's begin with Dr. Robert Spiera on why we should NOT use IL-6i
No evidence of disease modifying
Lose biomarker activity
Cost
@RheumNow #ACR23 #ACRbest https://t.co/XCT02wYb2s
Mike Putman EBRheum
1 year ago
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
Robert B Chao, MD
1 year ago
How does Dr. Robert Spiera manage GCA?
1) Tx with steroids alone, taper by 6 months
2) Do not chase ESR/CRP
3) Pay attention to steroid complications
4) Low threshold to use IL-6i
Similar plan for PMR
Taper steroids by month 4
@RheumNow #ACR23 https://t.co/KSwyfjobFY
Janet Pope
1 year ago
Here is the popular answer@to the #ACR23 debate of up front bDMARD in GCA and PMR Yes vs No. the audience has no consensus. Access is Impt, experience and criteria of who to use it in. @ACRheum @RheumNow https://t.co/7pxF4w926m
TheDaoIndex KDAO2011
1 year ago
Debaters and moderators acknowledge IL6i may not be the only steroid sparing agents that would work for #GCA. Abatacept, secukinumab, JAKi are being evaluated #greatdebate @rheumnow #ACR23
Robert B Chao, MD
1 year ago
@philseo on why we SHOULD use IL-6i in GCA and PMR
1) Infection risk similar to TNFi
2) Too many (63%) pts remain on steroids at 1-2 yrs
3) May accelerate remission
4) Steroids are Bad, even at low doses
@RheumNow #ACR23 https://t.co/muPPcAc6LC
Robert B Chao, MD
1 year ago
Still uncomfortable with IL-6i in GCA or PMR especially given the pt population and potential AE?
Be on the look out for NEW biologics!
Mavrilimumab
Secukinumab
and MORE!
@RheumNow #ACR23 https://t.co/gdcDIcvffa
David Liew drdavidliew
1 year ago
More vitamin D during pregnancy is better, right?
Hopkins Lupus cohort, vit D levels & adverse pregnancy outcomes
Actually, there's a sweet spot
(too high just as unfavourable as too low)
Maybe popping vit D pills isn't always limitless
@jhrheumatology #ACR23 ABST1364 @RheumNow https://t.co/TVPCqP3dq9
Bella Mehta bella_mehta
1 year ago
Patients with autoimmnue diseases have a high maternal and fetal complication rate!
Abst 1003 #ACR23 @RheumNow https://t.co/pnvvBUN2JG
Mike Putman EBRheum
1 year ago
Quick curmudgeonly complaint
WHY are we doing 316 week extensions? That's 292 weeks of $$$ data... for what?
1. Insufficient N to assess meaningful safety signals
2. Open label, no comparator
It's just a very very expensive observational study
@RheumNow #ACR23 Abstr1434 https://t.co/Thj1XjeAn1
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