Rheumatoid Arthritis
Eric Dein ericdeinmd
1 year 1 month ago
A#1743
Are there benefits of getting LDA to remission?
Remission CDAI <2.8, VLDA 2.8-6, LDA 6-10
After 1 yr f/u of LDA, 45% Rem, 40 VLDA, 16 LDA
Not in remiss - higher BMI, longer duration, higher resource utilization, worse PRO
No clear diff bw remission & VLDA
#ACR24 @RheumNow https://t.co/ut7c52JVDr
Richard Conway RichardPAConway
1 year 1 month ago
Frideres et al. Target trial emulation in RA-ILD. Primar outcome death or respiratory hospitialization. Abatacept (aHR 0.90), tocizilumab (aHR 0.93), tofacitinib (aHR 0.69) vs rituximab. @RheumNow #ACR24 Abstr#1713 https://t.co/fbE8xAnzQ2 https://t.co/uwzH8oAyAT
Eric Dein ericdeinmd
1 year 1 month ago
A#1694
To get one or two lungs for lung transplant? 🫁
Autoimmune related ILD transplant outcomes?
145 single (SLT), 461 double (DLT)
Similar 1 yr mortality - HR SLT 1.19 unadjusted, 1.49 adj - not statistically significance
@RheumNow #ACR24 https://t.co/uo8WbrNFAm
sheila RHEUMarampa
1 year 1 month ago
A retrospective analysis by Dr. ERayens et al showed that RA pts >/=50y given 2 RZV doses were less likely to develop HZ vs. unvaxxed grp
Incidence of PHN was also lower in the vaccinated group (0.2py vs.1.9py)
RZV is effective in preventing HZ & PhN
@Rheumnow #ACR25 abs0977 https://t.co/JhYBYnLmhl
Mrinalini Dey DrMiniDey
1 year 1 month ago
2023 @ACRheum guidance recommends #MediterraneanDiet in RA
What are barriers/facilitators to following the diet?
Many pts are willing to try but don't follow it
Barriers➡️ food insecurity & aversions
Many are unaware
Do you talk to your pts about diet?
Ab1673 #ACR24 @RheumNow
Adela Castro AdelaCastro222
1 year 1 month ago
RA-ILD:
💡Lifetime prevalence seems low but ~40% can have subclincal.
💡Screen early in symptomatic pts.
💡RA disease control decreases ILD progression and mortality.
💡RA-ILD UIP pattern seems to respond to immunosuppression.
#ACR24 @RheumNow https://t.co/q3iACMeYVU
Mike Putman EBRheum
1 year 1 month ago
Subgroup data from SELECT GCA, overall reinforces overall message
I was curious to see pts previously treated with TCZ; wonder if that selects for refractory phenotype - seems not to be the case
Take home: encouraging data, no subgroup issues
#ACR24 @RheumNow Abstr#1695 https://t.co/5iCLE6T4u3
Janet Pope Janetbirdope
1 year 1 month ago
This will change my practice!
#RCT #MMF + #MTX
superior to
#Cyclophosphamide then #Azathioprine
In
#Tayakasu’s #arteritis N=150
RCT ~1g BID #mycophenolate + 15mg/wk #Methotrexate
Vs #cyclo ➡️100mg #azathioprine
All got #glucocorticoids
#ACR24 @RheumNow @ACRheum #1696 https://t.co/OpRep1vsmx
Brian Jaros, MD Dr_Brian_MD
1 year 1 month ago
Very neat simulated model of GC regimens in AAV pt on fixed RTX by @zach_wallace_md and co
Over 5 years:
- No difference in relapse btwn standard GC vs. minimal GC + avacopan
- Higher DMII rates in standard group
Adds to trial + real world data
@RheumNow #ACR24 Abst 1598
Mike Putman EBRheum
1 year 1 month ago
Alright help me out here; this is pretty implausible, right?
Why would be pts be 11% more adherent to UPA? What's the bio-plausibility here? UPA 10% better than other JAKs?
Could do a network meta analysis; betting this doens't replicate
#ACR24 @RheumNow Abstr#1362 https://t.co/vpPq3vu9Wf
Janet Pope Janetbirdope
1 year 1 month ago
#Rheumatoid #arthritis is an independent risk factor for death in nonmetastatic clear cell renal ca !
👇N=32K, 802 w RA also
Caveats
immunotherapy Offered = in RA
Cancer specific mortality not affected
By #RA
Frailty & RA affected outcomes
#ACR24 @RheumNow @ACRheum #1327 https://t.co/rAQ57BPA19
David Liew drdavidliew
1 year 1 month ago
In this large 🇦🇺 RA cohort, median time on treatment for upadacitinib was lot higher than other JAKi
(28mo vs 17mo)
Why?
Patient selection, or a real difference between JAKi?
Would really like more comparative effectiveness data between JAKi
#ACR24 OPAL group ABST1370 @RheumNow https://t.co/OU2ayzqIc8
Mike Putman EBRheum
1 year 1 month ago
Spicy network SRMA, 123pts w/JAK-TNF-PLBO
TNF >> JAK w/respect to malignancy (expected) & better than PLBO (spicy!)
JAK > PLBO for heme cancers (makes sense); no significant (but slight trend) toward PLBO > JAK for all cancer
The debate continues
#ACR24 @RheumNow Abstr#0989 https://t.co/tBnb02gyzF
David Liew drdavidliew
1 year 1 month ago
Which RA patients are at increased risk of JAKi adverse events? Does disease activity matter?
in the upadacitinib ph3 trials, high disease activity pts had more:
serious infections
HZ
MACE
VTE
Active RA is a massive contributor to many AEs in JAKi pts
#ACR24 ABST1393 @RheumNow https://t.co/DlFf9Sfbja
Richard Conway RichardPAConway
1 year 1 month ago
Zhang @jeffsparks et al. Even more evidence that MTX does not cause ILD, and in fact prevents ILD, in RA, OR 0.48 in meta-analysis. @RheumNow #ACR24 Abstr#1384 https://t.co/YvQnmmvNjF https://t.co/crYUwHahDb


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