Paging the pharmacist Abstract 1973: Dedicated clinic pharmacist -> benefits Tasks included: 🔹 74% PA support 🔹 55% patient education 🔹 40% medication management ~50% pts had clinically meaningful improvement Providers report ↑ care quality & ↓ admin burden @RheumNow #ACR25

MAINRITSEG: RTX vs. AZA for maintenance in EGPA RTX not superior in primary remission outcome RTX favored in secondary outcome of remission with pred <4mg daily Limitation: only ~50% pt with FFS 1+ @RheumNow #ACR25 Abst 1765 https://t.co/dh5ZWCT12T

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Girolami et al. VA study. Safety of DMARDs in RA following melanoma. 644 patients. 3 year all cause mortality. No significant difference, but graph sure looks like b/tsDMARDs are better. No melanoma specific mortality/recurrence data however. @RheumNow #ACR25 Abstr#2237 #ACRBest https://t.co/IN4LDkioT7

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HCQ weight-based dosing: out HCQ whole blood monitoring: in Whole blood levels more precisely balance risks of SLE flare (under-dosing) vs. toxicitiy (over-dosing) Many pt on <5 mg/kg had supra-therapeutic blood levels with risk for toxicity @RheumNow #ACR25 #ACRBest Abst 1722 https://t.co/qIbACxAW39

• https://x.com/Dr_Brian_MD/status/1983186074932482553/photo/1

Passive transfer of Ab can occur w #IVIg #Ab can occur from IVIg passive transfer incl HepB IVIg - if pt has #cryoglobulins 👇 Can precipitate severe #cryo flare #ClinicalPearl Secrets & Pearls session #ACR25 @RheumNow @ACRheum https://t.co/tTaSuVy1yQ

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Pooled data fr diff SLE cohorts by Dr SGarg et al were evaluated to determine an upper threshold tx range of HCQ 750-1150 ng/mL: safe & effective HCQ levels >1150ng/mL-supratx, no added tx benefit CKD st >/=3: 2x ⬆️odds of toxic hcq levels #ACR25 @RheumNow Abs1722 #ACRBest https://t.co/RFx1VO0bov

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• https://x.com/RHEUMarampa/status/1983164717398147083/photo/1

3rd plenary session! #1722 Defining safe HCQ levels in SLE: whole-blood 750-1150ng/mL= therapeutic range; >1150ng/mL ➡️ ~2× toxicity risk; <750ng/mL ➡️ higher flare risk CKD ≥3 increases odds of supratherapeutic levels New era of precision monitoring in SLE? @RheumNow #ACR25

Plenary 3, HCQ blood levels in SLE HCQ level > 1150: 1.9x risk of HCQ toxicity HCQ level < 750: 1.4x risk of active SLE HCQ dose < 5mg/kg: 1.9x risk active SLE My take home? Blindly reducing dose to <5mg/kg is BAD; use levels instead! @RheumNow #ACRBest #ACR25 Abstr1722 https://t.co/UCBPAKAyon

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• https://x.com/EBRheum/status/1983156804226777296/photo/1

#ACR25 Please find my video and take on Abstr#0803. Should we use Belimumab before- or after a trial of concentional immunosuppressant in #SLE? @RheumNow https://t.co/ExIvrdJXw5 https://t.co/AVb5ohWwXZ

• Belimumab Before or After Immunosuppressant | RheumNow
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#ACR25 Abstr#0855 Five extra patients were added to complete IMPACT Open Label Phase 2 trial of add-on Certolizumab in APS women + LAC+ve. Results stood: primary endpoint was met (adverse pregnancy outcome=19.6%; lower than 20% expected). Significant enough to adopt @RheumNow https://t.co/zhFVGYXiaU

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