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

• https://x.com/Janetbirdope/status/1983176076089254137/photo/1

#1725 Functional NOTCH4 variants contribute to vasculopathy & fibrosis in SSc, particularly in African-American patients NOTCH4 hyperactivation disrupts angiogenesis & drives EndoMT; inhibition (including with FDA-approved Nirogacestat) restores vascular repair @RheumNow #ACR25

#1724 MAIT cells central in RA pathogenesis. These innate-like T cells accumulate in synovial fluid, driving fibroblast activation, cytokine release & joint damage. Blocking MAIT activation or deleting MR1 reduces arthritis in mice- a potential new target in RA. @RheumNow #ACR25

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

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

#1723 Why is systemic autoimmunity more common in females? Loss of X-chromosome inactivation maintenance in B cells (not T cells) amplifies interferon-driven disease, with increased autoantibodies, inflammation and renal injury. Key mechanistic advance. @RheumNow #ACR25

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

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

#ACR25 Please find my video interview with Dr Kate Rochlin on a novel Bi-specific T-cell engager (BiTE) in development which binds to pan-gamma delta T-cell instead of CD3 to minimise risk of cytokine release syndrome side effect. Abstr#1535 @RheumNow https://t.co/MOmUm41cyA https://t.co/TgIUGgWGw5

• The Power of Gamma Delta T Cell for Autoimmunity
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PET and histologic discordance in aortitis Of 5 aortitis patients who had PET/CT prior to aortic surgery with path, only 1 showed concordance (neg PET, neg biopsy) 4/5 patients had inflammatory biopsy with neg PET Small # but PET is not perfect! @RheumNow #ACR25 Abst 1620