Strategies to identify patients with suspected inflammatory back pain in the general population is critical for timely and proper diagnosis.

A new target for treatment in AxSpA is the dual inhibition of IL17A and IL17F (IL17A/F). IL17A is a key driver of the inflammation in the AxSpA and Psoriatic Arthritis (PsA). IL17A and its structurally related IL17F share biologic functional properties. Inhibition of both cytokines (IL17A/F) should result in a greater clinical benefit in AxSpA and PsA than IL17A inhibition alone.

There has been a lot of talk lately about the difference in the way male and female PsA patients experience their disease.  Are the differences only cultural or are there important clinical differences in the disease presentation, organ involvement and complications that physicians should be aware of?   

For lupus, sedentary lifestyle may be a driving force of disease activity.  Today, the final day of ACR, Sarah Patterson, MD from UCSF will present oral abstract #2225 entitled “Physical Inactivity is Associated with Increased Expressi

Vaccine efficacy remains an important and highly discussed topic at this year’s annual meeting given the ongoing COVID-19 global health crisis, current influenza season, and recently published 2022 ACR guidelines for vaccinations in patients with rheumatic and musculoskeletal diseases.

Day two at ACR 2022 was full of great sessions on imaging, vasculitis, lupus, vasculitis, spondyloarthritis, COVID, pregnancy, microbiome, economics and more. Here are the RheumNow faculty selections for #ACRbest abstracts today:

An interesting study presented at ACR22 looked at whether neural networks can distinguish seropositive rheumatoid arthritis (RA+), seronegative RA (RA-), and psoriatic arthritis (PsA) using hand MRI data based on the structural inflammation patterns.

Much has been written about tapering medications in rheumatic diseases, often due to high costs of medications, a desire to avoid side effects and patient preference to take less medications (especially if they have side effects). This is countered by something we all know: medications not taken don’t work, and those that are frequently missed may not provide optimal outcomes for the majority of patients.

While COVID vaccination and subsequent booster remain the cornerstone, pre-exposure prophylaxis such as Evusheld (tixagevimab and cilgavimab) has been approved by FDA in December 2021 and EMA in March 2022 for people immunocompromised either due to a medical condition or receiving treatment with immunosuppressants and may not mount an adequate immune response to COVID vaccination. How does this therapy fare in RMD patients?

Is there finally something new on the horizon in Sjogren’s syndrome? 

The masses have returned to ACR22, a live, face-to-face, and virtual, meeting that began Saturday in Philadelphia. There were hassles and glitches, yet the education and sessions were as you’d expect with many good presentations worth recapping.

Once in a while, I find an abstract at the ACR meeting that can potentially save lives and be implemented in practice now.   In Abstract #0939, Dr. J Patricia Dhar and colleagues shared data from a pilot study examining a new method to monitor cervical health in African American Women with Systemic Lupus Erythematosus (SLE) using a self-sampling brush to assess cervical cytology and human papilloma virus infection.

Data presented at ACR22 shows that cycling through TNFi in axSpA patients with primary lack of efficacy with first line TNFi has limited additional benefit in controlling disease. 

Interstitial lung disease (ILD) remains a leading cause of mortality in rheumatoid arthritis (RA). Estimates of involvement of ILD in RA remain relatively imprecise (estimated prevalence 5-20%), though this partly reflects the wide spectrum of ILD and differing ascertainment.

The ability to prevent RA in individuals at risk is a holy grail in rheumatology. There is a long history dating back to the PROMPT trial of methotrexate and PRAIRIE trial of rituximab. Both otrials showed an effect, but it seemed more likely to be a delaying of RA than prevention or modulation. Framing it another way, there were better outcomes in pre-RA because we were actually treating RA as it emerged with a proven effective treatment. It is