Minimal Disease Activity criteria are used to evaluate PsA disease activity and response to treatment. Given that a patient only has to meet 5 of the 7 criteria, should the individual components be weighted equally? 

The RheumNow faculty reporters have been scouring the meeting and online presentations to find the best abstracts from ACR22. Here are some of their choice abstracts reported today on day 1 of ACR 2022 (#ACRbest).  

It’s widely accepted that Psoriatic disease has multi-system, multi-domain potential that can lead to life altering complications if left untreated or undertreated. Rheumatologists have shifted the way we discuss treatment options and disease state expectations with patients. Two #ACR22 abstracts stood out to me regarding the Psoriatic disease patient experience and will, ultimately, add to what I do in clinic. 

Is patient-administered cervical cancer screening an option for women with SLE? Should I prescribe estrogen containing contraceptives to SLE women with APL antibodies? What complications should I be aware of in pregnant women with SLE? Here are three abstracts that provide insight.

Rheumatoid arthritis is known to be associated with a higher risk of infections. In abstract 0535, Porter and colleagues have assessed infection rates in the pre-RA and early RA phases as defined by antibiotics prescription and hospital admissions with an infection main diagnostic code in the UK National database.

In abstract #0327 presented during the poster session on Saturday, Dr. Ai Li Yeo and colleagues investigated the usefulness of serial anti-dsDNA testing in predicting flares among SLE patients who have persistently positive anti-dsDNA titers. 

Today's plenary session features a novel proposal on how and which patients with Idiopathic Inflammatory Myopathy (IIM) should be screened for cancer.  Abstract 0002 by Oldroyd et al, entitled "Cancer Screening Recommendations for Patients with Idiopathic Inflammatory Myopathy" took on this thorny practice issue. 

Recently the FDA approved deucravacitinib, a highly selective TYK2 inhibitor for psoriasis. Trials are positive in psoriatic arthritis and a phase II study in SLE. What about the effects? Presentations from the ACR22 meeting may provide answers.

Patients with RA are known to have a higher mortality risk than the general population. In abstract 0246, Crowson et al propose a retrospective population-based study stratifying RA patients according to their comorbidities.

ACR Convergence 2022 promises to be another exciting year for research in systemic lupus erythematosus (SLE), with multiple plenary sessions devoted to therapeutic advancements. Here’s a quick rundown of what to expect!

The management of RA patients with a history of cancer continues to be an area of concern. General recommendations are to treat patients with a history of solid organ cancer as no different to any other RA patient. Recently, the ORAL-Surveillance study demonstrated evidence of a greater risk of cancer with tofacitinib than with TNF inhibitors. In this setting, two posters both reassure and raise a new cause for concern.

A new treatment for AxSpA that has come on the scene are JAK inhibitors. In clinic, considerations for JAKi use are body mass index, smoking status, prior use of biologics and patients with high inflammatory states such as high CRP and inflammatory change on MRI scan of the spine and sacroiliac joints. There are further studies at #ACR22 which help answer these questions.

A Japanese large scale claims data study was able to collect 5-year data to study the treatment patterns in Still’s. In May 2019, intravenous tocilizumab was approved in Japan for Still’s disease. The study was designed to see patterns of steroid exposure before and after the approval of this therapy.

Type I interferon (IFN) is a powerful immune activator that is present at high levels in the majority of patients with lupus, an autoimmune disease.

Despite a wealth of treatment options, a number of notable unmet needs remain in PsA, most notably the significant diagnostic delay that many patients endure. We are all aware that those with psoriatic skin disease are the most at risk cohort for PsA. Identifying patients with psoriasis who have, or are at increased risk of PsA, appears to be the low hanging fruit that we just can’t fully seem to grasp.