How concerned should we be for #hydroxychloroquine retinopathy. >4000 pts prospectively followed. 1/2 w RA & 15% w #SLE. New risks Asian with pericentral pattern and overall. Length of time on use and ⬆️wt based dose per day & CKD all risks. Abst#0989 #ACR21 #ACRBest @RheumNow https://t.co/XTfdQpVC7H

In pts w/o RF, liver bx prev suggestd if lifetime cumulative MTX dose was 1-1.5g, then 3.5-4g. All pts in centre offered Fibroscan liver stifness associations: - age, BMI - not cumulative MTX dose maybe survival bias, but what we're doing now is fine! #ACR21 ABST0786 @RheumNow https://t.co/I6IhS3jhmC

Aware of COPA syndrome? ➡️Rare cause of immune-mediated lung dz ➡️Mimics RA-ILD, SLE, & vasculitis ➡️Adult-onset cases reported Abst#0529 determined that mutations in the COPA gene underlie some cases of severe pulmonary fibrosis. #ACR21 @RheumNow https://t.co/mCx3eT7Pv8

📢Do not miss the #Lupus Faculty panel discussion @RheumNow on a selection of interesting abstracts presented on Day 2 📝#ACR21 @KDAO2011 @Janetbirdope @bella_mehta @_Castillo_Pedro @RHEUMarampa https://t.co/e0v4qQIE4h

• Lupus Day 2 Highlights: Drs Dao, Mehta, Yusof, Pope, Reyes and Castillo | Rheum…

What to do if pt on a TNFi develops cancer? Can you safely restart TNFi later? Depends on cancer, timing - how long ago was cancer, Rx and patient preference. Data diff from RABBIT registry vs British bio registry @RheumNow #ACR21 #ACRBest 7S413 Have a look https://t.co/q9SFKlFJzg

Very interesting talks by Dr. Kim and Dr. Hyrich on DMARDs and Cancer risks #ACR21 @RheumNow https://t.co/Dl5WPo7mmj

This feels like an excellent starting point for Tuesday's ORAL Surveillance malignancy discussion. RWE Cohort: HR 1.01 (0.83-1.22) RCT-dup Cohort: HR 1.19 (0.86-1.64) ORAL Surveillance: HR 1.48 (1.04-2.09) Interesting day 4 ahead! great talk @SeoyoungCKim #ACR21 7S413 @RheumNow https://t.co/YSau21goMr

Does concomitant SJS affect tx effectiveness in RA? Abst#0839 suggest yes! ➡️RA+SjS have an inferior response to TNFi than RA patients w/o SjS BUT, RA/SJS pts w/ longer RA dz duration & ↑ DAS28 + HAQ-scores. What's your clinical experience with this? #ACR21 @Rheumnow https://t.co/TIc3raMOSJ

If obvious dermatomyositis, you don’t need EMG for dx but may use for severity of involvement or if failing Rx or r/o steroid myopathy. For ?polymyositis ALWAYS do bx and often do EMG as broad differential #ACR21 @RheumNow https://t.co/L1xu3OuRYJ

• Richard Conway on Twitter: "Controversial from John Stone at #ACR21 . Any …

RheumNow’s expanded coverage of #ACR21 is sponsored in part by @bmsnews, @JanssenUS, @Novartis. All content chosen by RheumNow & its Faculty.

A worthwhile point: despite historic concerns, in the modern era TNFi can used safely & well in HIV pts 18y follow-up, all pts high CD4 (their starting criteria: CD4>200, VL <60,000) no reported opportunistic infx good arthritis response #ACR21 ABST0965 @RheumNow @CCalabreseDO https://t.co/5pbRg63ubr

Abst#0572: In US veterans w/ RA followed for 17 yrs, several cytokines+chemokines ⭐️Associated w/ ↑ risk of incident MACE independent of typical CVD RF & RA activity & ⭐️Predicted MACE even if in LDA/remission WOW! We need to do better @ CVD risk strat! #ACRBest @RheumNow https://t.co/J74rRa9EQE