CARRA STOP-JIA 400pts, Obs study w/ 3 treatments plans : -Step up -Early combination -Biologic first Which one do you think works best? I'd say none: overall 40-60% not achieving CDI off steroids at 24 months. Results: 42% for SU, 52% EC, and 44% BF #Abtr0960 #ACR21 @RheumNow

Are these pictures representative of a Sjogren's tongue or oral candidiasis? Comment below with your thoughts! #ACR21 #ClinicalPearls @RheumNow https://t.co/yGHA0pA7w0

7S125 Interesting talk on Anatomy for the Clinician: Putting Your Best Foot Forward #ACR21 @RheumNow https://t.co/zLbDW9yfEb

Awesome presentation today from Dr. Cristina Ruiz-Romero on lipidomic profiles in RA vs PsA. Using mass spectrometry, found differences in both synovial bx and fluid. Potentially useful lipid markers, more studies to follow. #ACR21 #ACRBest Abst#0946 @RheumNow https://t.co/KmWCPKijSx

Andy 0963 #ACR21 @RheumNow covid19 vaccine immunogenicity in rheum pts overall good at 71%, fairly dependent on Rx choice: rituximab 38% after 1g & only 7 % after 1gx2; abatacept IV 45%. Rest biologics >80%, ⬇️MTX &MMF. Low dose prednisone w/out biologics did not affect Ab+ rates https://t.co/TkCC1sgMHG

Infx oral session 0964 Bitoun, et al. RTX lowers neutralizing Ab response compared to healthy controls, after COVID vaccination -- more supportive data https://t.co/6jvWHSjIgr #ACR21

• Rituximab Treatment Dramatically Reduces Neutralizing Humoral Response to mRNA …

#ultrasound led to a change in Dx or Tx 2/3 of the time in a Sports Med clinic! #ACR21 #ACRAmbassador #POCUS https://t.co/2CviSOQKiz

Tofacitinib vs TNF inhibitors in #RA patients +50yrs with >1 CV risk factor; the data from ORAL Surveillance that we have all been waiting for! #ACR21 Risk of MACE related largely to baseline CV risk https://t.co/SpuKTtP8ql

To add numbers to this - using ARR because it's easiest: Vitamin D: 123/12,937 = 0.95% rheum dx Placebo: 155/12,937 = 1.20% rheum dx ARR = 0.25% or NNT of 400 to prevent 1 case of rheum dx Better get prescribing ASAP!

#ACR21 #ACRAmbassador Fascinating analysis of rheum dx from the (negative!) VITAL study (https://t.co/aMtMCIf1F1) Very few pts 278/25,871 (1.1%) but HR 0.78, p = 0.045 for vitamin D preventing autoimmune disease Do you believe it? If so, what's your public policy advice? https://t.co/ZkO5nHAJz9

• https://www.nejm.org/doi/full/10.1056/nejmoa1809944

ORAL-Surveillance, an open label Phase 3b/4 RCT of tofacitinib (JAKi) vs TNFi in RA Numerical elevations in MACE and MI, highest among pts w/hx of CAD or high 10-year risk for MACE I have been considering baseline CVD / VTE / CA risk when prescribing these since this broke https://t.co/8DAx8IgnZM

Dr Blazer sheds light on the multilayered SDOHs as they affect outcomes in chronic diseases. Head over to #ACR21 https://t.co/Jq7aiRV3MD

Factors associated with Anti Drug Ab against TNFi over 2-y in axSpA pts are: ⭐️ 🔼 Disease activity ⭐️Development of adverse events ⭐️Treatment discontinuation Abst #0936 #ACR21 @RheumNow

Clinical Pearl at #ACR21 from Dr. John Stone: ⭐️Listen for bruits on patient's back, specifically, on both sides of the spine. ➡️If you hear a bruit, the Takayasu's lesion may be coming from either: *️⃣Pulmonary artery *️⃣Descending Aorta #ACRBest @RheumNow https://t.co/gVpeh7iowk