In rheumatoid arthritis we have a wide range of options available to us when we progress to a biologic treatment option. We have little to differentiate between these agents based on the clinical trials. We often make our choices based on minor hints from clinical features, comorbidities, or cost considerations.
sheila RHEUMarampa
4 years 10 months ago
Interesting study by @DrPoddubnyy et al. looking into the efficacy of SEC on HLAB27 subtypes (post hoc analysis of SKIPPAIN trial)
➡ SEC effective for both HLAB27+ and - grps
➡ Significant response seen among HLAB27+ and HLAB27 homozygous pts
@RheumNow #ACR21 abs0917 https://t.co/St37kdGY65
Richard Conway RichardPAConway
4 years 10 months ago
And here is ORAL-Surveillance, small increase in MACE and malignancy with tofacitinib vs TNFi. 1 extra MACE per 319-567 patient years, 1 extra malignancy per 275 patient years. Abstr#0831 #ACR21 @RheumNow https://t.co/wMJnspTTBy
David Liew drdavidliew
4 years 10 months ago
For rheumatologists, instinct says in RA everything’s better with MTX. For tofacitinib, where immunogenicity not an issue, is that actually true?
Canadian registry data: maybe no
after 36m, low no. ?valid, markups mine
Need to see more of this!
#ACR21 ABST0827 @RheumNow https://t.co/VVwd4SZgVx
sheila RHEUMarampa
4 years 10 months ago
Factors associated w/ poor COVID19 outcomes in #SLE from the GRA @rheum_covid
📌Demographics - age, sex, region
📌Glucocorticoid use
📌 Comorbids - renal, CV
📌Untreated/active dse
❗Very important msg here: Control dse, manage comorbids & avoid GCs
@RheumNow #ACR21 abs0866 https://t.co/eXR3KqGrJa
TheDaoIndex KDAO2011
4 years 10 months ago
Dr. Thomas reviews risk for progression to RA
👉+ACPA (9% risk)
👉1st degree relative 3-9X risk
👉70% risk in 5 years of both are true!👈
#ACR21 @rheumnow https://t.co/y5eUyacBFT
Dr. Antoni Chan synovialjoints
4 years 10 months ago
Radiographic progression in AS is greatest between ages 30-39. The presence of preexisting structural damage starts to accelerate it from earlier ages. Data from 1125 patients followed from 2001-2018 @RheumNow #ACR21 Abst#0897 https://t.co/g0t45R0lOd https://t.co/RvlO9EcMIX
Richard Conway RichardPAConway
4 years 10 months ago
3 year results of SELECT-COMPARE study of upadacitinib. No evidence of a signal in cardiovascular events or cancer. Reassuring, but really need an ORAL-Surveillance style study of upadacitinib to be confident. Abstr#0828 #ACR21 @RheumNow
Aurelie Najm AurelieRheumo
4 years 10 months ago
An important message from Dr Ranjeny Thomas on #RA #disease control: "Patients can have a significant impact on the control of their disease, and the interventions we recommend need to be personalised to their resilience ability." #ACR21 @RheumNow https://t.co/h63uz5kfU8
Robert B Chao, MD doctorRBC
4 years 10 months ago
Gender differences in secukinumab treatment of AS?
⭐️improved disease activity, global function, depression in men and women
⭐️women ⬆️disease burden
⭐️high retention rates irrespective of gender
Abs#909
#ACR21 @RheumNow
https://t.co/L6mCxuSMo1 https://t.co/pR3OBoXqaT
David Liew drdavidliew
4 years 10 months ago
Booking regular clinic visits for controlled RA pts - can we be more efficient?
12m RCT
Self-monitoring app, supported self-initiated care
only one scheduled follow-up visit
controlled RA pts
DAS28/pt satisfaction same
visits/y: 1.7 vs 3.0
@reade_020 #ACR21 ABST0830 @RheumNow https://t.co/600XTKo9GM
TheDaoIndex KDAO2011
4 years 10 months ago
Risks for RA:
- chromosome 6 has HLA risk genes encoding HLA-I and -II
- HLA-DRB1 *04:01 and *04:04 stonrgly assc w/ RA in white Americans/Europeans
- the Shared epitope increase risk for RA & severe disease; high assc with ACPA+
Protective➡️HLA-DRB1*13:01 @rheumnow #ACR21 2/2
TheDaoIndex KDAO2011
4 years 10 months ago
Chances for RA if a family member has RA?
Dr. B Masri reviews familial studies:
👉person w/1st degree relative w/ RA has 2-4 X risk
👉Multigen study standard incidence ratios: 3.02 child, 4.64 siblings, 9.31 in multiplex family, 6.48 twins, 1.17 in spouses #ACR21 @rheumnow 1/
TheDaoIndex KDAO2011
4 years 10 months ago
Dr. Ranjeny Thomas on preventing RA:
👉60% genetics/immunopathogenesis (noncontrollable factors)
👉40% lifestyle modifications: healthy diet, healthy weight, avoiding tobacco, reduce occupational exposure, improve exercise/sleep, decrease stress.
#ACR21 @rheumnow 1/2 https://t.co/eoh3kcekR8
Md Yuzaiful Md Yusof Yuz6Yusof
4 years 10 months ago
Don't forget to catch up with our @RheumNow Faculty Panel discussion on What's Hot and Not Daily Recap for Saturday #ACR21 @RichardPAConway @AurelieRheumo @bella_mehta @_Castillo_Pedro https://t.co/x2xu6k2h9x
