I was thrilled that the American College of Rheumatology put together the Community Aging Hub and multiple sessions to help rheumatologists identify gaps in care for older patients with rheumatic diseases. My friend and colleague, Dr. Una Makris, taught me the 5 M’s of aging that should be assessed in our patients.
Methotrexate (MTX) remains one of our most used and reliable tools against a variety of rheumatic diseases, including PsA. When the time comes, as it often does, to escalate from a MTX-monotherapy approach, we have several options. In clinic, initiation of these other medications has often been in the form of addition rather than substitution. But what do the patients want, and how much more is the MTX adding in those cases?
Safety comparisons of JAKi (tofacitinib) vs. TNFi from Oral Surveillance showed that, in patients with active RA on MTX and aged >50 years with one or more CV risk factors, that there was numerically more MACE events, malignancies, and VTE especially in higher dose.
A study from ACR21 convergence discussing data from the Global Rheumatology Alliance (GRA) describes the association between race/ethnicity on COVID-19 outcomes specifically in lupus patients.
The ACR 2021 meeting has concluded. Dr. Jack Cush recounts a few more great abstracts from this past week’s virtual meeting.
At #ACR21, the plenary session included an analysis of deaths from SLE throughout the US comparing 1999 to 2019 (Abstract #0454).
Macrophage activation syndrome (MAS) is a term commonly used by rheumatologists to describe a potentially life-threatening complication of systemic inflammatory disorders, most commonly occurring in people with systemic juvenile idiopathic arthritis (sJIA) and systemic lupus erythematosus (SLE). Time is the essence in the management of this condition as its associated mortality is very high.
Identifying patients that will develop RA in situations of seropositivity without overt clinical arthritis or identifying patients with undifferentiated oligo/polyarthritis that will develop RA remains a challenge in the field of rheumatology.
A study presented today by Mease et al. addresses the vital gap between what patients and physicians consider disabling because of PsA, and emphasizes “what matters” in a daily clinical encounter while dealing with PsA.
The REDO trial presented data in abstract 1443 in an oral presentation challenging how low we can go with rituximab for rheumatoid arthritis. Their study randomized 118 patients with rheumatoid arthritis to 1000 mg, 500 mg, and "ultra-low" dose 200 mg.
Early cardiovascular disease assessment and management is critical at diagnosis in patients with Rheumatoid Arthritis (RA). Patients with RA have a known increased risk of developing cardiovascular disease (CVD) due to a higher incidence of traditional cardiovascular (CV) risks such as hypertension and/or hyperlipidemia but also due to the systemic inflammation characteristic to RA.
My favorite three presentations from day 4 (Tuesday) at ACR 2021 included the following.
Evidence suggests that RA patients are at increased risk for cognitive impairment. This is likely mediated by certain factors, including chronic inflammation and accelerated atherosclerosis. In the clinical setting, it is important to identify RA patients at increased risk for cognitive impairment.
On the last day of ACR21 Annual Meeting, the RheumNow faculty selected these 15 as their favorite reports.
A treat-to-target strategy has been shown to improve clinical outcomes in patients with rheumatic diseases like rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis including systemic lupus erythematosus. The goal of treatment in SLE is aimed at remission or low disease activity.
