Low-dose steroids in RA: what's the harm, right? (You probably know where I'm going with this) ESPOIR 10y data: total events, and severe infections worse with dose and time (cumulative 8.4g ≡ 5mg/d) No doubt some residual confounding, but real risk! #ACR20 ABST1998 @RheumNow https://t.co/BAQmOR1ped

What would you use next? sero+ RA new keratitis requiring prednisone and now also 20 SJC. New rheumatoid nodules. Pt has been on triple csDMARDs + Leflunomide, then 2 JAKi and 2 TNFi also with MTX each time. All Rx works for 6 months then relapse. @RheumNow @CRASCRRheum https://t.co/9cTS1tNE42

Filgo decreased MRI inflammation of many structures early in Rx in SpA which seems novel says w Maksymowych 5M015 @RheumNow #ACR20 @CRASCRRheum #ACRbest https://t.co/LOOOn7Hjvp

Inadequate response to MTX, what next? “Are you forward thinking or are you stuck in the past? Conceptually it is just amazing that you can take a PO tablet as potent as a TNF or IL6 blocker... & the side effects are not so appalling.”—Dr. GreggSilverman. @RheumNow

Summary of #ACR20 part C: - A must see talk was the avacopan story - IVIG for myositis does work! More than just anecdotal evidence now - DIET is key to helping improve autoimmune dz! - low dz activity RA pts should taper off of MTX 1st when also on TNFi @jeffsparks @RheumNow

@RheumNow #ACR20 abs1923 prosp cohort study of angiographic lesions in Takayasu’ &GCA: although infrequent new angio lesions more likely in TAK. Improvement is possible in both conditions, more likely to occur in TAK. Change in the branch arteries more dynamic than in the aorta https://t.co/2KsZ6o3vtP

When do you think we are going to get a DMARD for OA? 50% or more over age 60 will have osteoarthritis, yet we are yet to discover a promising disease modifying therapy. #ACR20 @RheumNow @ElaineHusniMD

“We are giving autoimmune diseases to ourselves through bad diet.” — Dr. Gregg Silverman, #ACR20 @RheumNow @drnatalietv

@RheumNow #ACR20 abs1921 single center baseline & follow-up PET/CT scan study in pts w/ refractory LVV-GCA on TCZ: while 83.33%pts achieved clincial remission only 10% experiences normalization of Total vascular score. https://t.co/sQK4L7Zu76

“Avacopan is the little train that could that will eat the antibodies lunch!” - Dr. Gregg Silverman #ACR20 @RheumNow @petermerkel @LCalabreseDO @philseo @AdamJBrownMD

As #ACR20 is wrapping up, are you are planning to see the conference lectures after the meeting is over? @RheumNow

Dr Lillegraven presents a randomized open-label phase 4, non-Inferiority trial of TNFi tapering in RA patients in sustained remission. 63% of tapered patients flared over 12 months vs 5% of maintained. Good response to reintroduction of TNFi @rheumnow #ACR20 Abstr#2010 https://t.co/Ki7PTsetbH

@rheumnow #ACR20 abs1535 retrospective study of SI MRI reveals 20% pts w/out spondyloarthritis have BME on an MRI, predominantly in the antero-middle quadrant. Erosions were seen in 31% of healthy patients and in 61% of patients with spondyloarthritis

Summary of #ACR20 part B: - The future is bright with many trainees producing great research per Dr. Diane Karen - Belimumab (phase III) reduced proteinuria, improved renal for, and helped w/ tapering of GC in pts w/ lupus nephritis but more infect in GC group @RheumNow

“Rheumatologists diagnose diseases of inflammation, and we are really good at it!” - Dr. Greg Silverman #ACR20 @RheumNow