RWCS Highlights - Day 2 Save

As I attend RWCS virtually, I am always amazed by the amount of thought that goes into preparing great talks geared toward busy clinicians. Today, I am highlighting a few more pearls that you may find interesting as well.

Rheumatology 2020: Year in Review: What’s new in Spondyloarthritis with Alexis Ogdie, MD and Eric Ruderman, MD

• SPARTAKUS cohort data showed IBS was common in AxSpA AND was associated with increased AxSpA disease activity (Wallman JK, et al. Ann Rheum Dis. 79:159;2020) 
• Axial PsA and peripheral PsA BASDAI results showed similar scores, change in scores, and responsiveness in PsA regardless of presence of axial disease and therapy (Reddy S, et al. ACR 2020 #344)
• Patients with acne on isotretinoin from Saudi Arabian study were screened for inflammatory back pain. Nearly ¼ of these patients were found to have IBP, of these, 40% showed sacroiliits on MRI changes and 50% of those patients met ASAS criteria. However, when isotretinoin was discontinued, MRI changes resolved! (Elnady B, et al. Clin Rheumatol. 39:1829; 2020)

Osteoimmunology – Osteoporosis and Beyond with Glenn Haugeberg, MD

• Bisphosphonates may reduce the risk of acute MI. (Osteoporos Int (2013) 24:271-277)

MAS and HLH – Immunologic basis and clinical characteristics with Susan Shenoi, MD and Anne Stevens, MD

• HLH lab trends: decreasing WBC, platelets, ESR (secondary to consumption), and fibrinogen with increasing ferritin, LFTs, triglycerides and d-dimers. Watch for the trends, not just the numbers. 
• IL18, which amplifies inflammatory response, may be a driver of disease
• We cannot measure IL18 levels accurately in MAS but we can order CXCL9 which may help us to identify these patients (Weiss, canna 2018 Blood)