How do we manage difficult discussions about pregnancy in RA?

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Most rheumatologists know that it is important to get pregnancy planning right for women of childbearing age living with rheumatic diseases. That is easier said than done, though: the details are difficult, it is overwhelming for the patient, and the conversations are hard.

ACR23 – Day 1 Report

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ACR 2023 is back in San Diego for its annual convergence of thousands of rheumatologists to partake, discover and learn from thousands of abstracts and hundreds of sessions and presentations. It was a big return for the Poster Hall with rows and rows of research, friends, fellows and poster tours.  Below are a few of my favorite presentations from the posters, Plenary and oral sessions on day one.

Sex bias in RA: time to stop blaming hormones?

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Whether it’s RA, SLE or Sjogren’s, the increased prevalence of females affected by auto-immune diseases is well established, yet not fully understood. Often, I have heard that sexual hormones are responsible for every aspect of it. Two abstracts presented this year question this paradigm.

#ACR BEST Abstracts from San Diego – Day 1

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The RheumNow faculty reporters have been scouring the meeting for what they believe to be the best presentations from the first day at ACR 2023 in San Diego.  From hundreds of online presentations, the poster floor and the plenary podium, here are some of the best abstracts from Sunday Nov. 12th. You can spot these on Twitter by looking for the (#ACRbest) hashtag.

The Heart of Lupus

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Few people are aware of the EULAR recommendations for cardiovascular risk management in SLE published in 2022.  The recommendations had 4 overarching principles: increase awareness of elevated cardiovascular risk, need for regular cardiovascular screening, assess and manage modifiable risk factors, and patient education. During ACR 2023 Convergence, several abstracts were presented evaluating the prevalence of CV disease and exploring new tools to predict CV disease.

Canadian Consensus on MSK Ultrasound

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Dr. Jack Cush discusses abstract 0726 presented at the 2023 ACR Convergence meeting in San Diego, CA.

Do Probiotics Improve Psoriatic Arthritis?

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Psoriatic arthritis and the gut microbiome have become more intertwined, especially in the past few years. It was to my amazement that one of the first abstracts I came across was the effect of probiotic modulation on gut dysbiosis and disease activity in psoriatic arthritis patients. 

SpA Sleuths: The Case of Undiagnosed IBD

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Abstract #0494 provides context to our continual search for better understanding of inflammatory bowel disease in patients with AS, nr-AxSpA, and PsA.

Who gives a ‘JAK’ why and how they work, as long as they do!

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Several abstracts have studied the mechanism of action of JAK inhibitors (JAKi) in various diseases. JAKi alter many other mediators affected by the JAK STAT pathway. For instance, T cell signature in blood that is proliferative was associated with a response in RA.

Issues in AxSpA: Treatment Intensification, Pregnancy

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A lot of interesting studies will be presented at the poster sessions on Sunday, November 12 and some of them address practical real-world issues such as treatment intensification and the impact of pregnancy on axSpA imaging. 

The Fallacy of Biologic Treatment to Prevent Rheumatoid Arthritis

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The window of opportunity concept in RA shifted our focus to trying to treat disease earlier and more aggressively to improve long term outcomes. A natural development of this was to reconsider the possibility of therapeutic interventions aimed at the prevention of rheumatoid arthritis.

Bimekizumab is Coming… in Third Place

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Of the many exciting advancements for patients with psoriatic arthritis at ACR Convergence, one upcoming therapy stood out: the dual IL-17A/F inhibitor bimekizumab. Nearly two dozen bimekizumab abstracts will be featured at this year’s meeting and it recently received authorization in Europe and the U.S. for psoriasis. That makes this the year I plan to figure out where this drug will be useful for my patients with PsA.