Low Dose IL-2 Therapy in Sjögren’s

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There is a large, unmet need in treating Sjögren’s syndrome, yet a new randomized clinical trial has shown that low-dose interleukin 2 (LD-IL-2) was effective effective and well tolerated in patients with primary Sjögren’s syndrome (pSS), with evidence of restored immune balance.

ACR22 Takeaways: Pre-RA, Lupus, PsA and AS

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ACR22 Convergence left us bountiful with information from all over the world. Here are a few of my personal highlights and key takeaways. 

Tyk2 Inhibition Effective in SLE

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Deucravacitinib, an oral, selective TYK2 inhibitor, has demonstrated efficacy in a phase II trial active systemic lupus erythematosus (SLE) patients.

How Underweight Women Can Reduce Hip Fracture Risk

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How women can reduce the risk of hip fracture?  

Cancer Screening Recommendations in Idiopathic Inflammatory Myopathy

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Idiopathic inflammatory myopathy (IIM) is associated with increased risk of lung, ovarian, colorectal, lymphoma, breast, and naso-pharyngeal cancers, often within three years of disease onset. At ACR22, plenary abstract 0002, Oldroyd, et al, reviewed the 18 recommendations provided by the International Myositis Assessment and Clinical Studies Group (IMACS) steering committee.

Will a vegetarian diet and exercise actually help RA disease activity?

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The exact role of diet, physical activity, and stress management in the management of RA has long been debated. While reasonable evidence has supported the importance of physical activity in patients with RA, its capacity to reduce disease activity via conventional measures such as DAS28 was less well delineated.

Practical Guidance for the Clinical Rheumatologist in Unplanned Pregnancies

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Discussions regarding family planning, contraception, and pregnancy should be approached at each clinic visit to ensure providers understand patients’ personal goals. These conversations have the potential to decrease the risk of unplanned pregnancies. However, rheumatologists may need to manage unplanned pregnancies and the impacts of accidental teratogenic exposure.

Tight control of proteinuria in newly diagnosed lupus nephritis

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Since reduced proteinuria at one year is the best predictor of improved long-term renal outcomes in lupus nephritis, is there rationale to set a tighter treatment target?

Steroids in RA: Friend or foe (or both)?

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While have come so far from the days of our patients living on massive doses of steroids, we still have many patients who use steroids for our diseases, with increasing data for toxicity, even in low dose. As someone much smarter than me described them, steroids are our best frenemy.

Thresholds of Hydroxychloroquine Blood Levels

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Hydroxychloroquine remains the backbone of treatment for SLE, and the only drug clinically proven to decrease mortality. Optimization of usage is therefore critical in maximizing benefit and preventing harms. Hydroxychloroquine blood level testing is available in clinical practice and can help guide this management. 

The disconnect between objective inflammatory response and PROs in AxSpA

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The assessment of disease activity in AxSpA involves the use of objective inflammatory response (OIR) and patient reported outcomes (PROs). In clinics, a combination of OIR and PROs are used to measure disease activity and response to treatment.

Pain in Psoriatic Arthritis

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The prioritisation of pain, and its evaluation, is important in those with psoriatic arthritis, when the already incredibly heterogenous nature of the condition can complicate assessment. Whilst we lean towards all pain in PsA being nociceptive in nature, evidence suggests that a significant proportion of patients with PsA also have nociplastic pain, characterised by fibromyalgia.