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Why treatment of pre-RA isn't ready for prime time

The ACR Great Debate was on "To treat or not to treat in pre-RA?". What is the clinician to do?

Imaging in PMR

Despite the fact that polymyalgia rheumatica is the most prevalent inflammatory rheumatic disease in those over 65 years of age, progress in its diagnosis, monitoring and management have failed to garner momentum in decades past. However, ACR22 has fostered significant promise for its future.

ACR 2022 Appraisal, Praise & Critique (11.18.2022)

It was great to be back at an ACR annual meeting, this one in Philadelphia - Philly was great. A walking town, rich in culture, history and good places to meet and mingle. 

I loved the city, but not the convention center (not easy to navigate). 

Familial Mediterranean Fever mimics

Familial Mediterranean fever (FMF) is an inherited autoinflammatory disease characterized by recurrent attacks of fever and acute inflammation of the membranes lining the abdomen, joints and lungs. These attacks are often short-lasting, around 1-3 days.

Gender Differences in Axial Spondyloarthritis

Rheumatic conditions such as SLE and RA exhibit female predominance. In contrast, increasing evidence suggests that gender differences occur in axial spondyloarthritis in terms of time to diagnosis, clinical manifestations, treatment outcomes and quality of life.

RA-ILD takes centre stage

Interstitial lung disease is common in RA, occurring in approximately 8% of RA patients. It is associated with a poor prognosis, and a median survival of 3 years. This important condition has often been neglected within the spectrum of RA research. That is changing, with excellent research initiatives presented at ACR22. I am going to highlight two select abstracts from Monday’s dedicated RA-ILD session.

Sleep Quality & Psoriatic Arthritis

For people living with psoriatic arthritis (PsA), the comfort of a good night's sleep may feel out of reach for many.

Methotrexate + pegloticase increases response rates in gout

In abstract 0001 presented at ACR22 Convergence, researchers presented 12-month data from a randomized double-blind placebo-controlled trial of pegloticase with or without MTX.

Dual target blockade may be better than one in SLE

Inhibition of B-cell Activating Factor (BAFF) has revolutionised the treatment of patients with systemic lupus erythematosus. However, outcomes of therapies within the same class (i.e. BAFF-inhibitor) when evaluated in randomised controlled trials have been inconsistent.

ACR Best Abstracts - Day 3

The last day was jammed with important reports and research including the late breaking abstracts. 

 

The spicy topic of turmeric in rheumatoid arthritis

Curcumin, the active constituent of turmeric extract, has increasingly been promoted as a potential rheumatoid arthritis therapy, but data presented at ACR22 suggests that even in ideal situations, it is unable to do any better than placebo in replacing conventional RA therapies.

The complexity of opioid use in spondyloarthritis

A few things we know about opioids: use is common; it’s not efficacious in the treatment of spondyloarthritis; and, there is an opioid epidemic and its users are stigmatized. Abstract 0402 is a retrospective study that looked at patients with psoriatic arthritis or ankylosing spondylitis in the FORWARD databank. It sheds new light and leaves us with some food for thought
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