#ACR Best 2024 - Day 4

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Although the last day of ACR Convergence 2024 was but a half day - it was chock full of gems, many coming from the late breaking abstracts presented today.  As chosen by the RheumNow faculty, here are some highlight presentations you need to know about.

Methotrexate to Prevent RA, Clear as Mud

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Intervention in individuals predisposed to develop RA, with a holy grail of prevention of RA, has long been a hot topic. The 4-year results of the TREAT EARLIER study, presented at Tuesday’s oral abstract session, show that methotrexate appears to prevent the development of RA in high risk ACPA- patients.

Predicting flares in rheumatic diseases with machine learning

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Rheumatic diseases, such as axial spondyloarthritis (axSpA) and rheumatoid arthritis (RA), are marked by unpredictable disease flares that adversely impact quality of life and long-term outcomes.

How New Medications are Reframing Imaging Abnormalities in axSpA

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Bimekizumab (BKZ), a monoclonal antibody that selectively targets both IL-17A and IL-17F, was evaluated in the BE MOBILE 1 (non-radiographic axSpA) and BE MOBILE 2 (radiographic axSpA) trials and found to yield significant cli

Improving fertility in women with RA

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For many women, the journey to motherhood brings a sense of anticipation and joy. However, for those with rheumatoid arthritis, this journey presents unique challenges. At ACR Convergence 2024, researchers discussed how advancements in reproductive medicine and RA management are paving the way for improved outcomes.

Sex related differences in PsA

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Different factors are known to influence disease characteristics and outcomes in psoriatic arthritis (PsA).

Playing it Safe with RA? JAK vs. TNF Debate

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Reported safety signals, at odds with the efficacy of these medications, have left rheumatology clinicians in a difficult position when considering when during a patient’s treatment course and in which patients, specifically, JAKi should be used. Two abstracts from ACR convergence 2024 further contribute to our understanding of this potential risk profile.

Cognitive Impairment: The Hidden Burden in Lupus Care

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Suppose you have a patient with lupus returning for follow-up. Their joint symptoms are well controlled. The kidneys—managed with a combination of biologic DMARD and mycophenolate—show no signs of active urinary sediment or protein. Yet, during the routine visit, your patient brings up fatigue and difficulty remembering things. How do you address this? Several studies presented at ACR24 focused on cognitive impairment in lupus.

A new score to quantify GCA inflammation?

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The treatment paradigm for Giant Cell Arteritis (GCA) has been a binary approach to the presence or absence of vasculitis. When GCA is present, we institute high doses of glucocorticoids for treatment of the inflammatory process. This approach is not well individualized to the patient as we do not account for the degree of inflammation that may or may not be present in the disease. Improved markers to stratify the extent of inflammation can help to tailor a more personalized approach to treatment.

Up-front Secukinumab in PsA?

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We now have an absolute plethora of agents available for use in psoriatic arthritis (PsA). In contrast we have an almost complete lack of understanding of how best to optimise use of these agents – what is the right agent at the right time for the right patient. A study presented this week has given us some further information on the topic.

Gender Differences in SpA

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One of the hot topics during the meeting was gender differences in SpA. Three abstracts presented addressed issues related to these differences particularly in the aspects of treatment response and disease activity.

ACR 2024 - Day 3 Report

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Highlights from Day 3 at ACR24 included the plenary session presentation on Nipocalimab (previously reviewed), but the big highlight was the Lupus Nephritis guideline recommendations.