ACR23 – Day 3 Report

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These year’s annual ACR Convergence has been a success with the return of an insanely active Poster Hall! F2F learning amidst miles of research and many young talented aside wizened establish presenters is such a welcome return to ACR, the way it should be.

Should We Change How We Prescribe Methotrexate?

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For as long as I can remember, methotrexate has been the anchor drug treatment of rheumatoid arthritis. We also know it has limited oral bioavailability at doses greater than 15mg. There are subcutaneous forms that offer better bioavailability, but its subcutaneous nature can sometimes sway patients away from trying it in addition to its higher cost. Split dosing of methotrexate can be a solution to attain higher bioavailability; however, its effect on clinical efficacy is unknown. 

#ACRbest Abstracts – Day 3

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Today was a big day for the Plenaries, Curbside Consults, ACR Business meeting (and induction of our new ACR President Dr. Deborah Desir) and Late-Breaking Posters. Our hot-button reporters have compiled these #ACRbest abstracts for you! (November 14, 2023 at #ACR23)

Reduction of AxSpa-Associated Acute Anterior Uveitis with Certolizumab

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Acute anterior uveitis is the most common extra-musculoskeletal manifestation in axial spondyloarthritis (axSpA) affecting up to 50% of patients in some age groups. AAU can have a significant impact on quality of life with risk of permanent visual deficits if not adequately treated. 

Urinary biomarkers precede loss of kidney function for lupus nephritis

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In Abstract 0850, Dr. Andrea Fava from Johns Hopkins presents research on the value of urinary biomarkers as measure of intrarenal inflammation.

Effective Treatments for Rheumatoid Arthritis ILD

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The American College of Rheumatology guidelines for the diagnosis and management of interstitial lung disease, which includes rheumatoid arthritis interstitial lung disease (RA-ILD), has been one of the most controversial topics in the runup to ACR Convergence.

Day 2 Report - ACR Plenaries: Changing the Practice of Rheumatology

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Over the years of navigating the annual meeting, I found the sessions with the most impact to my practice were the Plenary Sessions. During these sessions, the latest research is presented, new ideas are floated, and old myths debunked. Here are the top ACR2023 Plenary abstracts I found impactful for my practice.

How early is early in psoriatic arthritis?

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Guidelines (ACR/EULAR/GRAPPA) for the management of psoriatic arthritis (PsA) recommend the early referral of patients with the suspected condition for early assessment and treatment.

IV Secukinumab for AxSpa

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The FDA recently announced approval for intravenous secukinumab (Cosentyx) for adults with psoriatic arthritis, ankylosing spondylitis, and non-radiographic spondylitis. Data for this new approval will be presented at ACR Convergence on November 14th by Dr. Atul Deodhar.

SGLT2 inhibitors: The new hype in SLE and LN management?

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Inhibitors of SGLT2 have been shown to reduce MACE in patients with type 2 DM and established cardiovascular disease. In patients with chronic kidney disease at risk of progression, SGLT2 inhibitors have shown reduction in risk of eGFR decline and hospitalization. In SLE, clinical trials have yet to explore the possible role of SGLT2i in improving renal outcomes in lupus nephritis. A couple of abstracts presented during the meeting tackled the topic of SGLT2 inhibition in SLE. 

New Biomarkers and Therapeutics Show Potential in Still's Disease

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Adult-onset Still’s disease (AOSD) is a rare complex, sporadic, systemic autoinflammatory disease similar to systemic juvenile idiopathic arthritis (sJIA) characterized by sustained fever, salmon-colored rash, and arthritis.

Cancer and TNF inhibitors

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Cancer risk minimisation is a high priority for people with rheumatic diseases, as it is for the general population. Tumor necrosis factor inhibitors (TNFi) have a long history of association with cancer risk discussions. An oral presentation by Suarez-Almazor et al provided more supportive data on using TNFi in this population.