@Janetbirdope #RNL2023 Benefit of intra-articular jt injections in early RA Injection of 6-12 swollen joints (!) vs systemic glucocorticoids -- FAR better ACR20 and ACR50 with less side effects @RheumNow https://t.co/AtgCKOd8IC

29 pts w/PsA Sine Psoriasis: 16F/13M, mean age 45 yrs w/ PsA ~6.2 yrs. 54% had 1st-degree relatives with PsA. 66% had DIP arthritis, 39% polyarticular, 36% oligoarticular, 25% were axial. Nail findings seen in 89%, enthesitis 59%, dactylitis 62% https://t.co/MlnIzGBzn0 https://t.co/8hHE3Yv8UE

Carol Langford #RNL2023 @RheumNow Rx options for GPA showed by targeted to patient's disease characteristics of severe vs non-severe disease CYC not for non-severe due to toxicity MTX, MMF not for severe disease https://t.co/O3U29jmsHv

Carol Langford #RNL2023 Use of CYC + RTX: Not routine upfront, but may be needed for escalating disease Limited data to support initial usage Higher risk of hypogammaglobulinemia, infection, and death @RheumNow https://t.co/SHwV8o4xX1

Dr. Langford #RNL2023 When to use CYC over RTX for severe GPA induction? - Severe disease with RTX intolerance - Worsening disease despite RTX - RGPN Cr > 4.0, mechanical ventilation? (these were excluded from RAVE trial) @RheumNow https://t.co/twVJ81pgUK

Dr. Carol Langford on GPA treatment Duration of remission maintenance therapy? - at least 2 years, after 2 years, maintenance appropriate in many cases - consider RTX, and other cDMARDs (MTX, MMF, AZA) @RheumNow #RNL2023 https://t.co/VmswcnzN5v

How to long for maintenance of GPA? Continue for 24 months, then consider: Relapse history? Organ damage? Toxicity? Patient wishes? Compliance? Family planning? Dr. Langford @RheumNow #RNL2023 https://t.co/u7lqCGGeNs

Beyond immunosuppression, Dr. Carol Langford reviews non-med management of GPA upper airway disease. Things to consider for patients and will change the way I practice. @rheumnow #RNL2023 https://t.co/4SlYx1r5ZK

Avacopan in GPA - non-inferior to prednisone for induction remission - received FDA approval for treatment of severe active GPA in combo with standard therapy and steroids - should be used in newly diagnosed active or relapsing disease @rheumnow #RNL2023 https://t.co/0DL1WUP177

Dr. Langford's take home for GPA. Remember to consider disease severity (will determine tx,) maintenance tx, and non-medical management including vaccination options for pts. #RNL2023 @RheumNow https://t.co/HWdv3Fv9zK