HZV in pts w/ #rheumatic dse by Dr CCMok et al 🔸Prevalence rates of HZV infxn (per 100py): SLE 1.7, RA 0.64, other RDs 0.76 🔸RFs assoc'd w/1st HZV infection 📌#SLE dx, serum albumin, serum creatinine; ⬆lympho/neutro ratio, CYC & Prednisolone use @RheumNow #ACR21 abs0862 https://t.co/TXRmoBBDXK

MACE risk Tofa vs TNFi ORAL surveillance: age 50+ w/1 additional CV risk, MTX-IR 👉higher # MACE, MI in Tofa 5 or 10 mg bid (no increase in stroke) 👉risks for MACE w/tofa: tobacco, ASA, age 65+, male sex 👉counsel high risk pts (?avoid use) Abst#0958 #Plenary #ACR21 @rheumnow https://t.co/tg35cts9tw

Clinical Pearl at #ACR21 by Dr. John Stone: ⭐️Patients w/ RNAPIII positive SSc do not always have puffy hands, Raynaud's phenomenon, or ANA positivity! #ACRBest @RheumNow @SChatterjee https://t.co/9J6OBibi4l

Oral Surveillance outcomes in a nutshell Tofacitinib two doses vs TNFi event driven trial more AEs of interest in Tofa groups MACE Malignancy SIE in older groups VTE esp #tofacitinib 10 mg BID @RheumNow #ACR21 #ACRBest abst#0958 https://t.co/j39g7yVVFB

Dr Naovarat reports on 18 year outcomes of HIV and rheumatic disease. 16 patients treated with TNFi, including 2 who switched to tocilizumab and ustekinumab. No major infections. Rising viral load in 1 led to discontinue. Abstr#0965 #ACR21 @RheumNow https://t.co/jcGPaURKmb

#ACR21 #Rheumatology #Pearl: In #Takayasu's, listen for bruits on the back- could be originating from pulmonary artery or descending aorta. @RheumNow https://t.co/0wGdR3Rqy2

Supplementation for 5 years with vitamin D3 +/- n-3 fatty acids reduced incident autoimmune disease by 25-30% in older adults vs. those who received neither supplement. The effect of vitamin D3 appeared stronger after 2 years @RheumNow #ACR21 Abst#0957 https://t.co/uOwNyjxEoG https://t.co/S5kIM4kj6L

Don't stop hydroxychloroquine in SLE, even when doing well. Associated with ⬆️flare risk. x2 even when in remission. Abstr#0959 #ACR21 @RheumNow https://t.co/1gGx0V5oxk

1133 MACE events in Oral Surveillance study - Tofa use in high risk pts had more MACE events than TNFi use. Abstr# 0958 #ACR21 Problems with the gimmish are: - Older patients, w/ Hi CV Risk - 50% prednisone use - Use of TNFi as comparator (effective at lowering CV risk) https://t.co/lzIyhgzvRe

The strawberry🍓gums of granulomatosis with polyangiitis! (Note: not always so florid) @RheumNow #ACR21 #RheumTwitter #MedTwitter https://t.co/qDfGJ5JeWz

⭐️IR for MACE, MI, non-fatal MI numerically ⬆️ in Tofa vs. TNFi ⭐️HR for MACE/MI/stroke >1 for Tofa vs. TNFi ⭐️Risk factors: Smoking, ASA use, Age>65, men ⭐️Pts without risk factors, IR for MACE were similar Abs#958 #ACR21 @RheumNow #ACRBest https://t.co/xA3aGu5Sqi https://t.co/VnPHBhrmdx

okay, so let's look at the #ACR21 plenary as we go so a reminder - FDA-mandated phase 3b/4 safety endpoint study specifically looking at patients >50yo with at least one other CV risk factor today we're looking at MACE: that's CV death (excl PE), MI, stroke ABST0958 @RheumNow https://t.co/9U8Sahb9Q7