Lupus

Sleep asleep

Dreaming of Relief: The Importance of Sleep in Lupus and Rheumatoid Arthritis

Andrea Fava, MD

Sleep plays a critical role in regulating inflammation and overall health. In rheumatic diseases like lupus and rheumatoid arthritis (RA), disrupted sleep is common and can exacerbate symptoms and disease progression. Experts Dr. Al Kim, Patty Katz, and Dr. Yvonne Lee emphasized the importance

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Beyond the Needle: Redefining the Assessment of Lupus Nephritis Lupus nephritis is one of the most silent and severe manifestations of systemic lupus erythematosus (SLE). https://t.co/fvGG0BZbOL #ACR24 https://t.co/wPXQz9Vese

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Dr. John Cush @RheumNow( View Tweet )
Abstract 2681: #SDOH factors & SLE risk: - Low income (AOR=2.779). - By race/ethnicity NHB (AOR=2.429), Hispanic (AOR=1.616). Behavioral: Psych distress (AOR=2.127), no exercise (AOR=1.677). Access: Medicaid (AOR=2.540), transport barriers (AOR=20.394). @RheumNow #ACR24

Akhil Sood MD @AkhilSoodMD( View Tweet )

#Ianalumab 300 mg sc q monthly B cell depleted and changes BAFF signalling 👇⬇️IFN May be promising in #lupus #SLE +data in primary #Sjogrens ACR24 @RheumNow @ACRheum Abst#2425 Needs Phase3 ➡️I suspect safer than CAR T and Bispecific T cell engagers but ? ⬇️efficacy

Janet Pope @Janetbirdope( View Tweet )

Prior studies have shown that IFN is increased in non-lesional skin of SLE pts. In this study, they found a ⬆️ expression of IFN stimulated genes (ISGs) in pts w/ a history of CLE. No correlation w/ CLASI act & IFN scores but only few pts. @RheumNow #ACR24 abs2678 https://t.co/cPT6yPkoCb

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sheila @RHEUMarampa( View Tweet )
Prof Petri reports the ff predictors of fracture in SLE: -older age -Caucasian race -female sex ⚠️ Prednisone (but not recent IM triamcinolone or IV methylpred) is a MAJOR risk factor. When possible, avoid prednisone! @RheumNow #ACR24 #ACRbest abs2679 @rheumarhyme https://t.co/q2NMRaYsAF

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sheila @RHEUMarampa( View Tweet )
All-caps abstract text throw-down by Michelle Petri re:fractures in SLE 😆 I keep saying this; our obsesssion with vitamin d is not commensurate w/reality It's. The. Prednisone. #ACR24 @RheumNow Abstr#2679 #ACRBest https://t.co/13luByNvYT

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Mike Putman @EBRheum( View Tweet )
What are the predictors of fracture in #SLE? 🦴Prednisone! Even at low doses ≤5mg 🦴Stroke 🦴Caucasian race 🦴Female 🦴Low BMD Try to avoid steroid use. If they are needed, IM triamcinolone or IVMP preferable to oral GC. Ab2679 #ACR24 @RheumNow

Mrinalini Dey @DrMiniDey( View Tweet )

Data from the RISE registry show that 9.3% of SLE pts had thrombocytopenia and a smaller percentage with mod-severe TP (2.7%). Severe TP was much rare. Large data, but well represented grp? @RheumNow #ACR24 abs2680 https://t.co/Y1Lo9lJGtO

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sheila @RHEUMarampa( View Tweet )
Late breaking abstract L17 CAR-NK Therapy for Refractory SLE. In a trial of 20 severe SLE patients: - 75% achieved LLDAS, 50% achieved DORIS remission at 6 months - B cell reconstitution: 2–3 months post-treatment - Safety: 2 mild cytokine release syndrome with fever; no severe… https://t.co/MS8cutm48o

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )

In Vivo CAR T Cell Therapy. A single intralymphatic injection of VivoVec™ particles: - Generates functional CAR T cells in vivo - Achieves complete B cell depletion in NHPs without lymphodepletion - Demonstrates potential for an off-the-shelf solution for autoimmune disease… https://t.co/5DTzRvZjbY https://t.co/DvTOqnhn1V

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
🚨 New SLE treatment update! 🚨 Dapirolizumab pegol (DZP), novel CD40L inhibitor, for moderate-to-severe lupus. Phase 3 trial, DZP reduced disease activity, helped taper steroids, and achieved a higher BICLA Safe and generally well tolerated! #ACR24 #L16 @rheumnow https://t.co/lFrKjz4CZ1

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Bella Mehta @bella_mehta( View Tweet )
Severe thrombocytopenia (TP) is rare but linked to major organ involvement and poor prognosis in #SLE. Data from the RISE registry shows TP in 9.3% of SLE patients, with higher prevalence in males, African-Americans+ those with multiple comorbidities. #ACR24 @RheumNow abst#2680

Bella Mehta @bella_mehta( View Tweet )

In prelim analysis of this controlled clinical trial, SLE pts w/ active dse who weres given addtl NAC for 3 mos had significantly reduced dse activity. Mechanism? NAC reduces rapamycin (mTOR) activation. Common AEs: nausea, vomiting @RheumNow #ACR24 abs2677 https://t.co/E4w2Qd7RwP

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sheila @RHEUMarampa( View Tweet )
cognitive represenation of female head

Cognitive Impairment: The Hidden Burden in Lupus Care

Akhil Sood, MD

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

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PHOENYCS GO, RCT of dapirplizumab, novel CD40Li in SLE Met primary endpoint (NNT~6 for BICLA) & numerical improvements in many other endpts 1 MI & 1 death from infection over 213 pts Encouraging for sure! Second phase 3 being launched #ACR24 @RheumNow Abstr#L16 #ACRbest https://t.co/QwDMKjhFvb

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Mike Putman @EBRheum( View Tweet )
It is NO LONGER a ACCEPTABLE To NOT consider #MMF or #Cyclo + another proven #Rx Added to #HCQ and #tapering /limiting #glucocorticoids RCTs in #lupus #nephritis support this ? Is which to add #belimumab #CNI #volclosporin #obinutuzimab #ACR #ACRbest @RheumNow @ACRheum https://t.co/a7WMFfCyXl

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Janet Pope @Janetbirdope( View Tweet )

acr_session2.jpeg

ACR 2024 - Day 3 Report

Jack Cush, MD

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.

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Pathophysiological pathways in neuropsychiatric SLE. 2 components: -Ischaemic -Inflammatory Zahi Touma @RheumNow #ACR24 https://t.co/wwlSSSpOIU

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Subsets of lupus arthritis. Kenneth Kalunian @RheumNow #ACR24 https://t.co/ZmHui126zr

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Study by Maria Dall'Era et al. compared voclosporin-based triple immunosuppressive therapy with high-dose GC in active lupus nephritis. - Fewer adverse events in the voclosporin group, despite a higher incidence of specific issues like decreased GFR and hypertension. - 25%… https://t.co/ToRu2rdErC https://t.co/uUXzNNuLDb

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Loiseau et al. 4700 pSS, 47000 comparators. pSS associated with increased risk of every CV/VTE outcome. Did not have that in my priors! @RheumNow #ACR24 Abstr#2631 https://t.co/QKemUhbcG8 https://t.co/twpjdS2L63

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Richard Conway @RichardPAConway( View Tweet )
A re-evaluation of lupus arthritis. Old dogma is RA is erosive and SLE non-erosive. With better imaging, lupus arthritis can be erosive. Vivianne Malstrom. @RheumNow #ACR24 https://t.co/JEqVPLGNfu

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Did you know? #Lupus arthritis have clinical and US classifications. On MRI, findings will show: - periarticular hyperplastic tissue - capsular swelling - edematous tenosynovitis @RheumNow #ACR24 @rheumarhyme @theactiverheum https://t.co/EoKh2Q3V9Z

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sheila @RHEUMarampa( View Tweet )
Dr. CStone et al. assessed nailfold dermoscopy in distinguishing DM from SLE Almost all DM pts had nailfold changes in at least 1 digit vs. SLE & majority of DM pts had nailfold changes in all 10 digits Dermoscopy is a simple alternative to capillaroscopy @rheumNow #ACR24 ab2404 https://t.co/6tEXAlX7lt

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sheila @RHEUMarampa( View Tweet )

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