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Lupus Linked With Greater Risk of Cardiovascular Complications of Childbirth

Dec 02, 2022

Pregnant women with systemic lupus erythematosus (SLE) were more prone to cardiovascular complications during delivery, and their risk seems to have increased over the past 15 years, according to national administrative data.

The cross-sectional study supports the role that the

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Just Can’t Get Enough of Hydroxychloroquine

Nov 30, 2022

When it comes to hydroxychloroquine dosing, issues on efficacy, toxicity and therapeutic thresholds may affect the optimal use of this important drug.

Following are three abstracts presented during the meeting that address these topics.

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ACR meeting education

ACR22 Takeaways: Pre-RA, Lupus, PsA and AS

Nov 29, 2022

ACR22 Convergence left us bountiful with information from all over the world. Here are a few of my personal highlights and key takeaways. 

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lupus SLE

Tyk2 Inhibition Effective in SLE

Nov 28, 2022

Deucravacitinib, an oral, selective TYK2 inhibitor, has demonstrated efficacy in a phase II trial active systemic lupus erythematosus (SLE) patients.

The results of this phase II trial were recently presented at ACR 2022. This  phase II multinational trial enrolled 363 adults with

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Is exercise the missing medicine in lupus? Sarah Patterson, MD from UCSF will present oral abstract #2225 entitled “Physical Inactivity is Associated with Increased Expression of T cell inflammatory genes in Systemic Lupus.”
Updates on Reproductive Health in Women with SLE Dr. Catherine Sims ( @DrCassySims) summarizes reproductive health abstracts presented at #ACR22.
SLE, Sex and STDs Once in a while, I find an abstract at the American College of Rheumatology meeting that can potentially save lives and be implemented in practice now. Dr. Dao ( @KDAO2011) discusses abstract #0939 presented at #ACR22.
New Treatments for SLE? Dr. Petri discusses abstract 1117 presented at #ACR22. Efficacy & Safety of Deucravacitinib, an Oral, Selective, Allosteric TYK2 Inhibitor, in Patients w/Active SLE: A Phase 2, Randomized, Double-Blind, Placebo-Controlled Study

Tight control of proteinuria in newly diagnosed lupus nephritis

Since reduced proteinuria at one year is the best predictor of improved long-term renal outcomes in lupus nephritis, is there rationale to set a tighter treatment target?

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Photovoice: A New Visual Research Method in Lupus Dr. Bella Mehta ( @bella_mehta) talks with Dr. Candace Feldman about Abstract 1099: Empowering Patients with Lupus Through Their Photographs at #ACR22.
Just accepted in Arthritis & Rheumatology: Incidence, Prevalence, and Mortality of Lupus Nephritis: A Population-Based Study Over Four Decades—The Lupus Midwest Network (LUMEN)

Thresholds of Hydroxychloroquine Blood Levels

Nov 23, 2022

Hydroxychloroquine remains the backbone of treatment for SLE, and the only drug clinically proven to decrease mortality. Optimization of usage is therefore critical in maximizing benefit and preventing harms. Hydroxychloroquine blood level testing is available in clinical practice and can help

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Was this a Mistake? HCQ Dose Reductions per AAOS Guidelines

In the wake of the 2016 AAOS Guidelines, rheumatologists dutifully reduced the dose HCQ take by patients with SLE to some number south of 5mg/kg per day. Though I believe the ophthalmologists correctly interpreted a 2014 paper in JAMA Ophthalmology that quoted a much-higher rate of HCQ

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New Treatments for SLE? Dr. Petri discusses abstract 1117 presented at #ACR22. Efficacy & Safety of Deucravacitinib, an Oral, Selective, Allosteric TYK2 Inhibitor, in Patients w/Active SLE: A Phase 2, Randomized, Double-Blind, Placebo-Controlled Study

SLE: Variability in Racial Disparities in Pregnancy Outcomes

Significant disparities exist in pregnancy outcomes in women with systemic lupus erythematosus (SLE), with previous cohorts identifying Black women as having a higher risk of maternal mortality compared to White women with SLE.

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Exciting Data for SLE: Plenaries from #ACR22 Dr. Michael Putman ( @EBRheum ) shares SLE updates shared at #ACR22.
Dual target blockade may be better than one in SLE Dr. Yusof ( @Yuz6Yusof) discusses abstracts #L07 and #1001 presented at #ACR22.
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ACR 2022 Appraisal, Praise & Critique (11.18.2022)

Nov 18, 2022

It was great to be back at an ACR annual meeting, this one in Philadelphia - Philly was great. A walking town, rich in culture, history and good places to meet and mingle. 

I loved the city, but not the convention center (not easy to navigate). 

The meeting itself was very

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lupus SLE

Dual target blockade may be better than one in SLE

Inhibition of B-cell Activating Factor (BAFF) has revolutionised the treatment of patients with systemic lupus erythematosus. However, outcomes of therapies within the same class (i.e. BAFF-inhibitor) when evaluated in randomised controlled trials have been inconsistent.

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Think Before You Order: Choose Wisely

Nov 14, 2022

Early in medical training, we are taught diagnoses are made 90% of the time based only on the history and physical exam of the patient; laboratory tests play a minor role. When ordered, tests are used as evidence to support the diagnosis already made by the physician. However, over time,

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Ab1674 #ACR22 HCQ in pregnancy is SAFE and Standard of Care! In Utero Exposure to HCQ does NOT ass w/ ocular toxicity: OCTs 5 yrs after birth 👀 PATCH study of HCQ to reduce CHB in pregnancy 18% CHB (historical) -> 7% treated risk OCT: retinal thickness nml at 5 yrs @RheumNow
Askanase et al. Phase 2 RCT Cenerimod (S1P modulator) in SLE. Primary endpoint not met. Some suggestion of efficacy at highest 4mg dose. But if its already like this in a phase 2, I doubt a phase 3 will bring better results @RheumNow #ACR22 Abstr#1656
This single ctr retro cohort study by Dr ZKazmi showed ⬇️HPV vax rates & ⬆️HPV infxn rates 🔅In HPV+ pts, risk of persistent HPV infxn was similar among ♀️ aged 21-26y & 27-45y (p>0.05) Is it time for updated cervical ca screening guidelines for #lupus? #ACR22 @RheumNow ABST#1671
Ab1671 #ACR22 Cervical Cancer screening in SLE 106 SLE patients, mean age 40. Only 3.7% w HPV vax! 24% abnml PAP, 30% HPV infection HPV highest in 21-26 yo (83%) vs 27-45 (35%) ASCUS 50% HPV+, 1 pt squamous cell ca Recs: HPV Vax💉, test HPV as high positivity @RheumNow @KDAO2011
Rossato et al. Women in highest tertile ultra-processed food intake 50% more likely to develop SLE than those in lowest tertile. Exacerbated by high BMI. @RheumNow #ACR22 Abstr#1634