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Rheum Drugs & IDSA Guidelines to Treat COVID-19

Dec 01, 2022

The Infectious Diseases Society of America has recently updated its recommendations with regards to the treatment of severely ill, hospitalized COVID-19 infected patients and also about the appropriate use of anti-IL-6, JAKs and colchicine.

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Methotrexate + pegloticase increases response rates in gout

In abstract 0001 presented at ACR22 Convergence, researchers presented 12-month data from a randomized double-blind placebo-controlled trial of pegloticase with or without MTX.

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GWAS analysis of 2.5m people (120k with gout) showing identifies 1486 candidate causal genes for gout. Looking at urate handling as well as disease propagation (eg. IL1/6). Widespread GWAS allowing us to investigate these diseases differently. @RheumNow #ACR22 #Plenary
#ACR highlights - #pegloticase in #gout - less reactions and more benefit w #MTX MIRROR RCT. Better than no MTX. Will change my practice - if I can access to a #peguricase, I will Rx w concomitant MTX Abst#0001 #ACR22 @RheumNow
Venuturupalli et al. Elevated CASPASE 1 expression in synovial biopsies of inter-critical gout suggest ongoing NLRP3 inflammasome activity between gout attacks. @RheumNow #ACR22 Abstr#1808
Nair et al. HLA-B*5801 allele in African American gout patients. Present in 8%. Higher than expected, ?need for screening pre-allopurinol? @RheumNow #ACR22 Abstr#1793
Hayashi et al. No effect of colchicine prophylaxis (vs NSAID or vs no prophylaxis) on MACE in re-analysis of CARES trial. @RheumNow #ACR22 Abstr#1809
Gurwith et al ABP-671 a URAT1 inhibitor effectively lowers serum urate @RheumNow #ACR22 Abstr#1822
Lin et al. Genetic risk (HR 2.3 women, 2.63 men) and lifestyle (HR 5.7 for women, 3.7 for men) both individual contributors and synergistic (HR 9.1 women, 8.7 men) in gout development in both men and women. Modifiable! @RheumNow #ACR22 Abstr#1633
Helget et al. Subanalysis of STOP Gout. Allopurinol and febuxostat equal efficacy in CKD 3. More AKI with allopurinol 8.3% vs 2.4%. @RheumNow #ACR22 Abstr#1829
Khanna et al Transdermal NaHCO₃ in gout flare. N=98. Response rate D7 95% vs 79% (p=0.01). Lower rescue med, 6% vs 20%. @RheumNow #ACR22 Abstr#1787
Ho et al. Consistent colchicine use assoc reduction in MACE in patients with gout and pre-existing CVD. @RheumNow #ACR22 Abstr#1815
Flood @FloodRachael et al. ULT reduces non-episodic foot pain in hyperuricaemic patients who fail to meet gout classification criteria. Predicted by double counter or tophus on US. @RheumNow #ACR22 Abstr#1828
McCormick et al Fruit juice and other sugar-sweetened drinks increase gout flare in dose-dependent manner @RheumNow #ACR22 Abstr#1805
Johnson et al. VA matched cohort study. 560,000 gout patients, 5.4 million controls. Gout asoc with increased CV risk of 68% HF hospitalization, 25% HF-related death, 22% MACE. Poor SU control assoc CVD events. @RheumNow #ACR22 Abstr#1580
Black et al. Treat to target in gout. Monthly rheumatologist review and urate titration vs 6-monthly. 89% vs 40% at target ≤0.30mmol/L (<5mg/dl). SU decrease 38% vs 18%. US features also improved. @RheumNow #ACR22 Abstr#1579
Data like this make us think even in the setting of a controlled clinical trial in #gout, non-white patients much less likely to achieve target serum urate! Black pts 70% less likely to reach target compared to whites! #ACR22 @RheumNow abst#1583
Protective effect of #allopurinol in gout Dose dependent reduction in risk of acute coronary syndrome in incident #Gout #ACR22 @RheumNow abst#1582
Fukui et al. Association different alcoholic drinks and urate in Japan. Patients always ask about this. We should drink more sake it seems! @RheumNow #ACR22 Abstr#1206

ACR 2022 - Day 1 Report

Nov 13, 2022

The masses have returned to ACR22, a live, face-to-face, and virtual, meeting that began Saturday in Philadelphia. There were hassles and glitches, yet the education and sessions were as you’d expect with many good presentations worth recapping.

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ACR Best Abstracts - Day 1

Nov 12, 2022

The RheumNow faculty reporters have been scouring the meeting and online presentations to find the best abstracts from ACR22. Here are some of their choice abstracts reported today on day 1 of ACR 2022 (#ACRbest).


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Adding MTX to Pegloticase for 52 wks in gout ◦ Improved response rate by 30% ◦ Reduced discontinuation rate by 40% ◦ Greater resolution of tophi by 20% ◦ Similar safety profile in MTX vs non-MTX groups Botson J, MIRROR RCT #ACR22 #ACRBest @RheumNow
This work can lay foundation to so much more! #ArtificialIntelligence and #naturallanguageprocessing on Facebook private #gout groups - Mental health mentioned in 4% of all posts/comments - primary care asso with “trust” and urgent care with “fear” @RheumNow #ACR22 abst#0201
Botson et al. 52 week results MIRROR trial. MTX added to pegloticase. 71% vs 39% SU <6mg/dl. Infusion reaction 13% vs 32% if ab+ 0% vs 30% ab- @RheumNow #ACR22 Abstr#0001 #ACRbest
Black study subjects remain underrepresented in rheumatology clinical trials except for gout. Abs 0089 Continued under-reporting of race and ethnicity in PsA trials. Abs 0090 We can do better #rheumtwitter #ACR22 @RheumNow and