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Vasculitis

Is MTX Safe in the Elderly? (12.1.2023)

Dec 01, 2023

Dr. Jack Cush reviews this past week's news and journal reports from RheumNow.com. Good news is that nearly 99% of adult rheumatology positions matched! But the challenge is that 45% of pediatric fellowship programs and 39% of pediatric rheum slots were unfilled in the 2024 NRMP match.

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WATCH: TMP SMX Prophylaxis in GPA https://t.co/JtIjgxwrCf https://t.co/Tmzdu00oyH

When should we be starting therapy in GCA and PMR?

Nov 28, 2023

The problem with having therapies that work is that you then have to figure out what to do with them. You cannot hide behind a shrug of the shoulders, or the ambiguity of therapeutic inadequacy. The question that follows the presence of a therapy is the question as to how to best use it.

GCA

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UK study 336 GCA pts shows after 12 mos of tocilizumab, TCZ stopped (w mean pred 2mg/d) & GCA flares at 6, 12 & 24 mos was 21%, 35% & 49% respectively; requiring prednisolone dose increase to 20 (10-40) mg/day (34% were major relapses) https://t.co/EZ78ciNK0R https://t.co/R1qFsvnhoF
Substudy of the ADVOCATE trial looked at 214 ANCA assoc vasculitis pts treated with #RTX; avacopan Rx showed improved recovery of renal function, faster reduction in albuminuria and lower glucocorticoid toxicity compared to a prednisone taper. https://t.co/91PtvQfoIr https://t.co/ZjYCVP5lqG
Infections During Treatment of GPA with Rituximab Dr. Richard Conway (Dublin, Ireland) discusses abstract 1584 presented at the 2023 ACR Convergence meeting in San Diego, CA. https://t.co/eKi3KExEnk https://t.co/b9G9w5e9tc
Identifying GCA diagnosis and disease activity through proteomics from plasma: diagnosis looks good disease activity looks harder (Much like a lot of things in GCA, really) Exciting work @MayoClinic @MdWarrington @jsung0906 #ACR23 ABST2601 @RheumNow https://t.co/SwxN58LieB
Greigert et al. IL17 in GCA. Increases vascular inflammation. Synergistic effect on myofibroblasts with IFN-γ - increases IL-1B, IL-6, GM-CSF, CCL20 (recruits T cells), CCL2 (recruits monocytes), VEGF (neoangiogenic). Abstr#2599 #ACR23 @RheumNow https://t.co/p4GumZStAZ https://t.co/zZv0TF4fmn
Nov 15, 2023
⭐️Further Assessment of a patient with rash c/w leukocytoclastic vasculitis: 👉History: ⏺️Timing, onset, progression? ⏺️Recent infectious for infectious symptoms? ⏺️Recent/new meds? ⏺️Hx of cancer? 👉Laboratory assessment for ALL: ⏺️CBC w/ diff ⏺️CMP (w/ interest in Cr,… https://t.co/tVqz6XDXt2 https://t.co/LqZpx5j0Bp
#ACRbest Peter Merkel as Distinguished Investigator said Data are good. Need data to develop questions, understand #vasculitis Hx of #vasculitis - great minds & drugs - now challenged by funding and comparators Session 15W127 #ACR23 @RheumNow @ACRheum https://t.co/5leIeLWZ6O
Nov 15, 2023
#vasculitis clinical trials are accelerating. Need the right time - early studies have lessons learned re feasibility and design/endpoints #ACR23 @RheumNow @ACRheum Great lecture - P Merkel 15W127 great graphs of vasculitis developments https://t.co/YRdPiaflxY
Nov 15, 2023

ACR23 – Day 3 Report

Nov 15, 2023

These year’s annual ACR Convergence has been a success with the return of an insanely active Poster Hall! F2F learning amidst miles of research and many young talented aside wizened establish presenters is such a welcome return to ACR, the way it should be.



Highlights from today

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👨‍⚖️ The Great Debate: should we use advanced therapies / biologics at disease onset in PMR & GCA? #ACR23 By Dr. Robert Spiera & Dr. Phil Seo @philseo #Vasculitis #PMR #GCA https://t.co/rkcUeEBLeZ

#ACRbest Abstracts – Day 3

Nov 14, 2023

Today was a big day for the Plenaries, Curbside Consults, ACR Business meeting (and induction of our new ACR President Dr. Deborah Desir) and Late-Breaking Posters. Our hot-button reporters have compiled these #ACRbest abstracts for you! (November 14, 2023 at #ACR23)

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Plenary Abs #2425: Pregnancies among vasculitis pts - higher frequency of spontaneous abortion and preterm delivery. Risk of maternal complications associated with vasculitis were observed to vary by vessel size and parity. #ACR23 https://t.co/qLcpNapcjg @rheumnow https://t.co/sk3dhySVfP
Nov 14, 2023
Rector et al. Pregnancy outcomes in vasculitis. More spontaneous abortion, elective termination, ectopic & molar pregnancy, x2 preterm delivery. Preeclampsia in 12%. Worse again in small vessel vasculitis Abstr#2425 #ACR23 @RheumNow https://t.co/cotncE16ma https://t.co/QoJpJIHJfJ
Nov 14, 2023
Intriguing data on #GCA treated with tocilizumab #aneurysm still occurs #vasculitis https://t.co/6cPlFRReLJ
Nepal et al. No increased risk of GI perforation for tocilizumab in GCA HR 1.05 . Diverticulitis (RR 3.51), IV methylprednisolone (RR 5.41) risk factors. This fits with my priors, steroids are a bigger risk than tocilizumab. Abstr#2560 #ACR23 @RheumNow https://t.co/BAmBQA0kEP https://t.co/zRjmDIkOHp
Nov 14, 2023
Great work @HoromanskiMd on a vasculitis in pregnancy plenary session! #ACR23 https://t.co/WSmqJjfBes
Fantastic presentation by Desh Nepal from MCW on risk of GI perforation in patients with #GCA Low incidence , no association with TCZ, but increased risk with IV methylprednisolone and h/o diverticulitis. @EBRheum #ACR23 https://t.co/bgvmjAXBEY
Kaymakci et al. 49 GCA patients in clinical remission undergoing thoracic aortic surgery. Active aortitis in 82%. Abstr#2557 #ACR23 @RheumNow https://t.co/WQh47LThGD https://t.co/DeORKmjYP7
Nov 14, 2023
Pregnancies outcomes in vasculitis: - Higher frequency of spontaneous abortion and preterm delivery - 12% had pre-eclampsia - Risk higher in multiparous > nalliparous - Risk highest in small vessel vasculitis Rector A, Abst#2425 #ACR23 #ACRBest @RheumNow https://t.co/TgbRWw9il5
Nov 14, 2023
MANDARA -52wk,ph3 non-inferiority study comparing efficacy & safety of benralizumab & mepolizumab in EGPA receiving SOC 👉Benralizumab was non-inferior to mepolizumab in achieving remission at wks 36 & 48 (2.71%; 95% CI –12.54, 17.96; p=0.7278) #ACR ABSTL14 @RheumNow #ACRbest https://t.co/S3aa3g5mnN
Nov 14, 2023
Vasculitis patients associated with increased pregnancy risks Large study of >600 pregnancies in >500 pts Vasculitis pts higher frequency of spontaneous abortion, elective termination, ectopic and molar pregnancy, preterm delivery 12% pre-eclampsia @RheumNow #ACR23 Abs#2425 https://t.co/Nqa77nxSFu
Nov 14, 2023
Pregnancy outcome in Vasculitis - Claim database study A#2425 #ACR23 @RheumNow 665 vasculitis pts, LVV 60, MV 160, SVV 217, variable 250 Incr risk of preterm delivery, particularly medically-ind deliv, esp Small vessel vasc (5x risk med-induced) Higer risk pre-eclampsia/eclampsia https://t.co/bWMyY5oqNK
Nov 14, 2023
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