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Vasculitis

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PsA Til Death Do Us Part (1.20.2023)

Jan 20, 2023

Dr. Jack Cush reviews the highlights from the past week on RheumNow.com.

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US study of 47 #GCA pts showed baseline US+ in 44/47 (72% TA, 72% LV). US was sensitivity to change over time w/ serial measures. TA-based US showed good correlation w/ Dz activity & discriminated remission vs, relapse https://t.co/2cDxac5oJw https://t.co/jH4rgvgELY
International survey of 394 GPs & 937 rheumatologists shows most PMR pts are not referred to Rheum. GPs referred 25% suspected PMR for Dx & 50% were returned to GP. 39% of Rheums saw new PMR >2 weeks after referral, half already on Pred https://t.co/K56nYRckpz https://t.co/j6ukqPaQXd
ACR GCA classification criteria tested in 676 patients suspected GCA (+US) - 276 dx w/ GCA; 400 not. Sensitivity was 87%, specificity 70%; 35 (13%) GCA pts did not meet criteria. & 119 non-GCA (30%) had ≥6 points (most PMR) https://t.co/bTrj83yM7l https://t.co/9iA8LbX6vB
In GCA, Hospital Admission Is Bad News 1/3 of patients admitted w/ GCA were rehospitalized within 6 months, largely because of complications potentially related to corticosteroid therapy, researchers found in a retrospective cohort study. https://t.co/zaWZn7F9sl https://t.co/OfuyZxNbaa
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2022 Rheumatology Year in Review (1-6-2023)

Jan 06, 2023

Dr. Jack Cush reviews the best of 2022 in Rheumatology - highlights on new drug indications, breakthrough lupus therapies, new biosimilars and the multivitamin letdown.

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GCA,woman

In Giant Cell Arteritis, Hospital Admission Is Bad News

MedPage Today
Jan 03, 2023

One-third of patients admitted with giant cell arteritis (GCA) were rehospitalized within 6 months, largely because of complications potentially related to corticosteroid therapy, researchers found in a retrospective cohort study.



Among the cohort of 1,206 patients hospitalized with

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2022 ACR/EULAR Giant Cell Arteritis Classification Criteria Giant cell arteritis (GCA) has historically been a clinical diagnosis (visual loss, headache, jaw pain, scalp tenderness, etc) supported by labs and histopathology. https://t.co/DN82rXco3N https://t.co/dpIixCFseT
2022 ACR/EULAR Giant Cell Arteritis Classification Criteria Giant cell arteritis (GCA) has historically been a clinical diagnosis (visual loss, headache, jaw pain, scalp tenderness, etc) supported by labs and histopathology. https://t.co/inHKcdXLmD https://t.co/g9v1zWkmRp
GCA,woman

2022 ACR/EULAR Giant Cell Arteritis Classification Criteria

Dec 12, 2022

Giant cell arteritis (GCA) has historically been a clinical diagnosis (visual loss, headache, jaw pain, scalp tenderness, etc) supported by labs and histopathology. Yet the diagnosis and classification of GCA has evolved, so much so that the ACR and EULAR have updated the 1990 Classification

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Imaging in PMR

Nov 18, 2022

Despite the fact that polymyalgia rheumatica is the most prevalent inflammatory rheumatic disease in those over 65 years of age, progress in its diagnosis, monitoring and management have failed to garner momentum in decades past.

However, ACR22 has fostered significant promise for its future.

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PMR spotlight

ACR22: Polymyalgia Rheumatica in the Spotlight

One of the enduring legacies of ACR 2022 for me will be the emphasis on polymyalgia rheumatica (PMR). Despite being highly inflammatory and relatively common, a remarkable paucity of trials have been run in this space. Read on for a quick PMR-roundup from the meeting! 

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Just so good to see PMR on the plenary stage at #ACR22, after #EULAR2022 too SAPHYR study: sarilumab allows for - a quicker steroid wean & less toxicity - but also far more disease remission, quicker symptom resolution, better quality of life Game-changing. ABST1676 @RheumNow https://t.co/ZVqlMNoniu https://t.co/Fv3VRZrKGe
Great moderating PMR talk w/@SattuiSEMD this AM; phenomenal slides @drceowen re:imaging in PMR Big ?s: -Who needs this? All/some/many -Which modality? Nice summary slide -How to treat "subclinical" GCA (risk of overtreatment imo) Ideas for next year? #ACR22 @rheumnow #ACRBest https://t.co/akvsud3YVO
Ab1676 #ACR22 SAPHYR: Sarilumab in Refractory PMR 52wk SAR 200 mg q2w + 14w taper GC v PBO+GC taper Primary endpt: sustain response at 52w Early term 2/2 COVID, 117 pt SAR remission 28% vs PBO 10%, p=0.02 Data consistent when removes CRP data PBO: more GCs 2/2 PMR flare @Rheumnow https://t.co/kHq3juULX1
Sarilumab (IL-6R inhibitor) in phase 3 trial for relapsing PMR (SAPHYR trial). Key inclusion: Disease flare while taking >7.5mg prednisolone Sustained remission: resolution of symptoms, normalisation of CRP, adherence to prednisolone taper @RheumNow #ACR22 #Plenary
Spiera et al. Sarilumab in refractory PMR (SAPHYR) - Phase 3 RCT. Significant effect of IL-6i. @RheumNow #ACR22 Abstr#1676 https://t.co/2MS441B8gU https://t.co/jBd7YJKrTs
SAPHYR results: SAR + 14 wk GC taper showed efficacy vs comparator arm in steroid refractory PMR, including clinically meaningful improvement in QoL. No new safety signals. Plenary Abs 1676 #ACR22 @RheumNow https://t.co/mHu3e9JbCp https://t.co/93kbczSTfS
This slide reminds me of a recent case I encountered 🧐 How can we differentiate #vasculitis vs. atherosclerosis? 👇 TAK - stenosis occurs in proximal arteries, thoracic aneurysms, US: conc, smooth thickg w/ long segment stenosis #ACR22 @Rheumnow #RheumTwitter @rheumarhyme https://t.co/So4VKsfBm4
Sarilumab (SAR) + 14 wk GC taper demonstrated significant efficacy vs the comparator arm in steroid refractory PMR patients and improvement in quality of life. Sustained remission was 28.3% SAR vs 10.3% comparator arm. Spiera R Abs#1676 https://t.co/gXGJzbYLHK #ACR22 @RheumNow https://t.co/oZBsRtxMUw
Interesting study (MAGICA) of withdrawing TCZ in GCA after 1 year of therapy Comparing abrupt vs gradual discontinuation Very important clinical quesiton; kudos to FVSG for making this happen! #ACR22 #Vasculitis22 @RheumNow https://t.co/912GCFik6L
PMR is no a disease of vague shoulder and hip pain. It's something much more specific: a chronic inflammatory disease of musculotendinous structures. We're starting to understand the real story. @drceowen lays it out for #ACR22 this morning @EBRheum @SattuiSEMD @RheumNow https://t.co/thqtCwSULM
How do we know what PMR is all about? Imaging has helped enormously, and every step of the way, imaging has got better and better. Specific findings which reveal the culpable pathology. @drceowen #ACR22 @RheumNow https://t.co/4OOOk0F3jW
Terrier @TerrierBen et al. PNEUMOVAS -pneumococcal vaccination in AAV treated with RTX Double dose of PCV13 at day 0 and day 7 followed by single dose of PPV23 at month 5 significantly improves antibody responses (2 in figure) @RheumNow #ACR22 Abstr#L016 https://t.co/qKqgvv7ZwI https://t.co/UHCuZNSF54
Promises to be a fantastic session! 🌟Delighted PMR is getting the attention it deserves 🌟 2pm GMT/ 9am EST #ACR22 @RheumNow @SattuiSEMD @EBRheum @drceowen https://t.co/ShRTS1DLXO
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