Maybe we should lower the dose of biologic if pts are in remission: High Drug levels can predict infx risk in RA pts on biologics from BSRBR registry and BRAGGSS cohort Abstr#961 @RheumNow #acr18
— k dao (@KDAO2011) October 21, 2018
Had great fun getting filmed for @RheumNow at #ACR18 today! pic.twitter.com/lECVkStCeF
— David Liew (@drdavidliew) October 21, 2018
Baricitinib 6 year pooled data set: no inc. mortality, SIE, zoster, malignancy, VTE (at 2 mg/d but may be inc with 4 mg/d) Abst#962 @rheumnow #acr18
— k dao (@KDAO2011) October 21, 2018
Among 265 pts with JIA 17 yrs after dx in a Nordic cohort, over HALF had abnormal TMJs by imaging. Abstract 980 Dr. Mia Glerup #dontforgettheTMJ #ACR18 @RheumNow
— Nicole Bitencourt (@NicoleBitencou5) October 21, 2018
Tocilizumab does not significantly increase GI perforation in Swedish cohort after adjusting for confounders abst#960 @rheumnow #acr18
— k dao (@KDAO2011) October 21, 2018
Dr Jeff Curtis: tocilizumab does NOT inc risk for MI, stroke, CVD death compared to other biologics (infliximab carried highest risk): from Medicare and Marketscan claims data: Abstr#958 @rheumnow #acr18
— k dao (@KDAO2011) October 21, 2018
Curbside consult at #Acr18: is EHOA a more severe from of OA or a distinct diagnostic entity? High association w/ metabolic syndorme and ⬆️ inflamm markers ( CRP,sIL-2R) support the latter but no consensus to date. NO evidence of HCQ& bDMARDs efficacy in EHOA @RheumNow pic.twitter.com/CMA51cQ0JJ
— Olga Petryna (@DrPetryna) October 21, 2018
#ACR18 @RheumNow the rise and rise of the JAK inhibitors. Are we witnessing the next phase in the RA treatment paradigm?
— Ian N Bruce (@Lupusdoc) October 21, 2018
Curbside consult by Dr. Jill Buyon: What to advise a pregnant some with +SSA/SSB?
-risk of heart block 2% if no prior hx and 18% if prior child with CHB
-Breast feeding is safe
-Low titer anti-Ro confers lower risk
-Management as per algorithm below @RheumNow #acr18 pic.twitter.com/EUyVsClkvp— Olga Petryna (@DrPetryna) October 21, 2018
Dr Petri noted that there is going to be a new antimalarial drug without toxicity : desethylhydroxychloroqyine @rheumnow #acr18
— k dao (@KDAO2011) October 21, 2018
"Self-efficacy is an important predictor of behavior" Dr. Juliet Aizer abstract 861. Using a self efficacy tool to measure trainees' comfort with referring to the literature to answer clinical questions #ACR18 @rheumnow
— Nicole Bitencourt (@NicoleBitencou5) October 21, 2018
With a greater number of treatment options, comes greater responsibility to find the subgroups to match the options. First steps with EGPA to pick those phenotypic subgroups from the outset from a multicentre European study #ACR18 ABST0908 @RheumNow pic.twitter.com/mD8ktzKwQF
— David Liew (@drdavidliew) October 21, 2018
#ACR18 @RheumNow abs891 upadacitinib in MTX naive RA. 50% had a DAS28 'remission' @ 24 weeks vs 19% on MTX. PROs and xray changes favour Upadacitinib.
— Ian N Bruce (@Lupusdoc) October 21, 2018
Riociguat vs placebo N=121 with moderate dcSSc showed less skin progression and less new organ involvement or worsening and slightly less lung worsening. Drug that treats PAH via guanylate cyclase. Interesting MOA in SSc in this phase ll RCT abs903 #ACR18 @RheumNow pic.twitter.com/xEaKCO5XXG
— Janet Pope (@Janetbirdope) October 21, 2018
Can we rely on MRI to diagnose #AS? Abst 897 Dr Baraliakos: MRI spine/SIj in 802 young healthy people were analysed. 18% had bone marrow oedema in SIJ; fatty lesions seen in 86% Answer: Be careful! Specificity better with thoracic changes & >5 lesions #ACR18 @RheumNow
— Philip Gardiner (@PhilipGardiner) October 21, 2018
Quote: ‘Imaging should always be interpreted in the clinical context’ Denis Poddubnyy #ACR18 @RheumNow #AS
— Philip Gardiner (@PhilipGardiner) October 21, 2018
ACR program addressing the pediatric rheumatology workforce shortage–funding undecided pediatric residents to attend the ACR national meeting and mentoring them along the way. Abstract 862 Dr. Sangeeta Sule #ACR18 @RheumNow
— Nicole Bitencourt (@NicoleBitencou5) October 21, 2018
Abst885 in RA patients on Tofacitinib Herpez Zoster risk increases two-fold with concomitant use of steroids while Methotrexate addition does not increase risk in either group:
TOF 3.4/100py
TOF+MTX 3.7/100py
TOF+GC 6.0/100 py
MTX+GC+TOF 6.5/100py
#acr18 @rheumnow— Olga Petryna (@DrPetryna) October 21, 2018
📸The Rheumatology Twitter Community (#RheumaTwitters) 📸
Tweet Up #ACR18
Networking with colleagues is one of the top reasons #rheumatology professionals come to the @ACRheum Annual Meeting@psufka@RheumNow@chriswincup@EBRheum@carvicab@carlostororeuma@LeoFerreyraG
Etc… pic.twitter.com/cJDSV56Q03— Juan Ovalles, MD, PhD (@DrJuanOvalles) October 21, 2018
Abst883 seropositivity associated w/increased risk of osteoporosis in male RA pts<70yo. Out of 67 osteoporosis patients
RF+ vs RF- 30 and 9 respectively, chi- square 0.0076.
CCP+ vs CCP- 18 and 7, chi- square 0.027. #acr18 @rheumnow— Olga Petryna (@DrPetryna) October 21, 2018
#ACR #874 Hyon Choi.
Data from >44k men in health prof study: 80% of population attributable risk of incident gout accounted for by 5 modifiable risk factors (weight, diet, alcohol, diuretics, vit C). Overweight biggest contributor.#SocialDeterminants #SDOH @RheumNow pic.twitter.com/Q2cH5zCGz9
— ǝlʇʇıɥʍ ɯɐs (@samwhittle) October 21, 2018
YIR 10. New rheumatic diseases related to checkpoint inhibitors. >100 papers on this in the past year.
Seeing inflam arthritis, lupus-like dz, myositis, sarcoid, Sjogren’s, vasculitis.
Can’t just stop these drugs, since they are keeping their cancer at bay. #ACR18 @RheumNow
— Dr. Paul Sufka (@psufka) October 21, 2018
Abstract L01: excess risk of CV disease in pts treated with febuxostat that have prior CVD… But no increased risk of CVD with any XOI if no prior CVD. #ACR18 @RheumNow pic.twitter.com/cFBCa3bHFV
— Dr. Paul Sufka (@psufka) October 21, 2018
Abstract 560: if a patient stable on etanercept has their copay go up >$40, they're much more likely to switch meds and lose control of their dz. #ACR18 @RheumNow pic.twitter.com/9RyrRnYSwo
— Dr. Paul Sufka (@psufka) October 21, 2018
Last talk of #ACR18 Review course coming up. Here are my notes on most of the lectures (missed some because of need for ☕️ after lunch) https://t.co/Kk0cKuO5Tp
— Dr. Paul Sufka (@psufka) October 20, 2018
Do rheumatologists do a good job asking about CV disease in our RA patients? Quite under reported and shows difficulty to capture in registries @RheumNow #ACR18 pic.twitter.com/RWmr4PUQLG
— Dr. Arthur Lau (@ArthurRheum) October 21, 2018
Registry study shows VTE rates similar btw ADA and Tofa. Small event rates overall in over 8000pts #ACR18 @RheumNow pic.twitter.com/J2CK9uQSbP
— Dr. Arthur Lau (@ArthurRheum) October 21, 2018
Over the years more are prescribing other MOAs instead of TNFs. Too small numbers for now to analyze by MOA. We’ll see how JAKs impact in future @RheumNow #ACR18 pic.twitter.com/ULyqgpd5ZW
— Dr. Arthur Lau (@ArthurRheum) October 21, 2018
Abst702 Meta-analysis Of RCTs: bDMARDs slow down radiographic progression in PsA regardless of concomitant MTX therapy. Radio-protective effect of IL17 not influenced by prior TNFi use #ACR2018 @RheumNow
— Olga Petryna (@DrPetryna) October 21, 2018
Abst837 In sero+RA pts high dose flu vaccine superior to standard dose in eliciting immune response. SC for below types: H3N2 22.3% vs 8.6%; B/Bris 44.6% vs 28.6%; H1N1 51.1% vs 30.0% . SP rates H3N2 48.5% vs 30.9%; B/Bris 60.9% vs 50.7%; H1N1 80.4% vs 73.5% #ACR18 @RheumNow
— Olga Petryna (@DrPetryna) October 21, 2018
EULAR future of RA: 3D ultrasound, MR/US, and CT/US fusion imaging: the future of imaging in rheumatoid arthritis? @RheumNow #ACR18
— Brittany A (@MissbeeMD) October 21, 2018
Dr Petri: Compelling published data on HCQ benefits @rheumnow #acr18 1. Decrease thrombosis 2. Decrease flares 3. Decrease new renal 4. Triples MMF response 5. Improve survival *Risk for retinopathy is so low compared to benefits. @rheumnow #acr18
— k dao (@KDAO2011) October 21, 2018
Could Statins reduce disease activity in #AS (Abst 895)? Dr Dau found some trends to suggest that it might, but in Q&A most were unconvinced by the statistics. Futher studies needed! @RheumNow #ACR18
— Philip Gardiner (@PhilipGardiner) October 21, 2018
EULAR future of RA treatment: incorporate information technology, focus on integrated care, shared decision making into care. @RheumNow #ACR18 pic.twitter.com/Y4aPGB6iqh
— Brittany A (@MissbeeMD) October 21, 2018
Insults flung by Dr Petri “The AAO is from a different planet when it comes to SLE!” In #TheGreatDebate #acr18 @rheumnow
— k dao (@KDAO2011) October 21, 2018
#ACR18 @RheumNow abs 890. Upadacitinib (JAK1 inhibitor) in RA superior to placebo and adalimumab in MTX-IR population and reduced radiographic progression vs placebo. Also PROs better with Upa vs other groups.
— Ian N Bruce (@Lupusdoc) October 21, 2018
In myositis associated ILD, relapsers can be predicted by high levels of KL-6 (Krebs von den Lungen) antigen at baseline compared to non-relapsers. Abstract 877 Dr. Satoshi Takanashi #potentiallyusefulbiomarker #ACR18 @rheumnow
— Nicole Bitencourt (@NicoleBitencou5) October 21, 2018
Chicken or egg? Increased gut dysbiosis in active AAV, goes back to normal with immunosuppressives and outright steroids, and worse disease activity has worse gut dysbiosis. Correlation or causation (and if so, which way)? Interesting from Dr. Najem @NIH #ACR18 ABST0906 @RheumNow
— David Liew (@drdavidliew) October 21, 2018