Risk for infection with TNFi+MTX is NOT increased compared to triple DMARD Rx confirmed in large claims database of commercial insurance #ACR18 @RheumNow abst#218 pic.twitter.com/p25QwUX3ZN

— k dao (@KDAO2011) October 21, 2018

Plenary session: High dose flu vaccine is safe and has better efficacy than standard flu vaccine in our adult RA patients abst#837 @RheumNow #ACR18 pic.twitter.com/MzAB6mUnHS

— k dao (@KDAO2011) October 21, 2018

Q&A 'Over half the GCA patients had LVV+ on PET/CT' [note to self: need to insist on more PET/CT and push for Tocilizumb] #ACR18 @RheumNow #GCA

— Philip Gardiner (@PhilipGardiner) October 23, 2018

Abst 884 Jeff Sparks. Predictors of ILD in #RA in 1281 patients: High disease activity, seropositivity – no surprises #ACR18 @RheumNow

— Philip Gardiner (@PhilipGardiner) October 23, 2018

Personal observation here: over 25 years of practice I’ve seen disease activity fall and severe ILD become uncommon – but MTX use much more common. Time to rethink! #Acr18 #RA

— Philip Gardiner (@PhilipGardiner) October 23, 2018

Abst 2977 Dr Werth Lenabasam – cannabinoid receptor type 2 (CB2) agonist that activates resolution of innate immune responses – effective in reducing interferon beta and gamma in #Dermatomyositis skin biopsies #ACR18

— Philip Gardiner (@PhilipGardiner) October 24, 2018

Lisa Sammaritano quoting a patient panel assisting in the development of Reproductive Guidelines for Rheumatology Patients. “My rheumatologist knows me better than my gynecologist.

— William Shergy (@WilliamShergy) October 23, 2018

2789 Ph3 Apremilast for Behcet’s oral ulcers: significantly lower number of OU (P≤0.0015) &reduction in OU pain (P≤0.0035) vs PBO at wks 1-12. APR efficacy sustained at wk28: 62% pts achieved complete response of OU &70% relative
reduction in OU pain from BL. #acr18 @rheumnow

— Olga Petryna (@DrPetryna) October 23, 2018

It may be the last day of #ACR18 but huge interest for talk by @Deepakarao (standing room only!) Really interesting presentation showing PD-1hi CXCR5- T peripheral helper cells are significantly expanded in #SLE In particular in those with high SLEDAI and dsDNA titres

— Chris Wincup (@chriswincup) October 24, 2018

Congratulations to Dr. @VickiShanmugam, chair of ACR annual meeting planning subcommittee, @donna_hoyne VP of Education, and the whole team at ACR for putting on an outstanding conference in Chicago! #ACR18

— Angus Worthing MD (@AngusWorthing) October 24, 2018

*Fewer* wound complications and infections in RA patients continuing methotrexate throughout orthopedic surgeries. Let your ortho colleagues know this! #ACR18 @rheumnow pic.twitter.com/eDtLvuE7Fw

— Dr. Paul Sufka (@psufka) October 20, 2018

Even low dose prednisone (5mg/day) associated with increased cumulative risk of infection #ACR18 @rheumnow pic.twitter.com/UULnw8LCdW

— Dr. Paul Sufka (@psufka) October 20, 2018

Higher number of dominant B cell receptor clones in peripheral blood predicts the development from arthralgia to active disease in rheumatoid arthritis, de Vries N #acr18

— Dr. Antoni Chan (@synovialjoints) October 21, 2018

Genetic Risk score prediction in Ankylosing Spondylitis using nearly 4000 SNPs in the European cohort showed performance as good as MRI screening and may help predict development of #ankylosingsponylitis Li Z #ACR18

— Dr. Antoni Chan (@synovialjoints) October 21, 2018

Interesting study in this very hard to treat population MDAS positive ILD . Combined Tacrolimus and IV Cyclophosphamide have a better survival rate. But at the expense of higher risk of infections despite prophylaxis #ACR18 #CleClinicRheum pic.twitter.com/aS0w8UQAME

— Rula Hajj-Ali (@RulaHajjAliMD) October 21, 2018

Case reports prompted prospective trial from Tsuji H showing evidence of combined high dose GC + TAC + CYC beneficial in idiopathic inflammatory myopathy with interstitial lung disease and MDA-5 antibody #ACR18

— Dr. Antoni Chan (@synovialjoints) October 21, 2018

Genetic predisposition to lupus in women may be contributed to by X chromosomes that encode TLR7 the receptor for RNA with B cell hyperproliferation when stimulated, Pascual M #sle #lupus #tlr #ACR18

— Dr. Antoni Chan (@synovialjoints) October 22, 2018

Interesting study of JAK-1 inhibitor in ankylosing spondylitis #ankylosingspondylitis #rheum #ACR18 https://t.co/c423eXEfqx

— Dr. Antoni Chan (@synovialjoints) October 22, 2018

METEOR registry analysis of data from 12 countries shows association between socioeconomic status of a country and disease activity in RA patients. Biologic DMARDs when available in poorer countries had less than expected effect on disease activity, Bergstra SA #ACR18

— Dr. Antoni Chan (@synovialjoints) October 24, 2018

The RISE registry showed that for 50% of RA patients, medication remained unchanged over the follow-up period, despite moderate to high disease activity. The treatment least likely to be altered was the combination of MTX and a biologic, Curtis J #ACR18

— Dr. Antoni Chan (@synovialjoints) October 24, 2018

REMORA app and wearables provided data that showed positive outcomes with better information about short-lived flares, better self-awareness of the disease and better conversations and more personalised care, Dixon W #ACR18

— Dr. Antoni Chan (@synovialjoints) October 24, 2018

checkpoint inhibitor-related myositis associated with poor outcomes. #2976 @RheumNow @HealioRheum #ACR18

— Cassandra Calabrese (@CCalabreseDO) October 24, 2018

Great summary in the ⁦@ACRheum⁩ Daily News of the ‘2018 Great Debate examines questions about hydroxychloroquine dosing guidelines’ #ACR18 https://t.co/ZKkrcixo5v

— Dr. Paul Sufka (@psufka) October 23, 2018

Would you leave ABIM and join alternate board certification bodies (eg: ABAI: American Board of Allergy and Immunology). ACR is looking into making a new combined board Am Board if Allergy, Immunology, and Rheumatology — ABAIR

— k dao (@KDAO2011) October 23, 2018

This comes up in real life, and will challenge your clinical skills. #ACR18 https://t.co/O03w6J9r9e

— Dr. Paul Sufka (@psufka) October 23, 2018

Questions about checkpoint inhibitors: Are immune-related AEs predicative of cancer therapy response? Will immunosuppressives required to treat patients with immune related AEs blunt the anti-tumoural effects? Mixed results to date. @RheumNow #ACR18

— Maeve Gamble (@MaeveGamble) October 22, 2018

Fun fact: Anti-Ro and -La were named after patients named Robair and Latiner 🤓 #lupus #ACR18 @RheumNow

— Maeve Gamble (@MaeveGamble) October 22, 2018

This is why it's important that rheumatologists discuss contraception and family planning with their patients. https://t.co/9YPNGsZsGP

— Maeve Gamble (@MaeveGamble) October 24, 2018

There is NO reason to withhold folate on day of MTX. Folic acid does not enter the cell via the RFC (folinic acid does). Therefore no evidence for competition. – Dr Joel Kremer @RheumNow #ACR18 🤔

— Maeve Gamble (@MaeveGamble) October 22, 2018

Want to help reduce the wait time for people to get in to see a rheumatologist? Donate to the ACR Rheum Research Foundation! In addition to funding research to cure arthritis, @RheumResearch funds training programs like the one I trained at #Georgetown #ACR18 pic.twitter.com/dfkrdLlaNE

— Angus Worthing MD (@AngusWorthing) October 23, 2018

Breast feeding update in Rheumatic Patients:
TNF inhibitors as a class are compatible with breast feeding.

Prednisone doses < 20 mg/day OK for breast feeding. Patients on higher doses should delay breast feeding for four hours after administration #ACR18 #CleClinicRheum

— Emily Littlejohn (@ELittlejohnDO) October 23, 2018

#ACR18
Short term relief during breastfeeding:
🌼 NSAIDs are compatible (ibuprofen preferred – short acting)
🌼 prednisone <20mg a day compatible
🌼 if using prednisone >20mg a day, then delay breastfeeding or discard milk for 4hr after administration

— Kanika Monga, MD (@DrKanikaMonga) October 23, 2018

#ACR18 social media dinner with @rheumecraig @samwhittle @DrBhana @alhkim @jeffsparks @EBRheum @PhilipGardiner @BeckySueToo pic.twitter.com/Kw0FejsnIE

— Dr. Paul Sufka (@psufka) October 24, 2018

Abstract 428. Pain reduction over 12 months using methotrexate for knee osteoarthritis. Good study: RCT, 12 months, statistically significant pain reduction in knee pain. (by comparison, MTX doesn't work for hand OA) #ACR18 pic.twitter.com/lwdNNZvR0R

— Dr. Paul Sufka (@psufka) October 24, 2018

Abstract 221: DIP involvement in RA is about 2%. More women than men, and more in pts with higher disease activity. Might be poor prognostic indicator. #ACR18 pic.twitter.com/YQR8kknRTl

— Dr. Paul Sufka (@psufka) October 24, 2018

Abstract 404: using IL-17 inhibitor to treat supraspinatus tendinopathy in a rat model. This is a common shoulder tendinopathy, and IL-17 Involved in human cases. #ACR18 pic.twitter.com/KwK6slNqA5

— Dr. Paul Sufka (@psufka) October 24, 2018

Abstract 2264: data to support use of methotrexate in granulomatous mastitis with good results. (Be aware of this condition – you *will* eventually see it) #ACR18 pic.twitter.com/SsDdz21t5r

— Dr. Paul Sufka (@psufka) October 24, 2018

My article on @RheumNow: 'Negotiation Skills for Rheumatologists' https://t.co/NfsTXd9qLK #ACR18

— Dr. Paul Sufka (@psufka) October 24, 2018

checkpoint inhibitor-related myositis has unique phenotype – myocarditis, myasthenia gravis-like symptoms abstract #2976 #ACR18 @RheumNow

— Cassandra Calabrese (@CCalabreseDO) October 25, 2018

RheumNow expanded twitter coverage of the ACR 2018 Annual meeting sponsored in part by Eli Lilly. All content chosen and distributed by RheumNow and its faculty.

— Dr. John Cush (@RheumNow) October 25, 2018

RheumNow expanded twitter coverage of the ACR 2018 Annual meeting sponsored in part by Novartis. All content chosen and distributed by RheumNow and its faculty.

— Dr. John Cush (@RheumNow) October 25, 2018

RheumNow expanded twitter coverage of the ACR 2018 Annual meeting sponsored in part by Horizon Pharma. All content chosen and distributed by RheumNow and its faculty.

— Dr. John Cush (@RheumNow) October 25, 2018

Take-home message from the basic science Year in Review is that TLR7 links together all this year’s novel findings in SLE pathogenesis. #ACR18 @RheumNow

— ǝlʇʇıɥʍ ɯɐs (@samwhittle) October 21, 2018