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Jun 4 • 7 tweets • 6 min read
#EULAR2022
How To Treat (HOT)
Anti-phospholipid syndrome Image
#EULAR2022
How To Treat (HOT)
Anti-phospholipid syndrome
🩸Primary Thromboprophylaxis
🩸Aspirin is recommended but might not be sufficient
🩸VKA use is asso. ⬆️ Bleeding risk (Risk>Benefit) ImageImageImageImage
#EULAR2022
How To Treat (HOT)
Anti-phospholipid syndrome
🩸Secondary Prophylaxis
🩸INR: 2-3 for venous thrombosis (Controversial)
🩸Is not effective in preventing arterial events though ImageImageImageImage
#EULAR2022
How To Treat (HOT)
Anti-phospholipid syndrome
🩸For Recurrent/Arterial Thrombosis
🩸INR 3-4 or 2-3 with LDA might be needed
🩸We still need more data on this
🩸The role of NOACs is controversial might be tried in low risk pts who don't tolerate VKA ImageImage
#EULAR2022
How To Treat (HOT)
Anti-phospholipid syndrome
🩸CAPS: Triple therapy
🩸GC+ IVIG/PLEX+ anticoagulation works well ImageImageImageImage
#EULAR2022
How To Treat (HOT)
Anti-phospholipid syndrome
🩸 Ritux and Eculizumab have shown some efficacy in refractory CAPS ImageImageImage
#EULAR2022
How To Treat (HOT)
Anti-phospholipid syndrome
🩸Obstetric APS
🩸1 Prophylaxis: LDA or LDA+LMWH
🩸2 Prophylaxis: LMWH + LDA
🩸Refractory: LMWH+LDA+HCQ+ Low dose steroids (Upto 15mg/day) ImageImage

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More from @ERheumat

EnvisionRheumat Profile picture
Jun 6
#EULAR2022
Pain in rheumatic and musculoskeletal diseases
😩Pathophysiology of pain in patients with RMDs is not always Nociceptive and can be nociplastic
😩Differentiation between inflammation-related and unrelated pain is important Image
#EULAR2022
Pain in rheumatic and musculoskeletal diseases
😩Pain can be Nociceptive, Neuropathic and Nociplastic
😩Or can be primary/Secondary
😩Pain sensitisation, processing and response are important for proper assimilation of pain ImageImageImageImage
#EULAR2022
😩No standard method to measure central pain
😩FMS can be present in upto 50% of patients
😩Asso with Higher disease activity and higher biologic use/change
😩A no. of central mechanisms contribute to pain ImageImageImageImage
Read 7 tweets
EnvisionRheumat Profile picture
Jun 5
#EULAR2022
What is New (WIN)
Osteoarthritis – evolving treatments
This talk is a must-watch on-demand - highly recommended
🗝Proposed NICE-UK guidelines for Image
#EULAR2022
🗝Most trials have tried correcting catabolic pathway
🗝 Most trials in OA have failed
🗝Cartilage though sparsely cellular/vascular exquisitely sensitive to injury
🗝 Max polymorphism in OA is found in the Anabolic pathway ImageImageImageImage
#EULAR2022
What is New (WIN)
Osteoarthritis – evolving treatments
🗝Shear stress leads to damage while compression leads to regeneration
🗝Has been utilized in Joint distraction showing good results Image
Read 6 tweets
EnvisionRheumat Profile picture
Jun 4
#EULAR2022
Rheumatology across boundaries
The eye in rheumatic diseases
🧿The Pathophysiology of Uveitis is poorly understood
🧿 Uveitis is thought to be due to enthesitis of ciliary body attachment
🧿TH17 and TH1 are major mediators of inflammation ImageImageImageImage
#EULAR2022
Rheumatology across boundaries
The eye in rheumatic diseases
🧿 Most common extra-articular feature
🧿 HLA-B27+vity, Recurrent uveitis and IBP 🚩 for rheumatology referral ImageImageImage
#EULAR2022
Rheumatology across boundaries
The eye in rheumatic diseases
🧿 Non-Anterior non infectious Uveitis has a no of causes 👉🏻 makes studying the disease difficult
🧿 Sarcoid, Behcet's other imp causes
🧿 Topical Rx 1st for Anterior Uveitis
🧿 Systemic 1st for NIU ImageImageImage
Read 6 tweets
EnvisionRheumat Profile picture
Jun 4
#EULAR2022
IBD management for Rheumatologist
🔎The options have been increasing over the years
🔎Remission rates have still not crossed 30-40% Ballpark ImageImageImage
#EULAR2022
IBD management for Rheumatologist
🔎Target of therapy is
♦️Clinical remission in short term
♦️Histological remission in medium-term
♦️Disease Modification in Long
🔎Histological activity better marker of future Flare ImageImageImage
#EULAR2022
IBD management for Rheumatologist
🔎Very Few Head to head trial to decide biologic of choice
🔎 Vedoli>Adali but Ustki=Adali ImageImageImage
Read 7 tweets
EnvisionRheumat Profile picture
Jun 4
#EULAR2022
New treatment strategies and approaches to young adults with inflammatory myositis
Treatment options available their doses in IIM Image
#EULAR2022
New treatment strategies and approaches to young adults with inflammatory myositis
♦️MTX+GC>>MTX+CIC>GC alone ImageImage
#EULAR2022
New treatment strategies and approaches to young adults with inflammatory myositis
🪩RIM trial
♦️Better response in JDM
♦️Antibody positive (Mi2,Jo1 +ve ) performed better than Ab negetive ImageImage
Read 8 tweets
EnvisionRheumat Profile picture
Jun 4
#EULAR2022
Contrasts in pathomechanisms and treatment targets between adult and paediatric inflammatory myositis
👁‍🗨 Awesome class on IIM pathogenesis
👁‍🗨The MSA and Phenotype Slide is 👌🏻👌🏻 ImageImageImage
#EULAR2022
Contrasts in pathomechanisms and treatment targets between adult and paediatric inflammatory myositis
👁‍🗨Summary of Mechanisms
👁‍🗨DM/JDM👉🏻 CD4 and TH17 mediated
👁‍🗨 Both Inflammatory and non inflammatory factors contribute ImageImageImage
#EULAR2022
👁‍🗨 Type I,II IFN sig
👉🏻 DM/JDM>>ASS/PM>IBM>IMNM
👉🏻 Mi2/TIF/MDA5>>Jo1>>SRP/HMCGR
👁‍🗨⬆️INF levels 👉🏻⬆️ disease activity
👁‍🗨pDC and mDC mediated
👁‍🗨Mediate Muscle atrophy(perifasicular) and Capillary loss ImageImageImage
Read 7 tweets

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