Rheum Cat Profile picture
Nov 11 11 tweets 8 min read
#ACR22 #ReviewCourse

Dr Bobo Tanner - Osteoporosis

🦴 Image
Trying to think of the last time I tweeted this topic. 2018?

#ACR22
When to order DXA? The old, standard rules per Medicare

3 & 5 are particularly pertinent to us in rheum

#ACR22 #ReviewCourse Image
What are the definitions of osteoporosis beyond T score =< -2.5?

#ACR22 #ReviewCourse Image
What labs should we order for osteoporosis?

👉Phos: can lead you towards rare bone dz

👉24 hour urine for Cr, calcium to understand Ca++ balance

❗️Biotin supplements can interfere with tests

#ACR22 #ReviewCourse Image
Helpful table for osteoporosis tx options (FDA toolbox)

Bisphosphonates & Denosumab: fellows, memorize this slide for the rheum boards and ITE

#ACR22 #ReviewCourse ImageImage
Duration of therapy? Drug holiday?

Most benefit 3 yrs (IV), 5 yrs (PO) for bisphosphonates

❗️Drug holiday can bring risk of AEs down. Drug holiday is "not a drug retirement"

👉If doing dental extraction, target 3-4m into denosumab

#ACR22 #ReviewCourse Image
A modified version of this figure would be helpful for helping pts weigh risks/benefits when considering ONJ risk

#ACR22 #Reviewcourse Image
Guidance on how to deal with rebound fx risk after stopping denosumab

Consider dosing IV zoledronic acid 6 months after stopping denosumab

#ACR22 #ReviewCourse Image
Treatment failure?

Review adherence, review the diagnosis

THEN consider switching tx

#ACR22 #ReviewCourse Image
Very high risk pt (e.g., elderly and severe osteoporosis): go the anabolic route

Considerations of tx for different life stages

#ACR22 #ReviewCourse Image

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More from @rheum_cat

Nov 13
#ACR22 social media talk, very meta Image
Part 1️⃣: optimize your conference tweeting
If you're reading this you probably know all of this!

The first pro-tip was figure out the conference hashtag
The second? Engage with others in rheum
#ACR22 Image
What else?

👉amplify your group
👉amplify speakers and sessions of interest
👉amplify your colleagues so they will amplify you in turn

#ACR22
Read 10 tweets
Nov 13
#ACR22 infection (COVID) posters Image
Abs 0784 @CCalabreseDO

Cleveland Clinic breakthrough infections, including data on n=21 who received Evusheld

📌Publication here: pubmed.ncbi.nlm.nih.gov/35791921/

#ACR22
@CCalabreseDO Abs 0779 @CCalabreseDO

Experience with evusheld PrEP with IMID on BCDT at Cleveland Clinic

📌Publication here: pubmed.ncbi.nlm.nih.gov/36123015/

#ACR22
Read 13 tweets
Nov 13
The EULAR e posters were tiny (bad) but speakers could zoom in and out (good)

That would have been nice for #IgniteTalks #ACR22
The sound is adequate though. EULAR issue was that the sound was poor in their (smaller) poster tour stages #ACR22 #IgniteTalk
Read 4 tweets
Nov 13
#ACR22 epidemiology posters Image
Abs 0700 @zach_wallace_md
💻Using NLP, ML algorithms to identify ANCA vasculitis cases

They also looked at the difference in performance metrics with/without filtering keywords

An explosion of NLP studies in rheum! #ACR22
@zach_wallace_md Abs 0732 Ho, et al. @JYazdanyMD @MilenaGianfran
💻Part of the explosion of NLP studies in rheum

Here the UCSF group aimed to capture VZV cases (differentiate from vaccination); and to capture active vs historical cases

See their diagrams explaining the steps!
#ACR22
Read 13 tweets
Nov 13
We have learned quite quickly that a virtual ONLY poster hall mixed into a hybrid meeting doesn't work well.

Poor wifi and the crashing platform compound the problem

And if it's online ONLY, is that truly hybrid?

#ACR22
This is not a complaint thread. I am hoping we can have discussion about what works/doesn't work, and what could be done next year for #ACR23
It goes without saying that an in-person poster hall is the most requested item on the wishlist for #ACR23

@GrantSchulert @Tuhina_Neogi
Read 5 tweets
Nov 13
Biostatician @MikeLaValley8 @BU_BMC_Rheum presents a quick overview on how to appropriately interpret results from studies #ACR22

Of course this is not an exhaustive deep dive, but covers some common errors of interpretation Image
@MikeLaValley8 @BU_BMC_Rheum First, what is your research question? What is the question you are trying to answer with t he study?

👉Does this exposure CAUSE this outcome?

#ACR22 Image
@MikeLaValley8 @BU_BMC_Rheum What are common observational study designs and what are big issues to watch out for?

These are issues that can affect the validity of their results.

There are more potential issues within these study designs that is beyond the scope of this table

#ACR22 Image
Read 15 tweets

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