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Nov 11, 2022 17 tweets 17 min read Read on X
Dr Carla Scanzello on OA #ACR22 #ReviewCourse

A review of the radiographic features that show us the extent of damage that's accrued over time

BUT they don't tell us anything about the pt's experience with the OA illness ImageImage
There's only one slide on an important and big concept: pain sensitization and its impact on the OA pain experience

See pioneering work in humans by @Tuhina_Neogi & colleagues

#ACR22 #ReviewCourse Image
What has MRI taught us about OA?

🦴What OA isn't: a disease of solely cartilage

🔍Important in identifying potential tissue sources of pain, e.g., synovitis, bone marrow lesions

#ACR22 #ReviewCourse Image
.@eular_org recs on imaging for OA

Remember that x-ray is not required for diagnosis

#ACR22 #ReviewCourse Image
Mgmt of OA: the cornerstone is patient education

What does it mean? Mgmt of expectations without needlessly discouraging pts.

👉Against the "wear & tear" language; pubmed.ncbi.nlm.nih.gov/30067920/
#ACR22 #ReviewCourse Image
Weight mgmt in OA:

👉OAI study, results pertinent to the knee (structural & symptom outcomes)
pubmed.ncbi.nlm.nih.gov/35245415/

#ACR22 #ReviewCourse Image
Encourage physical activity. Better education needed that this does not worsen wear & tear

🚶‍♀️🚶Work from @HiralMaster @dankwhitept: daily walking doesn't increase risk of jt replacement at 5 yrs
pubmed.ncbi.nlm.nih.gov/34175271/

#ACR22 #ReviewCourse Image
Supervised exercise with GLA:D: a/w ⬇️analgesic use

💊@jbthorlund study: pubmed.ncbi.nlm.nih.gov/32958468/

#ACR22 #ReviewCourse Image
💉IACS: effective? in short term, yes

Safe? OAI study with possible ⬆️risk of knee replacement

BUT from @BU_BMC_Rheum an active comparator design using IA hyaluronic acid did not show ⬆️risk. Thx to @Tuhina_Neogi @MikeLaValley8 for input on the more valid study design

#ACR22 ImageImage
@BU_BMC_Rheum @Tuhina_Neogi @MikeLaValley8 Viscosupplementation?

Meta analyses have not supported its efficacy

#ACR22 #ReviewCourse Image
@BU_BMC_Rheum @Tuhina_Neogi @MikeLaValley8 PRP: trials have not had standardized preparations & had issues with blinding

@KimBennell study was null after addressing these limitations

#ACR22 #CourseReview Image
@BU_BMC_Rheum @Tuhina_Neogi @MikeLaValley8 @KimBennell Back to work from @Tuhina_Neogi and colleagues: can we target pain sensitization?

Recall the anti NGF program. Tanezumab effective for pain improvement.

Other targets beyond NGF in development!

#ACR22 #CourseReview Image
A future for DMOADs?

#ACR22 #CourseReview Image
for more on this topic, see the talk from Dr Scanzello presented last year & in better health circumstances (get well soon!!)



#ACR22
This is my favorite microphone exchange:

@McCarthyProf: You know what question I'm going to ask you, don't you?

C.S.: yes, I do.

#ACR22
@McCarthyProf The actual question is the role of Ca++ crystals and calcification/mineralization in OA as a targetable phenotype

Unmet need in OA! Sounds like people should be funded to study this in detail #HintHint

#ACR22

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More from @rheum_cat

Nov 13, 2022
#ACR22 social media talk, very meta
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
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, 2022
#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, 2022
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, 2022
#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, 2022
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, 2022
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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