Rheum Cat Profile picture
Nov 12 18 tweets 18 min read
Dr Carol Langford for the clinical #YearInReview #ACR22
1⃣GLORIA pragmatic trial in RA >= 65 yrs, of add on low dose prednisolone

pubmed.ncbi.nlm.nih.gov/35641125/

NNH 9.5

#ACR22
How to weigh benefits and harms in GLORIA?

👉The protocol of this study provides tips to interpret the findings

#ACR22
2⃣We've all read ORAL Surveillance, the phase 4 RCT on tofacitinib vs TNFi in RA with CV risks

Outcomes: MACE, malignancy

#ACR22

pubmed.ncbi.nlm.nih.gov/35081280/
Co primary endpoint, non inferiority not met

Higher incidence of MACE, cancer in the >=65 subgroup

#ACR22
What about those with h/o ASCVD?

NNH 16 for 1 MACE event with TOFA

pubmed.ncbi.nlm.nih.gov/36137735/

#ACR22
Reminder of JAK inhibitors, MoA, and questions about toxicities.

Class effects? FDA put black box warning on all JAK inhibitors based on TOFA data

#ACR22
Besides RA, JAK inhibitors have been added to the armamentarium to #axSpA and #PsA

#ACR22
3⃣#gout! MIRROR RCT - PO MTX vs pbo to reduce Abs to pegloticase

pubmed.ncbi.nlm.nih.gov/36099211/

Benefits: improved gout control & safer pegloticase use
Harms: MTX SEs

#ACR22
4⃣ @docrota IVIG for dermatomyositis in @NEJM

pubmed.ncbi.nlm.nih.gov/36198179/

Cautions: cost, thromboembolic risk

#ACR22
@docrota @NEJM 5⃣CAR-T for refractory #SLE

pubmed.ncbi.nlm.nih.gov/36109639/

Note the risks esp cytokine release syndrome

#ACR22
@docrota @NEJM How does this work?

Ultimately CAR-T cell binds B19 on B cell leading to B cell lysis and depletion

#ACR22
@docrota @NEJM n=5 refractory SLE pts

1 needed tocilizumab for cytokine release syndrome

need longer f/u to see if remission persists

#ACR22
@docrota @NEJM A turning point for SLE targeted therapies

one of these: obinutuzumab (CD10 inhibition) pubmed.ncbi.nlm.nih.gov/34615636/

#ACR22
@docrota @NEJM 6⃣tocilizumab for PMR (GC dependent)

pubmed.ncbi.nlm.nih.gov/36125471/

BTW IV toci FDA approved for GCA earlier this year

#ACR22
@docrota @NEJM @rheum_covid @RichardPAConway @HsiehEvelyn @MaxKonigMD 9⃣ A turning point for pts on immunosuppression was the advent of evusheld

Original @NEJM didn't really study our population of interest

Enter the Israel data pubmed.ncbi.nlm.nih.gov/35904210/

#ACR22

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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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