Sex related differences in PsA
Different factors are known to influence disease characteristics and outcomes in psoriatic arthritis (PsA).
News
Playing it Safe with RA? JAK vs. TNF Debate
Reported safety signals, at odds with the efficacy of these medications, have left rheumatology clinicians in a difficult position when considering when during a patient’s treatment course and in which patients, specifically, JAKi should be used. Two abstracts from ACR convergence 2024 further contribute to our understanding of this potential risk profile.
Cognitive Impairment: The Hidden Burden in Lupus Care
Suppose you have a patient with lupus returning for follow-up. Their joint symptoms are well controlled. The kidneys—managed with a combination of biologic DMARD and mycophenolate—show no signs of active urinary sediment or protein. Yet, during the routine visit, your patient brings up fatigue and difficulty remembering things. How do you address this? Several studies presented at ACR24 focused on cognitive impairment in lupus.
A new score to quantify GCA inflammation?
The treatment paradigm for Giant Cell Arteritis (GCA) has been a binary approach to the presence or absence of vasculitis. When GCA is present, we institute high doses of glucocorticoids for treatment of the inflammatory process. This approach is not well individualized to the patient as we do not account for the degree of inflammation that may or may not be present in the disease. Improved markers to stratify the extent of inflammation can help to tailor a more personalized approach to treatment.
Up-front Secukinumab in PsA?
We now have an absolute plethora of agents available for use in psoriatic arthritis (PsA). In contrast we have an almost complete lack of understanding of how best to optimise use of these agents – what is the right agent at the right time for the right patient. A study presented this week has given us some further information on the topic.
Gender Differences in SpA
One of the hot topics during the meeting was gender differences in SpA. Three abstracts presented addressed issues related to these differences particularly in the aspects of treatment response and disease activity.
ACR 2024 - Day 3 Report
Highlights from Day 3 at ACR24 included the plenary session presentation on Nipocalimab (previously reviewed), but the big highlight was the Lupus Nephritis guideline recommendations.
JAKs and Other Drugs in PMR
This has been an interesting ACR meeting in terms of PMR updates. I would argue that we are still far too wedded to glucocorticoids only in the management of PMR. Yes, some patients will do fine with just glucocorticoids but we persist far too long with a glucocorticoid only strategy in others who clearly need an alternative as glucocorticoid adverse events multiply.
#ACR 2024 BEST Abstracts from Day 3
Lots of lupus research and the New ACR Guidelines on Lupus Nephritis management were presented today. These and other highlights as featured on our Twitter (X) feed from ACR24 in Washington, DC.
GLP-1 Agonists Show Promise in Slowing Kidney Disease in Lupus Nephritis
A retrospective cohort study presented at #ACR24 explores the benefits of GLP-1Ras in reducing the risk of end-stage renal disease (ESRD) for patients with lupus nephritis. Drawing on data from the TrinetX global research database, the study examines how GLP-1Ras may reduce ESRD progression in a population where 10-20% progress to ESRD within five years, even with immunosuppressive therapies.
ORAL Surveillance - Is Statin Use the Problem/Solution?
The findings from ORAL Surveillance Study have been a dominant conversation at recent ACR Convergence, with the seminal findings and subsequent analyses a target of debate. Subsequent post-hoc analyses, follow-up studies, and claims data analyses have been used to further interpret the data, though a clear answer on safety is not certain. A study presented on Sunday reported on a new post-hoc analysis that provides new insights.
