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Are Emulation Trials a Fantasy?

Are emulation ‘trials’ helpful, despite the biases that occur with observational data, or do they truly mimic the results of randomized controlled trials (RCTs)?

ACR 2024 - Day 1 Report

ACR Convergence 2024 opened today with a full slate of presentations, posters and specialty meetings.  The meeting began with a flip: the plenary sessions started at 9AM and the poster session began at 1030 AM. Below are some of the highlights from day one in Washington, DC.

axSpA: Moving the needle in time to diagnosis

The journey to axial spondyloarthritis (axSpA) diagnosis is often prolonged and challenging. Understanding the factors contributing to the delays is important to improve the clinical, psychological, social and economic outcomes. Data from the SPACE cohort (abstract 0566), the ASAS-PerSpA study (abstract 0550) and the US Claims data (abstract 0558), allows us to highlight the barriers to early diagnosis of axSpA and identify opportunities for improving early diagnosis and treatment.

#ACR 2024 BEST Abstracts from Day 1

The RheumNow faculty have parked at the plenaries, trafficked the posters and have been finding the best the meeting offers on the first day at ACR 2024 in Washington, DC.  Here are some of the best abstracts from Saturday Nov. 16th.

Difficult to Manage Axial Spondyloarthritis

Studies show that patients with difficult-to-manage axSpA have a higher disease activity; however, the lack of a consensus definition led researchers and clinicians to utilize their own proposed definition, resulting in variability of the characteristics of non-responders.

SELECT-GCA suggests JAKis may be the new kid on the block

Clinicians treating giant cell arteritis (GCA) have long had to contend with a disappointingly limited selection of drugs from which to select. A new group of drugs is finally showing promise in the treatment of GCA.

Is Pregnancy Truly the Solution for RA?

Pregnancy is perhaps the oldest treatment in rheumatoid arthritis (RA) and has been associated with a natural improvement in disease control in 50-75% of patients. Others, however, are not as successful with unchanged disease activity or worsening of their autoimmune disease.

RIP to Glucocorticoids in GPA

For many years glucocorticoids were the mainstay of our treatment of granulomatosis with polyangiitis (GPA). The paradigm shifted with cyclophosphamide and then again with rituximab, and we used less steroids, but we still used lots. Avacopan teased the demise of steroids, but in the trial they, and now we, still use them. Glucocorticoids are our old trusty friend, our comfort blanket. But no more! Good riddance to the medication with the highest long-term adverse event burden that we use. Long-term glucocorticoids in GPA should now be a rarity. The reason for such exuberance is the TAPIR study presented by Dr. Peter Merkel at Saturday’s opening plenary session.

Evaluation of Bimekizumab in PsA

Bimekizumab (BKZ) is a monoclonal IgG1 antibody that selectively inhibits interleukin (IL)‑17A and F. There have been more updates on the 2 year data on BKZ at #ACR24, and this is a summary of four studies being presented this year at ACR24.

How Online Searches Reveal Patient Needs

Managing health conditions is rapidly evolving as patients increasingly turn to online resources for answers—over 65% search for health-related questions online. Our study analyzed Google search trends for rheumatic disease topics, offering a fascinating glimpse into how online search behavior can reveal patient needs and experiences. This approach, known as "infodemiology," tracks real-time Google Trends data to understand symptom- and treatment-related searches for rheumatic conditions.

Reproductive Issues in axSpA: Fertility and Pregnancy

Axial spondyloarthritis (axSpA) affects young patients with symptom onset occurring in early adulthood. Apart from pain and quality of life, reproductive issues also arise because patients who are diagnosed with the disease are also in their reproductive age. Two interesting abstracts about reproductive issues in axSpA will be presented during the poster sessions on Saturday, November 16, 2024.

Improving the Value of Musculoskeletal Ultrasound in Rheumatology Care

Unlike traditional imaging techniques, MSUS can be easily used at the point-of-care and offers high-resolution images of joints, tendons, and soft tissues, facilitating the early detection of inflammation and structural damage. On Saturday, November 16th at the ACR Convergence 2024, Dr. Veena Ranganath, Dr. Gurjit Kaeley, and Dr. Catherine Bakewell will present the “Proposed ACR Guidance for Use of Musculoskeletal Ultrasound in Rheumatoid and Psoriatic Arthritis.” This is the first update in a decade since the 2012 ACR guidance on the reasonable use of MSUS in rheumatology clinical practice.
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