Recommendations for Cardiovascular Risk Management in Rheumatic and Mucoskeletal Diseases
Validation of existing generic and modified CVD risk prediction tools in large prospective studies and development of new disease-specific equations is done. Vascular imaging, circulating bio markers, identifying patient subgroups with high risk of CVD, long term effects of current and new drugs and role of antithrombotic agents in overall CVD risk in the patients.
Points to Consider on Therapeutic Drug Monitoring in Inflammatory Arthritis
Points to consider: Measurement of biopharmaceutical blood concentrations and ADAb in a validated lab. Identification of factors that influence these parameters. Routine use of proactive TDM not recommended for inflammatory RMDs. Reactive TDM could be considered in certain clinical situations. Other factors like observational studies/post hoc analyses of RCTs and population-based data.
Treatment of Severe Lupus Nephritis
Treatment of Lupus nephritis is a race against nephron loss. Current sequential therapy for LN allows for 20-30% complete clinical renal response. A treat-to-target approach might be implemented to avoid nephron loss. Per-protocol repeat renal biopsy may be a part of this strategy. A switch from sequential therapy to combination therapy is warranted compared to current therapy.
Secondary Immunodeficiency in Patients with Autoimmune Diseases
The most common secondary immunodeficiencies are antibody or cellular deficiencies. Secondary antibody deficiency is 30 times more common than primary antibody deficiency. Secondary immunodeficiencies are overlooked and undertreated and may be reversible but many are not. Assessment and decision on treatment require clinical context and functional Ab testing.
Autoimmunity and Primary Immunodeficiency
In the future with increasing use of functional genetics, many ill-defined syndromes of immunodeficiency or inflammatory diseases will be dissolved into genetic categories. Leniolisib is a potent and selective oral PI3Kδ inhibitor and also led to significant improvement in the immunological status and clinical presentation of patients with APDS/PASLI. Most common are antibody deficiencies.
Treatment of ILD in Patients with Primary Sjogren's Syndrome: A Single-center Retrospective Analysis
The study determined whether adding cyclophosphamide or rituximab to steroid and oral DMARD therapy improves pulmonary function test results in individuals with primary Sjogren's syndrome-interstitial lung disease (pSS-ILD) who have poor baseline pulmonary function. The study found that FVC improved significantly in patients who received add-on CYC and/or RTX.
Is There an Added Value of Imaging to Composite Index Measurement of Disease Activity in RA Patient?
The study determined whether there is an added value of imaging to the composite index measurement of disease activity in patients with RA. Clinical evaluation of remission alone may be inadequate to capture a persistent lack of inflammation at different joint sites. Imaging can complement the assessment of patients in clinical remission, offering additional data.
How to Assess Heart Function in Rheumatic Diseases?
A study analyses the heart function in rheumatic diseases, particularly how to assess it either in systemic sclerosis & rheumatic arthritis as a prototype disease. Myocardial damage modifies electric conduction and functionality. The ischemic microcirculatory component is always present in SSc patients. The disturbance of electric potentials is fundamental to suspect primary heart involvement.
Lupus Low Disease Activity State (LLDAS)
LLDAS has better performance than other definitions of low disease activity and is associated with low mortality. It was found to be almost same as that of remissions when SLE was treated with belimumab while comparing real world evidence. Post hoc clinical trial data for drugs like Anifrolumab, Azathioprin etc, concluded that LLDAS is discriminatory in clinical trials.
