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RheumNow Podcast - ACR 2021 Rehash (the good stuff..)

Nov 12, 2021

The ACR 2021 meeting has concluded. Dr. Jack Cush recounts a few more great abstracts from this past week’s virtual meeting.

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Emapalumab for the treatment of macrophage activation syndrome

Macrophage activation syndrome (MAS) is a term commonly used by rheumatologists to describe a potentially life-threatening complication of systemic inflammatory disorders, most commonly occurring in people with systemic juvenile idiopathic arthritis (sJIA) and systemic lupus erythematosus (

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#ACR21 [Dr Pooni] #Telemedicine #Pediatrics providers felt PE was worsened BUT msk exam was the MOST reliable. @endocrine_witch @millennialpediahttps://t.co/3FGCyBIxB2 https://t.co/fgwdk0WXKm
LiSa ◡̈︎ @rheumarhyme( View Tweet )
Nov 09, 2021
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ACR21 – Day 3 Report

Nov 09, 2021

Hitting the home stretch, day 3 presentations were big! Here are a few of my favorites: secukinumab efficacy in juvenile PsA; VEXAS - predicting poor outcomes; and the FDA Safety Update session.

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Handy overview of Jak/STAT pathways in rheumatic diseases and available inhibitors (Dr. Joost Swart). Happening now in the Pediatrics Hub (New Therapies & Biologic Safety in Pediatric Rheumatology​). #ACR21 #pedsrheum https://t.co/i4bYr4GKOP
Katie Poholek @kpoho( View Tweet )
Nov 09, 2021
#ACR21 #pedsrheum I say it counts! I mean, at the end of the day, these are all just pictures of food on the internet, right? #ACRBakeAnythingChallenge https://t.co/bVQuealWWX

Dr. Laura Lewandowski @LauraLewMad11( View Tweet )

Nov 09, 2021
New dimensions in cellular immunology. Great session, some which I understood. Kids with #JIA have more cytolytic pathway missense - some leads to macrophage activation syndrome #MAS Low NK cells in Juvenile Dermatomyositis. 9T112 #ACR21 @RheumNow https://t.co/5lUkqr65UM
Nov 09, 2021
ACR Best

ACR21 Best Abstracts We Saw - Day 3 (Monday)

Nov 08, 2021

The third day of ACR 2021 took a big leap in online content.  Here is a compilation (with links) of presentations were the “ACRBest” as seen by our RheumNow faculty. 

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Can you stop monitoring eyes in + ANA and/or pauciarticular pt who becomes an adult if no uveitis ever, in last 5 yrs, etc. When can we stop looking? #AVR21 @RheumNow https://t.co/1Ml1BuJD7Y
Nov 08, 2021
#ACR21 #pedsrheum Risk factors for poor outcomes: delay to diagnosis, poor access to therapy, poor access to care https://t.co/SlFyav5KV6
Dr. Laura Lewandowski @LauraLewMad11( View Tweet )
Nov 08, 2021
Please don’t miss MISC (pronounced Miss C)=multisystem inflammatory syndrome. Pediatric syndrome post #SARSCoV2 infection. May go w macrophage activation syndrome (MAS) w distinct proteomics signature. Potentially v poor outcomes. Need to dx and treat #ACR21 abst0961 @RheumNow https://t.co/uaBbUdg3lt
Nov 07, 2021
#ACR21 #pedsrheum juvenile localized scleroderma Polypositive profile 3 or more autos correlated with more severe skin score, more activity https://t.co/vVXV4jjLvG
Dr. Laura Lewandowski @LauraLewMad11( View Tweet )
Nov 07, 2021
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JAK Inhibitors in Refractory Adult and Childhood-Onset Still’s Disease

Still's disease is an autoinflammatory disease characterized by spiking fever, rash, polyarthralgia, sore throat and even life-threatening complications, such as macrophage activation syndrome. It was first described by George Still in the late 1800s. Systemic Juvenile Idiopathic Arthritis (

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CARRA STOP-JIA 400pts, Obs study w/ 3 treatments plans : -Step up -Early combination -Biologic first Which one do you think works best? I'd say none: overall 40-60% not achieving CDI off steroids at 24 months. Results: 42% for SU, 52% EC, and 44% BF #Abtr0960 #ACR21 @RheumNow
Nov 07, 2021
✨Great Pearls when screening patients for clinically suspect #Scleroderma or #Juvenile #Dermatomyositis 📌 Don’t Stop Work Up at Negative ANA if strongly suspect SSc 📌 #Myositis Specific Antibodies have different phenotypes in kids than adults (MDA-5, TIF-1g, NXP-2) #ACR21 https://t.co/KrkkzA5bkV
Ashima Makol MD @AshimaMakol( View Tweet )
Nov 07, 2021
Nationwide study - low income - greater length of stay than highest income. Lowest income many be supported but those who do not have those resources may have an increased length of stay in children hospitalized with pediatric #lupus @dsoulsMD @rheumnow #ACR21 abst#0768 https://t.co/j7VDpVW7ND
Bella Mehta @bella_mehta( View Tweet )
Nov 07, 2021
Plenary at #ACR21 Renal outcome Risk of minority patients with pediatric #lupus @rheumnow abst#0956 inpatient hospitalizations. https://t.co/HK8w246Dsn
Bella Mehta @bella_mehta( View Tweet )
Nov 07, 2021
"We need to do more than improving quality of care to close the gap in racial disparities." - Dr. J Chang Trends of adverse renal outcomes⬇️w/time in children hosp w/SLE. Improvements seen across racial/ethnic group, but black-white disparity persists abst#0956 #ACR21 @rheumnow https://t.co/HcOwQiKCb2
TheDaoIndex @KDAO2011( View Tweet )
Nov 07, 2021
ACR Best

ACR21 Best Abstracts - Day 1

Nov 07, 2021

The RheumNow faculty have been glued to their monitors all day, watching video, and running down abstract presentations to find the best – several of these stood out as #ACRBests. Here is a listing of “Best” they saw on Day 1.

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TNFi + JIA = watch the skin! A nearly 3fold increase of paradoxal psoriasis in JIA patients exposed to TNFi reported in the CARRA registry w/ incidence rate the highest on children receiving adalimumab. #Abst0241 @RheumNow #ACR2021 https://t.co/uXOwV2RlGu https://t.co/8f8mvVUkV2
Aurelie Najm @AurelieRheumo( View Tweet )
Nov 06, 2021
#ACR21 #Abstr0261 In stable Non sJIA, is it safe to taper or stop MTX? Of 375 pts in CARRA registry, 24% tapered and 14% stopped MTX. No diff in flare rates btw those continued vs tapered/stopped. Sustained remission was in ⬆️tapered vs stopped @RheumNow https://t.co/Mm1yfzRBQz https://t.co/rkHvXWj2oO
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Nov 06, 2021
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Opening Day Report

Nov 06, 2021

The opening of ACR2 Convergence was a hit for all who signed up and viewed in. The day included the presidential address by outgoing president Dr. David Karp (UT Southwestern) and a keynote talk and interview with Dr. Seema Yasmin (Stanford).



The Year in Review

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Juvenile dermatomyositis, with Gottren's and diffuse hyperpigmentation Regional Winner of Europe & Central Asia Image Competition: Rheum Dz in Patients of Color #ACR21 @rheumnow https://t.co/vxayxgINa8
TheDaoIndex @KDAO2011( View Tweet )
Nov 06, 2021
This 15-day-old boy developed this rash, which was diagnosed with neonatal lupus; anti-Ro and anti-La Abs were present, in both, mother and child. The mother never had had symptoms suggesting SLE or any autoimmune disease. The rash healed after 45 days; the boy is doing great😍 https://t.co/fYB0IzE7kY
Emilio Martin Mola @emartinmola( View Tweet )
Oct 16, 2021
Retrospective study hospitalized new-onset systemic JIA (2008-19):52 children’s hospitals & 534 sJiAshows 29% rx w/ biologics & 58% steroids. Over time Biologic use increased & MTX decreased. Biologic correlated w/ Hi hospital volume, ICU stay, later years https://t.co/blbOps9zVQ

Dr. John Cush @RheumNow( View Tweet )

Oct 15, 2021
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