🧐 An observational study suggests that proteinuria levels do not predict LN histologic class.

🧐In addition, eGFR cutoff of 75 mL/min/1.73 m2 after one year of treatment is strongly predictive of progression to CKD

📍Thanks to Dr. John Cush

👉 academic.oup.com/rheumatology/a…

📌Anti-Synthetase Classification Criteria coming in early 2024. Stays tuned for news from CLASS project!!!

✅Jo-1 ab is the most (other anti-synthetase abs (high false + and -)
✅anti-Ro52 and CYTOPLASMIC ANA are common
✅ Any form of ILD

Thanks to Rohit Aggarwal

📕2019-Proposed management algorithm for Immune-mediated necrotising myopathy #IMNM , based on recommendations presented at the #European #Neuromuscular Centre international workshop

#Myositis #Myopathy

📌anti-SAE(+)/DM:

🔺mild disease phenotype

🔺🔺HCQ → severe exfoliation of the skin

#Hedef24 #Rheumatology #Myositis

📌anti-Mi2(+)/DM:

📍Glucocorticoids good response (+)

📍📍good prognosis (+)

📍📍📍Rapid and effective response to RTX treatment

#Hedef24 #Rheumatology #Myositis

📌anti-MDA5(+)/DM:

❗️Severe disease phenotype/50% RP-ILD--ILD and vasculitic lesion▶️▶️ RTX

❗️Ab titers reflect disease activity/resistance to treatment ▶️▶️Correlated with ferritin levels

❗️Skin involvement → Immsup treatment resistant

#Hedef24 #Rheumatology #Myositis

🥇 According to Diagnosis and Organ Involvement

-overlap myositis: increased ILD
- anti-synthetase syndrome: increased ILD (70%)
-IMNM: aggressive immunsup. treatment (combination therapy at the beginning)
- sIBM: Alemtuzumab?

#Hedef24 #Rheumatology #Myositis

📕🔎 Prof Dr. Merih Birlik gave a great talk on 'Can Autoantibodies Guide Myositis Treatment?'

🥇 According to Diagnosis and Organ Involvement
🥈According to the cancer risk
🥉According to the autoantibodies

#Hedef24 #Rheumatology #Myositis

Two recent reviews of #ANCA vasculitis with wonderful graphics, and for the first time I think, #PR3 🔹 and #MPO 🔸 phenotypes are considered in parallel but SEPARATELY! A new era with individualized treatment is coming for sure!
🔹doi.org/10.1016/s2665-…
🔸doi.org/10.1016/s2665-…

4/4

✅ Optimal approach 🔜 elucidating the patient's molecular profile at the tissue (kidney) level

#Hedef24 #SLE #Rheumatology

3/4
🔺 PLEX effect is limited

🔺 Car-T cell treatment in difficult cases

🔺 Emerging targets, which are still being studied, hold promise in facilitating the attainment of treatment goals in refractory LN.

#Hedef24 #SLE #Rheumatology

2/4
🔺 Monitor hypogammaglobulinemia: Give IVIG If needed

🔺 Different options for those who do not respond to anti-B cell therapy:
✅ Eculizumab is effective (especially if accompanied by TMA)
✅ Bortezomib
✅ Daratumumab

#Hedef24 #SLE #Rheumatology

✅ A wonderful session on the management of refractory lupus nephritis by Prof Dr.Bahar Artım Esen (1/4)

🔺 The combination of MMF + RTX is effective in refractory LN.

🔺 Obinituzumab is a more potent anti-CD20; It may be effective in refractory patients.
#Hedef24 #SLE

(3/3)
🔺 Extra-renal activity and <3 g/day proteinuria: BEL is more appropriate
🔺 GFR > 45 and significant proteinuria: VOC is more appropriate
#Hedef24 #Rheumatology #SLE

(2/3)
🔺Lack of systemic findings/active serology may be a possibility of TMA. kidney biopsy may be required.
🔺 Treatments that can be added after other causes (treatment compliance, drug blood level measurement) are excluded: BEL and VOC
#Hedef24 #Rheumatology #SLE

🎯 A wonderful session on the management of refractory lupus nephritis by Prof Dr.Bahar Artım Esen (1/3)
🔺 The definition of refractory LN is not standard
🔺 Residual proteinuria may be a sign of segmental glomerulosclerosis, not just immunological activity.
#Hedef24 #SLE

My talk today at The EUVAS Course - Istanbul
at the “Target in Rheumatology 2024” (Hedef 2024) Meeting (25-27 April 2024), Istanbul, Türkiye.
'Cardiovascular Co-morbidities in ANCA-associated vasculitis'

4 different clusters in EGPA

Omer Karadag

#egpa
ANCA positive vs negative EGPA

From lecture by Alfred Mahr

✅ Her Cuma güncel makale önerileri verilecektir.
✅ Article suggestions will be provided every Friday.

🎯 sciencedirect.com/science/articl…

Laurent ARNAUD
#SLE #Lupus