Giles #RNL2025
@rheumnow.bsky.social

ORAL Surveillance - 3 Yrs Later
How do interpret in care of pts?

Pts with known hx of ASCVD have higher risk w TOFA v TNF. If no hx ASCVD, no increase risk even w risk factors

Statins were underused in study pts at risk or w CVD, may help mitigate risks

B England
75% of RA pts have multi-morbidity
Pts develop multi-morbidity BEFORE the onset of RA
Should we have different goals: Prioritize LDA over remission in pts w multimorbidity
Collaborate w PCP: one size doesn't fit all, do something better than nothing!
@rheumnow.bsky.social #RNL2025

3 Questions To Ask in Clinic
@unamakris.bsky.social on STEADI Questions
1 Have you fallen in past year?
2 Do you feel unsteady when walking or standing?
3 Are you worried about falling?

#RNL2025 @rheumnow.bsky.social

Review Med Lists in Rheum
- ~40% of pts w RA/SLE on Potentially Inappropriate Meds (PIM)
-Review Beers Criteria for Rx to avoid in older pts
- Include: antidepress, benzo, steroid + NSAID, gaba, nifed, PPI, mm relax

@unamakris.bsky.social at #RNL2025 @rheumnow.bsky.social
@JihaRheum @NamrataRheum

How to approach older individuals in Rheumatology:
Geriatric 5M's
@unamakris.bsky.social
1. Mind
2. Mobility
3. Medications
4. Multicomplexity - whole person living w multiple conditions, illness, biopsych needs
5. What Matters Most

#RNL2025
@rheumnow.bsky.social

@unamakris.bsky.social #RNL25
@rheumnow.bsky.social
Older pts w RA
1/3 of pts onset >60-65
- More acute onset, more systemic, more PMR-like, larger jts
- Higher IL-6, lower TNF-a, less RF, high ESR
-Co-morbidities, polypharmacy, cognition, depression
Age does not equal frailty, but does correlate

J Curtis #RNL2025 @rheumnow.bsky.social
AI Will Not Replace You
- AI cannot replace human interaction, examination, procedures, interpreting guidelines for an individual, providing empathy, and facilitate good patient education
Will become a tool... but not a replacement to a good clinician

AI models require good Positive Predictive Value (PPV)
But: PPV decreases as prevalence decreases
- In choosing a successful biologic:
Harder to predict more challenging patients (multiple failures, co-morbidities, etc) - ACR50 non-response is higher
J Curtis
@rheumnow.bsky.social #RNL2025

🏈Kick-off of @rheumnow.bsky.social RN Live w Jeff Curtis #RNL2025 🏈
AI in RA?
Can help with Rheum Boards Questions, though AI is not confident in answers
May not be better than paper charts for triage
Other roles: pt chatbot, AI scribe, research populations, generate DDx, consume guidelines

What a weekend ahead!
#RNL2025
#FlyEaglesFly 

Follow along with me and @rheumnow.bsky.social @RichardPAConway @AdelaCastro222 for all the Rheumatology… as I tweet away my pre-game anxieties!