Highlighting the most interesting, shocking or informative abstracts I saw at the 2024 American College of Rheumatology Conference in Washington DC.
Abstracts at the American College of Rheumatology conference are brief summaries of new research studies that highlight key findings and advancements in rheumatic diseases, making it easier for patients and professionals to stay informed about the latest developments in the field.
You can view all the ACR24 abstracts here
I have chosen these studies as my favorites for a variety of reasons. Some of them address topics that are rarely discussed in Rheumatology research but are highly relevant to me as a patient. It’s refreshing to see research on topics that I struggle with daily. Other studies taught me a lot about topics that I either didn’t realize were connected to my rheumatoid arthritis or were difficult to accept.
I have selected studies that closely align with my diagnosis and life experiences. These include fibromyalgia, socioeconomic factors, disparities, patient education, patient engagement in research, mental health, cardiovascular health, cognitive impairment, fatigue, and exercise.
A study assessed Premenstrual Dysphoric Disorder (PMDD) in women with rheumatoid arthritis (RA) compared to healthy women using the Premenstrual Symptoms Screening Tool (PSST). It found that women with RA had a higher prevalence and severity of PMDD symptoms, significantly impacting their daily life, compared to healthy women who reported milder symptoms. This suggests that RA may increase susceptibility to PMDD and substantially affect well-being.
This abstract discusses a study on the association between menopause and the severity of systemic rheumatic diseases (SRDs), such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), in peri-menopausal and menopausal women. The study found that 32% of women with SRDs reported worsening symptoms during or after menopause, but this did not differ significantly between those with RA and SLE. However, a higher proportion of women with RA reported more severe flares compared to those with SLE
A study found that fatigue is a significant factor in difficult-to-treat rheumatoid arthritis (D2T RA), despite not being part of its definition. Of 145 RA patients, 26.21% developed D2T RA, characterized by older age, more comorbidities, greater disability, and higher levels of multidimensional fatigue. The study suggests that fatigue evaluations, considering gender differences, are crucial for managing D2T RA.
The study investigates whether Carpal Tunnel Syndrome (CTS) is an early, unrecognized feature of rheumatoid arthritis (RA). Using a population-based cohort, the study found that CTS was more prevalent in RA patients compared to non-RA individuals, even before RA diagnosis. The prevalence of CTS was higher in seronegative RA patients compared to seropositive patients, although this difference was not statistically significant. The findings suggest that CTS could be an early indicator of RA, highlighting the importance of early recognition and treatment.
The study investigates whether fibromyalgia could be an early indicator of autoimmune conditions. Analyzing data from over 14,000 patients, it found that those diagnosed with fibromyalgia had a significantly higher risk of developing autoimmune diseases like rheumatoid arthritis and systemic lupus erythematosus compared to a control group.
The study analyzes the representation of fibromyalgia in rheumatology literature over a ten-year period. Despite fibromyalgia affecting up to 12 million adults in the U.S., it is significantly under-researched compared to other rheumatologic diseases like rheumatoid arthritis. The findings suggest a need for more research and publication on fibromyalgia to address this disparity.
The study, titled “When Medications Fail: A Mixed Methods Study Evaluating the Experience and Health-Related Quality of Life (HRQOL) of Adults with Rheumatoid Arthritis Non-Responsive to Treatment,” explores the experiences of adults with rheumatoid arthritis (RA) who have not responded to treatment. Using interviews and surveys, the study found that non-response significantly impacts patients’ HRQOL, causing frustration, mood issues, and functional limitations. The importance of shared decision-making and strong patient-doctor relationships was emphasized by participants
The study investigates financial distress and its determinants in adults with rheumatoid arthritis (RA). It found that RA patients experience higher financial distress compared to those with non-inflammatory musculoskeletal diseases. Key determinants include depression, disease severity, younger age, lower household income, and lack of college education.
Sleep
A systematic review and meta-analysis of 70,105 rheumatoid arthritis (RA) patients found that 22% had insomnia, significantly higher than the 5.6% general population prevalence. Insomnia in RA was linked to greater pain, fatigue, and poorer well-being and quality of life, underscoring the need for targeted interventions to address this common comorbidity.
A study of 319 patients with rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), and psoriatic arthritis (PsA) found poor sleep in 56% of RA, 53.8% of PsA, and 66% of axSpA patients. Risk factors varied: RA had links to BMI and CRP, while back pain was a factor for axSpA and PsA, and female gender and older age added risks for axSpA and PsA, respectively.
Mental Health
A study titled “Treat (Depression to Reach)-to-Target in Rheumatoid Arthritis” found that depression, affecting up to 38.8% of rheumatoid arthritis (RA) patients, impacts subjective disease measures like morning stiffness and patient-reported outcomes. Addressing depression can improve these outcomes and help reach RA treatment targets, highlighting the need for comprehensive management including mental health care.
The cross-sectional study evaluates the prevalence of anxiety, depression, and fatigue in patients with rheumatic diseases. Out of 1,014 patients, 37% reported anxiety and 21.8% reported depression. Fatigue was also a common issue, significantly impacting patients’ quality of life. The study emphasizes the need for mental health support in rheumatology care.
A study screening rheumatology patients with the PHQ-9 found varying depression rates: 8.05% in systemic lupus erythematosus, 7.53% in inflammatory arthritis, 6.33% in rheumatoid arthritis, 4.82% in psoriatic arthritis, and 3.60% in psoriasis. Female and younger patients, and those with certain comorbidities like anxiety and fibromyalgia, were more likely to screen positive, highlighting the need for regular depression screening in rheumatology.
A study in the All of Us Research Program found that diagnosed and treated depression was more strongly linked to cardiovascular disease (CVD) risk in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) patients than genetic depression risk. The study used a depression polygenic risk score and a CVD outcome composite of myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft, or stroke.
The study examines the impact of illness cognition and self-esteem on the quality of life (QoL) in reproductive-age women with autoimmune rheumatic diseases (ARDs). It found that higher acceptance and perceived benefits of the disease were associated with better QoL and self-esteem, while higher helplessness was linked to worse QoL.
Cognitive Dysfunction – Brain Fog
A study found that 86.95% of patients with rheumatic diseases like fibromyalgia and osteoarthritis showed cognitive impairment, with working memory and attention most affected. The study highlights the importance of cognitive evaluations for comprehensive care in these patients, many of whom also had psychiatric comorbidities.
Fatigue
A study investigated residual fatigue in rheumatoid arthritis (RA) patients in clinical remission, finding it common despite controlled disease. Factors linked to fatigue severity included disease activity, comorbidities, and certain medications. The study concluded that addressing these factors could improve RA patients’ quality of life by better managing fatigue, even in remission.
Comorbidities
A study identified common comorbidities in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA) to understand their overall health challenges. Among 1,960 patients, top comorbidities for RA were osteoarthritis, osteoporosis, fibromyalgia, obesity, and asthma. For PsA, they were psoriasis, osteoarthritis, obesity, fibromyalgia, and asthma. For axSpA, they were osteoarthritis, asthma, obesity, fibromyalgia, and osteoporosis. The study concluded that these comorbidities can complicate treatment and highlighted the need for comprehensive care.
The study investigates the relationship between the salivary and stool microbiome and disease activity and vascular function in patients with rheumatoid arthritis (RA). It found that salivary microbiome composition is associated with arterial stiffness (AIx), while stool microbiome composition is linked to disease activity (DAS28-CRP). The results suggest that different microbiome sites may influence distinct RA-related outcomes
Nutrition
The study explores the mechanistic pathways of the “Plants for Joints” (PFJ) lifestyle and dietary intervention for rheumatoid arthritis (RA). The 16-week intervention, which includes a whole-food plant-based diet, physical activity, and stress management, significantly reduced the 28-joint Disease Activity Score (DAS28) in RA patients. The study aims to assess gut barrier integrity and identify key metabolites to understand how the PFJ intervention leads to its observed clinical effects
The study investigates delays in cancer screening among patients with rheumatoid arthritis (RA). It found that RA patients were less likely to undergo cervical cancer screening compared to non-RA patients, even after adjusting for age and race. However, there were no significant delays in breast, prostate, or colorectal cancer screenings. The study highlights the need for targeted interventions to improve cancer screening rates in RA patients.
A study analyzing 1991-2021 trends in rheumatoid arthritis (RA) in the United States found a 42.86% increase in incidence, 48.29% in prevalence, 31.51% in disability-adjusted life years (DALYs), and 1.36% in death rates. Significant state-level disparities were noted, with higher DALYs in states like Alaska and lower in states like Florida, highlighting the need for targeted interventions to address the growing RA burden and geographic inequities.
The study investigates proteomic signatures in patients with difficult-to-treat rheumatoid arthritis (D2T RA) to identify predictive biomarkers. By analyzing plasma samples, the researchers identified specific proteins associated with D2T RA, which could help in monitoring disease activity and predicting disease progression
The study evaluates the knowledge, attitudes, and intention towards HPV vaccination among reproductive-age women with rheumatic diseases. It highlights the importance of increasing awareness and addressing misconceptions to improve vaccination rates in this vulnerable population.
A study of 350 immune-mediated inflammatory disease (IMID) patients in France, mostly women, found significant knowledge gaps about human papillomavirus (HPV): 20% didn’t know HPV causes cervical cancer, 53% weren’t aware of higher HPV prevalence in immunosuppressed individuals, and 23% didn’t know about the effective HPV vaccine. Despite these risks, only 7% reported routine HPV vaccination.
A study of 3,868 patients with musculoskeletal and autoimmune diseases found that achieving ≥5% weight loss through medication-assisted weight loss was associated with significant improvements in patient-reported disease activity and quality of life outcomes like pain, fatigue, and overall health. Obesity was identified as a key factor, with obese patients most likely to benefit from weight loss therapies, underscoring the importance of weight management in treating these conditions.
A study of individuals with rheumatologic diseases in the United States found that while digital health tools like mobile apps, wearables, and patient portals have potential to improve health outcomes, their adoption and effectiveness vary. Factors like age, socioeconomic status, digital literacy, and technology access influence use. The study underscores the need to address these barriers to ensure all patients can benefit from digital health tools.
The study explores whether the sex of the rheumatologist influences long-term outcomes in RA patients receiving biological therapies. Analyzing data from 1,171 patients, it found that those treated by female rheumatologists had significantly better disease control and remission rates compared to those treated by male rheumatologists.
A study investigated how integrative health practices affect health-related quality of life (HRQoL) in women with rheumatoid arthritis (RA). It found that 60% of participants used practices like mindfulness, massage, and yoga. Higher physical activity and better diet quality were linked to greater life satisfaction, worthwhileness, and happiness. The study suggests that integrative practices, exercise, and a good diet can improve HRQoL in women with RA.
Rheumatic diseases like rheumatoid arthritis and lupus often have symptoms that fluctuate throughout the day, and understanding these patterns can improve treatment. A study explored how Google searches for rheumatic disease symptoms and treatments vary over 24 hours. It found that searches for symptoms and treatments peak at certain times, suggesting when symptoms may worsen and when people seek relief. The study concluded that these 24-hour trends could help healthcare providers better understand and address patients’ daily challenges.
The study examines fracture incidence rates in persons with rheumatoid arthritis (RA) based on their disease activity levels. It found that RA patients have higher fracture rates compared to those without RA, with the highest rates observed in patients with high disease activity. The study highlights the importance of monitoring and managing disease activity to reduce fracture risk in RA patients.
The study examines the relationship between sociodemographic factors and hand function in patients with early rheumatoid arthritis (RA). It found that factors such as country of birth, level of education, and comorbidities significantly impact hand function, particularly grip strength. Patients born outside Europe and those with lower education levels had notably lower grip strength. The study suggests that these sociodemographic factors may influence muscle strength, cultural aspects, or language-related difficulties with test instructions.
The study examines the impact of common infections on medication interruptions, quality of life, and disease flares in patients with rheumatoid arthritis (RA). It found that infections frequently lead to medication interruptions and negatively affect fatigue, work productivity, and disease control, highlighting the need for better management strategies
The study looked at how easy it is to understand the American College of Rheumatology’s patient education materials. They found that most of these materials are too difficult for the average person to read, as they are written at a high school level or above. To fix this, they used ChatGPT to rewrite the materials to make them easier to understand, but even then, they were still a bit too hard for most people.
The PRIMA study explores a patient-centered approach using infodemiology to analyze social media content and understand the experiences and perceptions of rheumatoid arthritis (RA) patients. By examining posts from online forums, the study highlights key topics such as daily pain management, community support, and the impact of RA on quality of life.
The systematic literature review examines the association between health literacy and disease, clinical, functional, and management outcomes in inflammatory arthritis (IA). The review included 29 studies and found that low health literacy is linked to greater disease activity, disability, mental health symptoms, and healthcare utilization. The findings highlight the need for interventions to improve health literacy in IA patients to enhance their overall outcomes.
The study evaluates the impact of a physician-created educational video and to-do lists on promoting preventive health measures in patients with rheumatic diseases. The intervention aimed to enhance patient adherence to preventive health guidelines, showing promising results in improving patient engagement and health outcomes.
A study comparing perceptions of shared decision-making (SDM) between 369 Latin American rheumatology patients and 144 rheumatologists found a significant gap: 96.5% of rheumatologists believed they shared decision-making with patients, but 37.7% of patients felt they did not. The study highlights the need for improved communication to make patients feel more involved in the decision-making process.
A study using 2021 Medical Expenditure Panel Survey data found that rheumatoid arthritis (RA) patients reported higher self-efficacy in managing their condition without medical help compared to those with other chronic diseases, with RA patients having 1.49 times the odds of believing in their self-management ability. This suggests RA patients may have a stronger sense of self-efficacy, potentially impacting treatment outcomes and well-being.
The integrative review titled “How Do Patient Decision Aids Enable Purposeful Shared Decision-Making in Rheumatology?” examines how patient decision aids (PDAs) support shared decision-making (SDM) in rheumatology. The study identifies various PDAs used in rheumatology and categorizes them based on the Purposeful SDM Framework, which includes four modes: weighing treatment options, negotiating conflicts, problem-solving competing demands, and developing existential insight1. The review found that most PDAs focus on weighing treatment options, with fewer addressing other modes of SDM
The study aims to identify patient priorities for patient-reported outcome measures (PROMs) in rheumatoid arthritis (RA) through a modified Delphi consensus approach. By engaging RA patients in the selection process, the study seeks to prioritize PROMs that are most relevant and useful for routine clinical care and health system performance measurement.
A study comparing substance abuse levels in fibromyalgia patients to non-patients accompanying them to the clinic found varying drug abuse rates among fibromyalgia patients and differences in substance abuse patterns between the groups. The study suggests that drug abuse might be more common in fibromyalgia patients than the general population, highlighting the need for healthcare providers to consider this when managing fibromyalgia.
A study of 18,248 individuals found significant links between musculoskeletal conditions like osteoarthritis and rheumatoid arthritis and perceived healthcare discrimination. Younger people and women reported more discrimination, while Hispanics reported less. The study underscores the importance of addressing perceived discrimination in managing musculoskeletal conditions.
The study investigates the potential of the 14-3-3η auto-antibody as a diagnostic marker for axial spondyloarthritis (AxSpA). Conducted longitudinally, it involved analyzing sera from AxSpA patients and healthy controls, revealing that AxSpA patients had significantly higher levels of 14-3-3η auto-antibodies. The diagnostic performance was promising, with an area under the curve (AUC) of 0.82, indicating good sensitivity and specificity for identifying AxSpA.
A study of a national peer support program for teens and young adults with lupus and their families found positive impacts over two years: a 4.9% increase in feeling supported, significant increases in lupus knowledge (90.3% to 96%) and understanding of lupus-related issues (90.4% to 96%), and a 6.6% increase in parents feeling better able to cope. However, there was a slight decrease in participants’ ability to manage their lupus (87.1% to 84%).
A study of axial spondyloarthritis (axSpA) patients found they had higher kinesiophobia (fear of movement) scores compared to healthy controls. Moderate to high kinesiophobia was linked to poorer performance on mobility tests like the AS Physical Performance Index and Short Physical Performance Battery, and worse patient-reported outcomes like increased pain and less daily activity. axSpA patients had worse results than controls in pain, activity, and mobility tests.
A study of systemic lupus erythematosus (SLE) patients found that difficulty performing valued life activities (VLAs) and greater use of accommodations were strongly linked to depressive symptoms, even after controlling for general physical functioning. This suggests that maintaining the ability to perform important life activities is crucial for psychological well-being in SLE.
A study comparing Down syndrome-associated arthritis (DA) to juvenile idiopathic arthritis (JIA) found that while both had mostly polyarticular arthritis, DA patients had more autoimmune comorbidities and less uveitis. Despite this, DA patients had lower disease activity scores, less pain over time (tracking with disease activity), and better clinical outcomes with treatment compared to JIA patients, who reported increasing pain unrelated to disease activity.
