At ACR23 I had a twitter-disagreement about steroid tapers from PEXIVAS with Mike Walsh, the lead author on the PEXIVAS trial. He kindly agreed to join me for a moderated discussion. Loved hearing his perspective and have to admit he pulled me closer to his practice... but not all the way there. Longer podcast than usual but I prefer to release audio uncut and this took as long as it needed! Hoping y'all enjoy.

Articles referenced during the podcast:

PEXIVAS: https://www.nejm.org/doi/full/10.1056/nejmoa1803537

PEXIVAS DAH Subset: https://www.atsjournals.org/doi/10.1164/rccm.202308-1426OC

Fussner Abstract: https://acrabstracts.org/abstract/characteristics-and-outcomes-of-participants-with-and-without-diffuse-alveolar-hemorrhage-in-the-plasma-exchange-and-glucocorticoids-in-severe-anca-associated-vasculitis-pexivas-trial/

Walsh Meta Analysis: https://pubmed.ncbi.nlm.nih.gov/35217545/

Rheum4Debate is back!

In this episode I moderated a debate between two pulmonologists about RA-ILD. As a reminder, Rheum4Debate is an Oxford-style debate show, where two debators disagree over a motion during 3 rounds of discussion. The motion for todays show was:

“Asymptomatic patients with rheumatoid arthritis and high risk features for interstitial lung disease should be screened using pulmonary function testing and a high resolution CT scan”

Joshua defended the motion and Scott argued against it. I thoroughly enjoyed the discussion and am sure you will as well!

Nice study this week on an important topic. Can we prevent the development of rheumatoid arthritis by initiating DMARDs during a preclinical phase? Lots to discuss: what does it mean to be "pre-clinical?" How does this fit with other studies of this nature?

Check it out! https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02650-8/fulltext