2) Dr. Lerma is core faculty at both @ckd_ce & @cardiomet_CE and is an expert #nephrologist and #educator. This tweetorial is accredited for 0.5h CE/#CME for #physicians #nurses #NPs #PAs #pharmacists. Please follow along!
— @CKD_ce (@ckd_ce) January 10, 2022
4) So let's look at Focal Segmental Glomerulosclerosis (#FSGS) 2012 -> 2021 in the evolving @goKDIGO guidance.https://t.co/4jLrZvGyMK pic.twitter.com/eX1FUA5GeX
— @CKD_ce (@ckd_ce) January 10, 2022
6) Pathologically, #FSGS may be further classified into collapsing, cellular, tip lesion, or perihilar variant forms.https://t.co/k0sSKoQzd1 pic.twitter.com/jGTQJAOvDu
— @CKD_ce (@ckd_ce) January 10, 2022
8) The terms “primary” and “idiopathic” FSGS have too often been used interchangeably, leading to a great deal of confusion around FSGS nomenclature. The @goKDIGO Work Group stepped in and suggests eliminating the use of “idiopathic” to describe any type of FSGS . . .
— @CKD_ce (@ckd_ce) January 10, 2022
10) Further clarification in the #FSGS space includes standard definitions for remission, relapse, resistance, & treatment dependence for FSGShttps://t.co/4jLrZvGyMK pic.twitter.com/nmL8211HPM
— @CKD_ce (@ckd_ce) January 10, 2022
12) Further, adults with #FSGS who do NOT have nephrotic syndrome should be evaluated for a secondary causehttps://t.co/4jLrZvGyMK pic.twitter.com/FfbEJiAcrg
— @CKD_ce (@ckd_ce) January 10, 2022
14) . . . in other components of the glomerular filtration barrier such as the glomerular basement membrane (#GBM) & the fenestrated endothelial layer. https://t.co/QFN5fdfXUQ pic.twitter.com/D8bVSQq8xw
— @CKD_ce (@ckd_ce) January 10, 2022
16) Mark your response and return TOMORROW for the correct answer, more education on #FSGS, and your link to FREE CE/#CME! #nephtwitter @nephondemand @IgAN_JBarratt @ChristosArgyrop @CKJsocial @ERAkidney @kidneypathology @Vikas_R_D @Renalpathsoc
— @CKD_ce (@ckd_ce) January 10, 2022
18) Yesterday's poll? Wait–did you vote?? If not, scroll up to tweet # 15 and TAKE A STAND before going forward! pic.twitter.com/KMCCSoy2Pa
— @CKD_ce (@ckd_ce) January 11, 2022
20) Genetic testing has been incorporated in many research studies that support discovery of disease mechanisms, novel therapeutic targets, and phenotype/ genotype associations.https://t.co/QFN5fdfXUQ
— @CKD_ce (@ckd_ce) January 11, 2022
22) Before we go to specific treatment of FSGS, let us look at “General Management Principles for Patients with Glomerular Diseases”
— @CKD_ce (@ckd_ce) January 11, 2022
🔓https://t.co/4jLrZvGyMK pic.twitter.com/RMDpYDcOqz
24) So . . . now on to treatment of #FSGS: see
— @CKD_ce (@ckd_ce) January 11, 2022
🔓https://t.co/4jLrZvGyMK. #Immunosuppression should not be used in adults with FSGS of undetermined cause (FSGS-UC), or in those with secondary FSGS.
26) Adults with primary #FSGS who respond to glucocorticoid treatment should receive glucocorticoids for ≥6 months. In adults with relative contraindications or intolerance to glucocorticoids, alternative immunosuppression with CNIs should be considered as initial therapy. pic.twitter.com/SkjW0JBnos
— @CKD_ce (@ckd_ce) January 11, 2022
28) So what does the future hold for FSGS therapies? pic.twitter.com/KnT92X4wo9
— @CKD_ce (@ckd_ce) January 11, 2022
30) And then you can put 👀on data: in DUET: A Phase 2 study, patients with FSGS achieved significantly greater reductions in proteinuria after 8 weeks of #sparsentan versus #irbesartan. Sparsentan was safe and well tolerated.
— @CKD_ce (@ckd_ce) January 11, 2022
🔓https://t.co/exykXBkE3J pic.twitter.com/Ec5ts4bg0l
32) Take a look also at the DUPLEX Study, and ongoing Phase 3 characterization of the long-term antiproteinuric efficacy &nephroprotective potential of dual ETA and AT1 receptor blockade with #sparsentan, compared to irbesentan, in patients with FSGS:
— @CKD_ce (@ckd_ce) January 11, 2022
🔓https://t.co/bwOTbPVQSB pic.twitter.com/XdW0EKxs1M
34) Mark your answer and return tomorrow. You'll get the correct answer and a link to grab your FREE CE/#CME! COME BACK! Nods to @drbstewart @NatRevNeph @VelezNephHepato @acssjr @Sglt2inhibitorL @SantosGallegoMD @drricardocorrea @AliceYYCheng #FSGS
— @CKD_ce (@ckd_ce) January 11, 2022
36) Yes . . . we already have #DAPA-CKD: in pts w/CKD, ➕or➖diabetes, risk of composite of sustained⬇️eGFR of at least 50%/ESKD/death from renal/CV causes was significantly lower with dapagliflozin (vs placebo)#VisualAbstract by @whatsthegfr
— @CKD_ce (@ckd_ce) January 12, 2022
🔓https://t.co/XS7XmyrYmi pic.twitter.com/2llYUqQm3E
38) And then there's #PODO, a Phase 2 Study of PF-06730512 in #FSGS
— @CKD_ce (@ckd_ce) January 12, 2022
Findings from this proof-of-concept study may support further development & evaluation of PF-06730512 to treat FSGS & warrant Phase 3 clinical trials#VisualAbstract by @Priti899
🔓https://t.co/LoOrq2pRdX pic.twitter.com/UfQViIlL4I
40) In summary, the new classification of #FSGS will allow differential stratification of patients with FSGS based on their clinical presentation and pathological findings on kidney biopsy.
— @CKD_ce (@ckd_ce) January 12, 2022
42) Such efforts will facilitate the identification of effective therapeutic agents.
— @CKD_ce (@ckd_ce) January 12, 2022
🔓https://t.co/nRxiRT1NY8 pic.twitter.com/AyCq1v10Wy
43) And THAT'S IT! You made it! 0.5h CE/#CME credit for #physicians #PAs #NPs #nurses #pharmacists. Just go to https://t.co/xDkOCZP7st and print your certificate. And FOLLOW US for more expert-led #accredited #tweetorials right here on @ckd_ce. I am @edgarvlermamd
— @CKD_ce (@ckd_ce) January 12, 2022