Philip Seo (@philseo) header
Philip Seo (@philseo) profile picture

Recovering Director, Vasculitis Center & Rheumatology Fellowship @jhrheumatology| Former Physician Editor, The Rheumatologist (@ACRheum)| @UpToDate | He/Him

Baltimore, MD
Joined June 2010
Philip Seo retweeted
Here is the inside story on how @UpToDate does what it does. From my experience as an author/section editor for UpToDate for 20 years, here is how it works. It’s amazing! Every day a team of people @UpToDate scour the top medical journals (and major meeting abstracts) for articles of importance. In my case they pertain to myeloma and related disorders. Any article that is felt to be important is sent to a expert MD medical editor at UpToDate who reviews the paper. If the information is felt to be important, the relevant chapter is updated with this content, summarized in a few sentences in Word track and then sent to the author of the chapter who is a top expert in the field. As an author I have to review the update in detail and then make a decision whether to include the new information, and whether the way it has been incorporated is correct or needs to be edited. Once I make a decision, it is then reviewed by an expert section editor. For 15 years for me, the section editor was Dr. Robert Kyle! (Currently I’m the section editor and we have about 6 experts serve as authors on over 40 chapters pertaining to myeloma and related disorders). The section editor independently decides whether the author made the right call and either approves or we have a back and forth till we agree. The updated chapter is then reviewed again by the expert MD editor at UpToDate and then posted. For important phase III trials or FDA approvals we usually make the update within a week. Sometimes by the next day! With so many important papers, every week there are 2-3 updates pertaining to my chapters that go through the above process! It’s hard work but it keeps me ridiculously current. And more importantly it keeps the content accurate and current. This is not random addition of new information. It’s vetted information that’s added. Every UpToDate chapter is also peer reviewed annually. Each chapter also undergoes an annual author and editor review to make sure that the overall content and flow is good and to delete content that may be no longer important or accurate. The extraordinary process and rigor involved is why it’s such an invaluable irreplaceable resource. It is AMAZING and hard to replicate. UpToDate is easy to navigate. But the newly launched UpToDate Expert AI takes it to the next level! It makes the entire content available to query just like you query a top ranked LLM. But it’s not searching the random internet or a stack of published articles. It’s primarily trained and derives vetted and adjudicated UpToDate content. It will not randomly hallucinate. It will not list 10 options for treatment newly diagnosed myeloma but will give you what experts currently feel is the best option based on the latest evidence. All answers are referenced and pointing to specific content sections in UpToDate (which also has links to source material). So you can immediately get all the background information if you need more detail. Working with UpToDate has helped my career immensely. For the last 20 years it has been impossible for me to not know about every important study related to myeloma and related disorders as they get published! For 20 years, I have received a precise summary of every important article published in my field. More importantly I am forced to read them, review the source material, and make a judgment call. As a result I remember this stuff. A gift indeed!
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Philip Seo retweeted
There was a meeting with Duke med school leadership and they allowed anonymous questions to be submitted by faculty. One question was, given all the budget cuts and layoffs why are there so many vice deans and what exactly do they do? Awkward. But apparently many faculty members loved that question.
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Philip Seo retweeted
Ways to reinvigorate the physical exam in medicine Step 1. Do the exam. No "WNL"—we never looked nejm.org/doi/full/10.1056/NE…
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#ACR25 Repro Health ✅ TNFi safe in pregnancy/lactation—no “certolizumab switch” needed ✅ Non-TNFi (IL-1/17/12-23, Belimumab, Ustekinumab) → no red flags ✅ Rituximab: life/organ-threatening OK; compatible w/ breastfeeding #ReproRheum #pregnancy
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#GCA & #PMR @ACRheum #ACR25 #gamechangers #ACRBest Yr 2 Select-GCA abst#776 #upadacitinib in yr2 of GCA REDUCES flares HELPFUL info ?ability to get drug for 2 yrs hopefully Failed Phase3 RCT of #secukinumab in #GCA helped #PMR abst#1175 & +Ph3 for PMR REPLENISH RCT @RheumNow
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#Ianalumab decreases disease activity in active #Sjögren's #disease 2 phase3 DB #RCT added to #SoC in primary #SjD >90% #Ro+ +#ESSDAI in monthly sc dosing vs placebo, Many 2ndary outcomes improved, safe LB#24 #ACR25 @ACRheum @RheumNow #ACRBest
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CAR-T vs bispecific antibodies - what's the difference? @andrew02114 @MGHCancerCenter with the heme-onc point of view in the #ACR25 BCRC @RheumNow – at Rosemont, IL
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The next VEXAS, but also maybe we can treat it? IDH1/2 Another clonal hematopoesis known to cause heme malignancy, but also some inflamm sequelae (autoinflamm-like e.g. PMR/GCA) & you can directly inhibit it Wow. We will hear more #ACR25 LB21 @RheumNow acrabstracts.org/abstract/id…
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Philip Seo retweeted
Plenary 1: SELECT-GCA (RCT, UPA vs PLBO in GCA) Pts in remission re-randomized at wk52 Higher maintenance of remission in pts who continued UPA15 (69%) vs switchers from UPA15->PLBO (29%) Argues strongly for continuing tx in GCA for >1yr! @RheumNow #ACR25 Ab#0776 #ACRBest
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Philip Seo retweeted
Post-hoc PEXIVAS study, estimating risk of relapse from baseline variables Lotsa fancy stats, mostly corroborated known risk factors, but model predicted relapse reasonably well! Probably useful for approach to monitoring... mayyybe treatment? #ACR25 @RheumNow #Abstr0722
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Philip Seo retweeted
Cool study using vasculitis patient-powered reserach network (VPPRN) "SNOT-22" tool captures sinonasal symptoms; associated with disease activity (expected) but also worse among pts even in remission Very important impacter of QOL in AAV #ACR25 @RheumNow Abstr0725
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Philip Seo retweeted
Open label noninferiority RCT "METOGiA" in GCA TCZ improved relapse free survival (83% vs 67% MTX) & pred free remission (81% vs 61% MTX) wk 52. Ignore the weird primary endpt at week 78 Everyone also got pred; are we sure MTX works at all? @RheumNow #ACR25 #ACRBest Abstr#0891
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Philip Seo retweeted
Analysis from FVSG identified 36pts with anti-rituximab antibodies In AAV, lookout for this in pts who are MPO+ & w/higher CD19 at 6 mos. Worse relapse free survival in both AAV & CRYO! @TerrierBen can you share the prevalence of these abs? #ACR25 @RheumNow #ACRBest abstr#1604
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Philip Seo retweeted
Post Hoc analysis from SELECT-GCA Increased rate of herpes zoster for 26wk steroid-UPA 15mg (7.3% vs 4.2% 52wk steroid-plbo) but lower rate of SERIOUS infections (7.9% vs 12.7% 52wk steroid-plbo) Zoster risk is real; steroids are the bigger problem @Rheumnow #ACR25 Abstr#0895
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Philip Seo retweeted
Really useful observational study, 305 pts with TAK Out of 205 pts w/subsequent imaging, 72 (35%) w/NEW lesions in previously-unaffected territory Majority of lesions stenotic. Emphasizes importance of regular monitoring #ACR25 @RheumNow Abstr#1631
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Philip Seo retweeted
This poster is absolutely bonkers & I LOVE it Huge table. Frequency of everything over time Really interesting to see which activity persists / how much damage is accumulated Every trial should be obligated to share this (esp SLE!) #ACR25 @RheumNow #ACRBest Abst#1608
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Philip Seo retweeted
56 pts w/tracheobronchial stenosis in GPA, highly frustrating disease manifestation Not surprising to see severe dx & prior intralesional tx assoc with incidence (ie necessity) of tracheal dilation Leflunomide protective? Have others seen this? #ACR @RheumNow Abstr#1596
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Philip Seo retweeted
Post hoc eval of relapses from MANDARA, MEPO vs BEN in EGPA 30% of pts had relapse, 81% of which were asthma +/- sinonasal disease Remainder were mostly muscle involved, only a few mononeuritis Mostly as expected; useful epi data for clinic #ACR25 @RheumNow Abstr#1769
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Philip Seo retweeted
Excited about this target trial emulation in RA-ILD Compared to RTX, NO significant difference in hospitalization/transplant/death for JAK, ABA, IL6 or TNF Trends toward ABA and JAK looking better than RTX Need trials for sure, but I like this project a lot @RheumNow #ACR25 #ACRBest Abstr#2262
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