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  • RNL25 Weschler 2
    Formerly classified as an ANCA-associated vasculitis, EGPA is both most commonly ANCA negative and clinically different to the other two ANCA-associated vasculitis conditions, GPA and MPA. The management of EGPA has frequently fallen into the trap of being copied from its more common and well-known cousins. Now, however, we are seeing a discordance and following GPA/MPA management will potentially lead to both over-treatment and suboptimal treatment for EGPA. In this context, the Sunday morning session at RNL 2025 on “EGPA management in 2025 and beyond” by Dr. Michael Wechsler was both timely and clinically relevant.
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Eric Dein @ericdeinmd 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… https://t.co/RIe7BhSgvJ https://t.co/4dVdR088XF
Dr. John Cush @RheumNow (  View Tweet)
TheDaoIndex @KDAO2011 A practical clinic-based approach to assessing CVD, CA screening, lung disease, infections for rheums by Dr Bryant England who offers us menus.. start by asking about symptoms. #RNL2025 https://t.co/AcQDJS870I https://t.co/UCyDOF2GRZ
Dr. John Cush @RheumNow (  View Tweet)
Adela Castro @AdelaCastro222 Multimorbidity in Rheumatoid Arthritis: -Affects >75% of pts -Reduces quality of life and increases mortality -Highly associated w/ D2T RA -Requires multidisciplinary care teams (PCP, specialists, case management, PT) -Management should start early… https://t.co/Sshm8CUWOA https://t.co/W9dojZT99T
Dr. John Cush @RheumNow (  View Tweet)
Jeffrey Curtis @RADoctor Great talk at #RNL2025 by Dr Una Makris on managing geriatric rheumatology patients. How often do we under-treat #Rheumatoid arthritis patients with advanced therapies because we fall into the trap of ageism? https://t.co/kWLxt15n4X https://t.co/cmLjqigNol
Dr. John Cush @RheumNow (  View Tweet)
Janet Pope @Janetbirdope Dispel the #myth #rheumatoid #arthritis is NOT Just a disease of Young and middle aged Elderly PREVALENT #RA Pts and 👇 INCIDENT Pts in >65yrs is skyrocketing 🚀 Need #Rx goals and equitable #Rx Uma Makris #RNL2025 https://t.co/3IsVKTSEyy

Dr. John Cush @RheumNow (  View Tweet)

Will AI put me out of a job? The advent of artificial intelligence (AI) continue to amaze us in this changing world and in multiple areas of medicine. As an evolving science, rheumatology has also been introduced to AI where interesting applications seem to enhance patient… https://t.co/W0ysHzxiRg https://t.co/rPOcjC2lyR
Dr. John Cush @RheumNow (  View Tweet)
TheDaoIndex @KDAO2011 @UnaMakris wants us to shift our approach to #GeriRheum. #RNL2025– remember the 5 M’s Multimorbidity Mind Medications Mobility what Matters most https://t.co/MIVnpw87rW https://t.co/D4AmrYhyWH
Dr. John Cush @RheumNow (  View Tweet)

That's not my problem - or is it? Multimorbidity in RA

Traditionally, rheumatologists have often been deferential to the non-articular concerns in RA to other providers, though these issues are often left unaddressed. What role do rheumatologists have in the management of multimorbidity in our patients?

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Adela Castro @AdelaCastro222 Are your patients aging with RA, or are they diagnosed with Late Onset RA (LORA)? -LORA pts tend to present acutely -High inflammatory markers~PMR Like -Seronegative/Decreased titers of RF/CCP @UnaMakris #RNL2025 https://t.co/tLrGBV6P1i https://t.co/53HVvUmrG4
Dr. John Cush @RheumNow (  View Tweet)
TheDaoIndex @KDAO2011 Late onset RA (LORA) aka RA diagnosed at an older age — pts have higher inflammatory markers, presents like PMR; they also have polypharmacy, comorbidities, frailty, etc that can complicate management @UnaMakris #RNL2025 @RheumNow #GeriRheum… https://t.co/E2WFwfCsWD https://t.co/tKF0OnUFQH
Dr. John Cush @RheumNow (  View Tweet)
Eric Dein @ericdeinmd J Curtis #RNL2025 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… https://t.co/FVe8CtcxfK https://t.co/0mXjEikN1K
Dr. John Cush @RheumNow (  View Tweet)
#Benralizumab vs #Mepolizumab both work for #EGPA Which to use? 🤷‍♀️ perhaps some advantage of more steroid sparing w Benralizumab? ? JAKi ?long acting #IL5i #RNL2025 ⁦@RheumNow⁩ https://t.co/UkthHpNRIq
Janet Pope @Janetbirdope (  View Tweet)
Obinutuzumab Efficacy in Active Lupus Nephritis A phase 3, randomized controlled trial of an anti-CD20 monoclonal antibody, obinutuzumab, was shown to be effective and safe in patients with active lupus nephritis. https://t.co/e1cDvJcC9g https://t.co/HUDd1ocAvc
Dr. John Cush @RheumNow (  View Tweet)
“Preventing” Arthritis in Psoriasis Prevention of the development of our systemic rheumatic diseases in individuals deemed at risk, or with some form of precursor disease process, has been a hot topic in recent years. https://t.co/nGKGUkKVUl https://t.co/PruJZLAq9n
Dr. John Cush @RheumNow (  View Tweet)
Eric Dein @ericdeinmd 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… https://t.co/eAOR0jFmO3 https://t.co/TB6Ecd8nZh
Dr. John Cush @RheumNow (  View Tweet)
Adela Castro @AdelaCastro222 How can AI be useful for RA pts and rheumatologists? -AI models have the potential for improving diagnosis, management and outcomes in RA pts. -Can also improve efficiency and clinic workflow. -Not so perfect as it sounds (hallucinations, limited… https://t.co/YA4A990p2v https://t.co/YnHtbP83Nm
Dr. John Cush @RheumNow (  View Tweet)
Dr Rhee @RennieRhee mimics of medium/large vessel vasculitis. Increase in cross-sectional imaging use has increased the number of these we get referred. Segmental arterial mediolysis also pops up a fair bit. @RheumNow #RNL2025 https://t.co/yozRGE9Ncl
Richard Conway @RichardPAConway (  View Tweet)
ICYMI: Treatment of sclerosing skin disease: -Progression: inflammation➡️sclerosis➡️ atrophy -Existing therapies target inflammation not sclerosis-poorly developed ttx for sclerosis -First aspect is determining disease state, depth of involvement, extracutaneous manifestations… https://t.co/lYQRW2yDRG https://t.co/DQZjYKS2Ks
Adela Castro @AdelaCastro222 (  View Tweet)
🆕 slide from @Official_ASAS HLA-B27 strongly associated with Anterior #Uveitis in #SpA #AAU #AxSpA #B27 https://t.co/lq19vIys9x
Dr Gurdeep S Dulay @gurdeep_dulay (  View Tweet)
@RichardPAConway on PMR #RNL2025 @RheumNow PMR mimics: look for mimics in unusual/refractory cases - Suspect the mimics to avoid undertreatment or over-treatment Conway: PMR is NOT easy. Easy to misdiagnosis, easy to mistreat. "One of our most challenging cases" https://t.co/WqPWwCuutF
Eric Dein @ericdeinmd (  View Tweet)
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