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Rheumatology’s Blind Spot: The Persistent Exclusion of Older Adults

Jiha Lee, MD

As the population ages globally, rheumatologists are caring for an increasingly older patient population more than ever before. In RA alone, nearly 40 percent of patients are now aged 65 years or older. Yet the evidence guiding our treatment decisions continues to come from studies that rarely include them, giving rise to a fundamental question: do we really know how best to treat older adults with rheumatic diseases?

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ACR Convergence 2025 Sheds Light on Disparities, Age-Related Trends, and Epidemiology in Autoimmune Rheumatic Diseases

ACR Press Release

At ACR Convergence 2025, new research explored critical disparities and epidemiologic trends shaping outcomes in autoimmune rheumatic diseases across diverse populations and age groups. Studies presented at the meeting highlighted issues ranging from kidney transplant outcomes in lupus to medication disparities in rheumatoid arthritis and demographic patterns in systemic sclerosis and axial spondyloarthritis.

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Pre-ACR25 (10.24.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and info reports the day before ACR 2025

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Skin Biopsies to Predict Scleroderma Outcomes?

Jack Cush, MD

Researchers from the Hospital for Special Surgery and Weill Cornell Medicine have shown that skin biopsies in patients with systemic sclerosis (SSc) can define a fibroblast immunophenotype that may have prognostic and early treatment decision impact.

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High-Resolution CT in CTD-Interstitial Lung Disease

Jack Cush, MD

A systematic review and meta-analysis examined the role of high-resolution computed tomography (HRCT) in diagnosing and characterizing interstitial lung disease (ILD) associated with connective tissue diseases (CTDs).

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Scleroderma-associated Interstitial Lung Disease

Marcy B. Bolster, MD

While we know there are certain clinical features serving as predictors that patients with SSc may develop ILD, including diffuse skin disease and serologies such as anti-Scl-70 and Th/To antibodies, it is imperative that clinicians consider that any patient, particularly early in their disease course (5 years of disease since the first non-Raynaud phenomenon symptom) could develop ILD. 

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What you need to know about scleroderma-related lung fibrosis

Dinesh Khanna, MD, MSc

What do you need to know about scleroderma-related lung fibrosis as a practicing rheumatologist? Here are takeaways from these guidelines and my practice.

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Abstract 1563: Ongoing Phase 1/2 trial of Rese-cel CAR-T in systemic sclerosis 🔹Pt with severe skin involvement showed improvement in mRSS (42→34), PFTs & nailfold capillaroscopy at 6 mo 🔹Grade 2 CRS, no ICANS or DLT reported Early but exciting findings @RheumNow #ACR25

Akhil Sood MD, MS AkhilSoodMD ( View Tweet)

Dr. LRoss presents the SCTC SSc Heart Involvement classification criteria ♥️Criteria score >/= 11pts 🔸SN 77.8%; SP 95.9% 🔸OR 82.6 Huge endeavor towards standardization of SHI to help improve patient outcomes in the future 👏👏 #ACR25 @RheumNow https://t.co/QrgYlksjZB

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sheila RHEUMarampa ( View Tweet)
#1725 Functional NOTCH4 variants contribute to vasculopathy & fibrosis in SSc, particularly in African-American patients NOTCH4 hyperactivation disrupts angiogenesis & drives EndoMT; inhibition (including with FDA-approved Nirogacestat) restores vascular repair @RheumNow #ACR25

Mrinalini Dey DrMiniDey ( View Tweet)

Sun et al. Telitacicept in SARD-ILD (pSS, ASS, RA). 25 patients. Improvements in CT, PFTs, 6MWT. @RheumNow #ACR25 Abstr#1361 https://t.co/q679LOaOyL

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Richard Conway RichardPAConway ( View Tweet)
Who with #SSc-ILD will progress? progression is non linear - can stabilize and worsen Search for Predictive biomarker For clinical care & enriching RCTs Maybe #KL6 🤷‍♀️ Maybe IP-10, MIG No strong #biomarker Depends on what is used #ACR25 @RheumNow @ACRheum Abst#0882 #0883 https://t.co/lyTRUEY9SI

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Janet Pope Janetbirdope ( View Tweet)
Don’t forget 👇 #lcSSc Pts can get and progress #ILD 1/3 of #limited #cutaneous #systemic #sclerosis #scleroderma GET ILD From #EUSTAR >14% progress Esp +Scl70 Remember to screen #CREST Pts & allow these Pts into lung disease trials #ACR25 @RheumNow @ACRheum abst#0879 https://t.co/X15tUgClzN

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Janet Pope Janetbirdope ( View Tweet)
Pregnancy risk in Sjögren’s & scleroderma Meta-analysis (n=4,820) shows ↑ risk of miscarriage in Sjögren’s (RR 1.8) & ↑ preterm birth in SSc (RR 2.4). Calls for preconception counseling & multidisciplinary high-risk OB care. @RheumNow #ACR25 Abstract #1398

Jiha Lee JihaRheum ( View Tweet)

#Cancers esp #hematologic & #lung are ⬆️in Pts w #inflammatory #rheum #diseases Odds ratios of hem malignancies are wide & risk stratification is imp Are we doing a good job? 🤔skin cancer screening ??- not as per general standards Abst#0172 #ACR25 @RheumNow @ACRheum https://t.co/Uve9knXD3o

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Janet Pope Janetbirdope ( View Tweet)
12 yr study of 115 Systemic Sclerosis pts shows Finger-to-palm distance (tip 4th finger to distal palmar crease) may be a useful tool for predicting the progression of skin thickening and the development of digital ulcers in the early stages of severe SSc https://t.co/brCEz5Fqac https://t.co/tiVBdfH39q

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Dr. John Cush RheumNow ( View Tweet)
Detection, Monitoring & Management of Autoimmune ILD The American Journal of Managed Care has reviewed the approach to patients with ILD; a significant cause of morbidity and mortality in those with SARDs, including RA, SSc, and IIM. https://t.co/xtRfLNyZA6 https://t.co/S9JFlMd9CN

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Dr. John Cush RheumNow ( View Tweet)
High-Resolution CT in CTD-Interstitial Lung Disease A systematic review and meta-analysis examined the role of high-resolution computed tomography (HRCT) in diagnosing and characterizing interstitial lung disease (ILD) associated with connective tissue diseases (CTDs). https://t.co/9FmEe6BgN7
Dr. John Cush RheumNow ( View Tweet)
How to assess ILD in your patients? Have a high index of suspicion in your patients with connective tissue disease (especially systemic sclerosis, inflammatory myositis), and rheumatoid arthritis. All patients with CTD may develop ILD but it is more common (% of patients with https://t.co/UXdvPJCqDi
Dr. John Cush RheumNow ( View Tweet)
Why shall we screen all patients with SSc for ILD? Focusing screening strategy on patients « at risk » misses 25% of patients with ILD ILD being the main cause of mortality in SSc @RheumNow #APLAR25 https://t.co/djzCTdZoVb

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Aurelie Najm AurelieRheumo ( View Tweet)
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