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New biomarkers in axSpA. In early axSpA (DESIR cohort), higher baseline Phospholipid transfer protein (PLTP) activity was linked to sacroiliac radiographic progression over 5 years. Lower zonulin and lipopolysaccharides (LPS) levels also associated with progression. Highlights https://t.co/1uBtR4QA97
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Clinical Year in Preview
SpA: no difference in efficacy rotating vs switching bDMARD MoA for next steps
@RheumNow #ACR25 #LB09 https://t.co/shCLgk7Yqz
Jiha Lee JihaRheum ( View Tweet)
In a U.S. axSpA cohort (n=4,799), women had a 24% higher adjusted risk of TNFi discontinuation vs men especially under age 65. No sex differences seen for IL-17i or JAKi, though sample sizes were small. Highlights need for sex-informed treatment strategies. Abstract#2634 https://t.co/58Dw3nFCsf
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Use of AI in AxSpA imaging for diagnosis. ASembleNet, a hybrid deep learning model, achieved 99% accuracy on coronal and 98.1% on axial MRI for AS classification, outcomes higher than ResNet50, Xception, and InceptionV3. Validated on ASAS cases, with Grad-CAM interpretability and https://t.co/yU8shaIdP2
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
What's the latest in PsA? https://t.co/I8ZgRQpVy6
Great review for whats new in PsA by @drpnash
Looking forward for Large IL23-Axial study results.
@RheumNow
#ACR25
Links:
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
Cohort study comparing 3yr safety outcomes of JAKi vs. TNFi in AS pts
JAKi use: ⬆️incidence of HZ infxn but not significant; ⬆️all-cause mortality (HR 4.94) and GI bleed (p=0.04)
Individualize tx. consider potential complications
#ACR25 @RheumNow Abs2633 https://t.co/pjKAazQFwW
Links:
sheila RHEUMarampa ( View Tweet)
Sex differences in 💊 d/c in axSpA from the RISE registry
🔅Females - ⬆️discontinuation risks for TNFi
🔅No sex differences seen in dc risks for IL17i and JAKis
🔅Young females discontinued faster than males
Gender diff in SpA can guide tx decisions
#ACR25 @RheumNow Abs2634 https://t.co/kcXfZrU4zI
Links:
sheila RHEUMarampa ( View Tweet)
In a retrospective TrinetX analysis of 3 year safety outcome in AS, JAKi use was linked to higher mortality and GI bleeding vs TNFi, but lower malignancy risk. Infection rates were similar, with a trend toward more herpes zoster in JAKi users. Abstract#2633 @RheumNow #ACR25 https://t.co/pPY0wpAKA3
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Agrawal et al. Case study of tofacitinib + bDMARDs in refractory IA. 7 SpA, 2 RA, 1 JIA. Effective and safe. @RheumNow #ACR25 Abstr#2338 https://t.co/Y0B3W4csJX
Richard Conway RichardPAConway ( View Tweet)
In a 4-year study of 85 SpA patients, ChatGPT-4o matched SPSS in analyzing NLR/PLR trends. Outputs were identical, but ChatGPT offered faster interpretation and clinical context, highlighting AI’s potential to streamline early-stage research. Abstract#2354 @RheumNow #ACR25 https://t.co/W3pPQijPBD
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
ROC-SpA study assessed whether changing to an IL-17Ai was superior to rotating to a 2nd TNFi in axSpA pts who failed on a 1st TNFi
At wk 24, no significant diff in ASAS40 rates bet the 2 groups
IL-17Ai not superior to a 2nd TNFi
Rotate or change?
#ACR25 @Rheumnow AbsLB09 https://t.co/4EtNEFTSN9
sheila RHEUMarampa ( View Tweet)
To be continued (or discontinued?): Abstract 2360: Compared to TNFi, IL-17i & JAKi users had 🔹 Higher odds of med switching <180 days 🔹 Shorter time to discontinuation @RheumNow #ACR25 #axSpA https://t.co/IOHaFSJqHn
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Is taking NSAIDs +TNFi better for the joints?
Abstract 2359: In radiographic axSpA, NSAIDS + TNFi associated with
-fewer syndesmophytes 36% vs 58% TNFi
- no significant effect on hip structural changes
- @RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
In case you have a (gut) feeling something’s off…
Abstract 2315: The gut microbiome in #SpA 🔬
⬆️ Proteobacteria (incl. Escherichia spp)
⬇️ Firmicutes (“good” bacteria)
Higher disease activity ↔️ lower alpha diversity
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Zavada et al. 52 patients. bDMARD therapy improves sexual function at 6 months in r-axSpA. Improvements in function, desire, satisfaction in those with baseline erectile dysfunction @RheumNow #ACR25 Abstr#2346 https://t.co/IUMGCFnXZh
Richard Conway RichardPAConway ( View Tweet)
Konsta et al. Adding NSAID to TNF inhibits spinal but not hip radiograpic progress. 262 patients, TNF+NSAID 100, TNF alone 162. New syndesmophytes 36% vs 58%. ΔmSASSS-score/year 0.1 vs 0.7. No effect on progression of hip radiographs. @RheumNow #ACR25 Abstr#2359 #ACRBest https://t.co/k9j2M2E3ze
Richard Conway RichardPAConway ( View Tweet)
Macedo et al. Increasing exercise improved QoL in axSpA. Mobility limitation and obesity worsened it. At least to some degree these effects appear independent. @RheumNow #ACR25 Abstr#2326 https://t.co/Ei4cKTNHyn
Richard Conway RichardPAConway ( View Tweet)
Gender differences in p/axSpA in Turkiye from ASAS-PerSpA:
Males - early onset IBP (<45yrs); sacroiliitis on CR, HLA-B27+ (vs. females)
Females - peripheral dse, enthesitis, Pso, dactylitis; ⬆️dse activity, FM (vs. males)
Individualize & optimize tx.
#ACR25 @RheumNow Abs2322 https://t.co/vcisNguJLB
sheila RHEUMarampa ( View Tweet)
Rotation or Change in Biologic post TNFi failure in axSpA. Switching biologic class after TNFi failure improved outcomes in axial SpA. In a randomized trial of axSpA patients with inadequate response to a first TNFi, switching to an IL-17Ai was not superior to cycling to a second https://t.co/MEsokWeT8e
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
This cohort study from Ontario of 🚺w/axSpA
✳️GDM, antepartum hem, SMM (severe maternal morbidity) -⬆️ in axSpA
✳️Neonat complications-preterm birth
Factors assoc w/SMM- age, comorbidity, gestational age at delivery
Better strategies for maternal care
#ACR25 @RheumNow Abs2200 https://t.co/LrVzJLnvWe
Links:
sheila RHEUMarampa ( View Tweet)
