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Can the blood reflect what’s happening in the joint? In early RA, 11 synovial proteins mirrored serum levels, forming an inflammatory signature linked to disease activity and csDMARD response. High-signature pts had stronger treatment responses (AUC>0.8)
@RheumNow #ACR25 A#0070
Jiha Lee JihaRheum ( View Tweet)
Miller et al. Fibrinogen for GCA diagnosis and flare identification. Similar to ESR/CRP in diagnosis. For flares, lower sensitivity (79%) but better specificity (96%) @RheumNow #ACR25 Abstr#750 https://t.co/SIkAkEeYh1
Richard Conway RichardPAConway ( View Tweet)
Fascinating: tDR-1, a microbial sRNA, appears protective for RA in at risk ACPA+ pts:
- tDR-1 higher = less develop RA
- can predict seropos RA development
- in vitro type 1 IFN mapping checks out
Useful in itself, but importantly: why does it happen?
#ACR25 ABST0775 @RheumNow https://t.co/ep99dNAzFV
Links:
David Liew drdavidliew ( View Tweet)
Observational study of fibrinogen for diagnosis of GCA
At a cutoff of 4.7, roughly similar diagnostic performance as compared to ESR/CRP
Kind of neat, but does not appear to have additive benefit
#ACR25 @RheumNow Abstr#0750 https://t.co/xy2qn4jHXP
Mike Putman EBRheum ( View Tweet)
ILD found in 30% of Sjögren’s pts w/ HRCT.
A new nomogram-based tool (AUC 0.8) predicts ILD risk using age, ESR, C3, hypergammaglobulinemia & anti-La/SSB.
Goal: guide HRCT referrals & catch ILD earlier.
@RheumNow #ACR25 Abstract #0510 https://t.co/FvAprq8eol
Jiha Lee JihaRheum ( View Tweet)
#ACR25 Abstr#775 Previous study showed plasma tRNA-derived RNA (tDR-1), produced by bacteria from the phylum Proteobacteria, was assoc. with lower RA activity.
In 60 At-Risk CCP3+ people, Plasma tDR-1 improved prediction of RA. Need validation & adoption in practice @RheumNow https://t.co/XBmtohBEHc
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
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 https://t.co/XI9y8KgDNR
Links:
Mike Putman EBRheum ( View Tweet)
tRNA-derived RNA (tDR-1), circulating microbial RNA
Associated w/ reduction in risk of RA conversion in asymptomatic CCP+ individuals (60 vs. 120+ ctrls),
‼️ tDR-1 alone over performs prediction model w/ smoking shared episode and RF w/ AUC 0.86
What is the mechanism? tDR-1 https://t.co/fuyk4NeOyA
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
#0775
Higher circulating microbial small RNA tDR-1 linked to lower risk of developing RA in CCP3+ individuals (AUC 0.86).
tDR-1 downregulates interferon-response genes in vitro, suggesting microbiome-mediated anti-inflammatory mechanism in RA pathogenesis. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
Abstract #0607: The age at diagnosis of SLE is rising in US based cohort📈
Those diagnosed ≥30 yrs were:
⬆️ More likely to have oral ulcers, hematologic features, +ANA
⬇️ Less likely to have malar rash or proteinuria
@RheumNow #ACR25 https://t.co/pMPVLg1xTZ
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
In a nationally representative NHANES sample, inflammatory back pain (IBP) was not associated with HLA-B27 positivity or elevated CRP, regardless of IBP criteria used (e.g., Berlin 8a: OR 0.88, p=0.876). IBP alone may be insufficient for identifying axSpA-related immunogenetic or https://t.co/82NjVU171z
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
What can we learn from longitudinal peripheral blood multi-omic profiling in at-risk individuals?
50 RA converters vs. non converters from StopRA study
Decision tree showing highest risk for conversion to clinical RA in Individuals w/
-CCP3 ≥108 units
-T peripheral helpers https://t.co/jw53EB6tI6
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
#0774
Multi-omic profiling of anti-CCP3+ “at-risk” individuals reveals Tph & cytotoxic CD8+ expansions, altered gene/chromatin profiles and predictive model (AUC 0.77) for RA conversion
PTPN22 locus accessibility & Tph ≥ 2.45% identify highest risk. @RheumNow #ACR25 https://t.co/JDSMkdmoGv
Mrinalini Dey DrMiniDey ( View Tweet)
A new marker for stratification of ILD in dermatomyositis: Anti MDA5 antibodies!
Japanese study
MDA5 (201-300) positivity associated w/
Lower 6-month progression-free survival (43% vs. 74%)
Lower 5-year survival rates (34% vs. 66%)
Validation in other populations awaited https://t.co/IBiYyATer4
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
#0773 Anti-MDA5 epitope mapping identifies key regions (aa 201-300, 601-700) linked to treatment resistance & poor prognosis in DM-ILD and even IIPs.
Epitope-specific antibodies could refine risk stratification & guide therapy in ILD beyond autoimmune disease. @RheumNow #ACR25 https://t.co/moRffVGZPn
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR25 Abstr#0772. Should we be worried of #SLE patients with low uPCR 0.25-0.49? Kidney biopsy in N=28 + poor prognostic (Non-White, active serology or active sediment)
- 71% had LN (No class IV or Mixed)
- 46% actionable LN
Cost-effectiveness data needed.
#ACRBest @RheumNow https://t.co/Bt3fuA3aJh
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
AI-enhanced MRI integrating STIR and T1-weighted MRI with BME data reflecting both inflammatory and structural changes, enabling the AI model to predict clinical diagnoses of axSpA with accuracy of 82%. Successfully identified axSpA patients who did not meet the ASAS criteria for https://t.co/dLlGj0ZFpj
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Plenary session at #ACR25!
#0772 When should we biopsy in SLE?
In pts with uPCR 0.25-0.49 g/g + LN predictors, 69% already had LN (many Class III/V). Low C3/C4 were most important factors.
0.5 g/g cutoff may delay diagnosis and treatment. Time to rethink thresholds? @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
Early, low level proteinuria is a harbinger in SLE. ~50% with elevated UPCR but <0.5 had actionable LN on early bx.
Risk factor = low c3/c4
Urine biomarkers promising
#ACRBest #ACR25 @RheumNow https://t.co/WuNPKeqeid
Links:
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
What's new in the Pre-RA world?
Slowly unraveling mechanisms and biology associated to transition from CCP+ asymptomatic pre-RA state to clinical RA
Here is my summary of a few abstracts presented at #ACR25 proposing biomarkers beyond the realm of clinical and classical
Aurelie Najm AurelieRheumo ( View Tweet)
