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Should You Add MTX to a TNF Inhibitor in Psoriasis?
Target emulation trial shows adding methotrexate (MTX) to adalimumab (ADA) does not augment the effectiveness and persistence of adalimumab alone in treating plaque psoriasis in adults.
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IMPACT Study - Certolizumab Efficacy in APS Pregnancies
A pilot trial assessed the safety and value of tumour necrosis factor α inhibitor treatment with certolizumab in patients with high-risk pregnancies with antiphospholipid syndrome (APS).
Diagnosing Neuropsychiatric SLE (5.23.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com - including views on the vagus nerve, NPSLE and CAR-T mania.
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Biologics in Pregnancy Patients With Autoimmune Disease
A large cohort, claims data study shows that among pregnant women receiving biologic therapies for autoimmune conditions, 72% continued their biologics pregnancy, more so among inflammatory bowel disease (IBD) patients than those with rheumatoid arthritis (RA), psoriasis (PsO) or psoriatic arthri
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Comparative efficacy of tofacitinib vs. adalimumab in RA - metanalysis of 9 RCTs, 24,643 pts finds Tofa signif superior to ADA for ACR20 (RR 1.28), HAQ-DI, VAS, but no difference in adverse events (RR 0.96) or DAS28-CRP improvement https://t.co/5mVY2Qvdms https://t.co/czxnlYHEAl
Dr. John Cush RheumNow ( View Tweet)
Early PsA? Treat fast, treat hard.
The STAMP RCT showed that early secukinumab + MTX led to faster ACR50 and PASI90 responses vs standard care in a T2T strategy. By 12 months, outcomes were similar, but early SEC needed fewer escalations.
Abstract#OP0092
@RheumNow #EULAR2025 https://t.co/cAZTc9eN16
Jiha Lee JihaRheum ( View Tweet)
#OP0066 Danish registry study finds no increased risk of cancer recurrence with bDMARDs vs csDMARDs in RA patients with prior solid tumor in remission. IPTW-adjusted HR for any bDMARD: 0.92 (95% CI 0.38–2.21).
📉 TNFi, ,RTX also not associated with recurrence
@RheumNow #EULAR2025
Jiha Lee JihaRheum ( View Tweet)
Can IL-17F signalling be modulated by treatment with TNFi?
In PsA pts non responders to previous TNFi, there was increased expression of IL17F-related gene signature. Suggesting a potential mechanism for the consistent level of clinical response observed with BKZ.
Abstract https://t.co/D6fvp18UTz
Links:
Adela Castro AdelaCastro222 ( View Tweet)
Worried about cancer risk with ts/bDMARDs in RA?
Real-world data from over 4,600 patients says: don’t be. No increased risk of cancer (incl. NMSC) for JAKi, IL6i, CD20i, or CTLA4-A vs TNFi in long-term registry follow-up.
Abstract#OP0065
@RheumNow #EULAR2025
Jiha Lee JihaRheum ( View Tweet)
Early intensive therapy in PsA.
STAMP RCT in early PsA:
•ACR50 at 3mo: 43% (early secukinumab) vs 22% (SoC)
•MDA at 3mo: 48% vs 25%
•PASI90 at 3mo: 60% vs 22%
By 12months: outcomes similar, but early secukinumab led to faster control and fewer therapy escalations. https://t.co/TKa5z24NQX
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Should we start strong in PsA?
In the SPEED RCT (Coates et al), both early TNFi and combo csDMARDs outperformed step-up care in moderate-severe PsA. TNFi showed the most sustained benefit through 48w.
Abstract#OP0089
@RheumNow #EULAR2025
Jiha Lee JihaRheum ( View Tweet)
POSTER HALL PRESENTATION: Sponsored by AbbVie Medical Affairs + Health Impact.
🔍Real-world outcomes in patients with RA remaining on first-line TNFi
📽️See Dr. Charles-Schoeman discuss subsequent outcomes in patients who did or did not achieve response at 3 or 6 months https://t.co/8RmcigG7SF
Dr. John Cush RheumNow ( View Tweet)
Swiss Registry study of PsA outcomes when started on either TNFi (N 503) or IL-17i (n 341), latter w/ more severe PSO. IL-17i durability superior to TNFi (median 828 vs 445 d, P<.001), w/ less D/C in women (HR 0.57); but ACR 20 (14 v 33%) & ACR50 (7 v 24%) favored TNFi use https://t.co/R33bwSeB3E
Dr. John Cush RheumNow ( View Tweet)
Target trial emulation study data from British Dermatologists Biologics & Immunomodulators Register, compared 231 PSO Rx w/ MTX + Adalimumab against 1553 PSO on ADA. @1Yr MTX did not augment ADA only responses based on Rx survival (79% vs 78%) or PASI75 (49% vs 52%). https://t.co/DSYNd9P5Om
Dr. John Cush RheumNow ( View Tweet)
Are PSO pts also Rx for PSA? Registry study of 17,310 PSO pts (19% also w PsA). @ baseline Biologics used in 44% of PSO, but higher rate in PSO+PsA (66% vs 39% PSO). 9.4% of PSO+PsA pts on Rx approved for PSO, but not explicitly for PsA. https://t.co/jMqk6gm1RR https://t.co/CQnwYO9yRO
Links:
Dr. John Cush RheumNow ( View Tweet)
IMPACT Study - Certolizumab Efficacy in APS Pregnancies
A pilot trial assessed the safety and value of tumour necrosis factor α inhibitor treatment with certolizumab in patients with high-risk pregnancies with antiphospholipid syndrome (APS). Certolizumab (CZP) was shown to https://t.co/776CTvvGfb
Dr. John Cush RheumNow ( View Tweet)
Using publicly available FAERS safety data, drug-induced photosensitivity (DIP) - among 17+ million safety reports, there 20,236 linked to DIP. The most common wereimmunosuppressants, monoclonal Abs, neoplastic agents, including adalimumab, adapalene, secukinumab, fingolimod https://t.co/QWg8FVvrZb
Dr. John Cush RheumNow ( View Tweet)
IMPACT Study - Certolizumab Efficacy in APS Pregnancies
A pilot trial assessed the safety and value of tumour necrosis factor α inhibitor treatment with certolizumab in patients with high-risk pregnancies with antiphospholipid syndrome (APS). Certolizumab (CZP) was shown to https://t.co/sbXW6vNX5y
Dr. John Cush RheumNow ( View Tweet)
Certolizumab effective in preventing adverse pregnancy outcomes in high-risk antiphospholipid syndrome. CZP given to 51 APS pts wks 8 to 28. 9 w/ primary APO (17.6%) (6 w/ pregnancy loss <10 wks) - significantly lower than historical controls. Median delivery 36.5 wks. Neonatal https://t.co/KfOOM7sEAt
Dr. John Cush RheumNow ( View Tweet)
DANBIO registry study of 720 RA pts w/ a prior solid cancer (breast, colon. lung, endometrial, melanoma, bladder) in remission who received any biologic DMARD, TNFi or RTX found no incr risk of CA recurrence w/ any bDMARD, TNFi, RTX. Specifically, no incr in breast CA recurrence https://t.co/YJw8qXz1yM
Dr. John Cush RheumNow ( View Tweet)
