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Hitting the Target: T2T Therapy in SLE
Treat-to-target strategies are not a new concept in rheumatology. It has shown to improve patient outcomes and quality of life in RA and PsA, and is now being increasingly adopted not only in SLE research but also in clinical practice. This article reviews key highlights from Dr. Eric Morand’s plenary session lecture on Treat to Target in SLE: Current Evidence and Future Directions, presented during the recent APLAR 2025 Congress.
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SLE and Osteoporosis
In one of the SLE sessions at the APLAR 2025 Congress, Prof. Sandra Navarra discussed the assessment and management of osteoporosis in SLE patients, particularly glucocorticoid-induced osteoporosis (GIOP) and this article reviews the highlights and key takeaways from her talk.
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Hitting the Target: T2T Therapy in SLE
Treat-to-target strategies are not a new concept in rheumatology. It has shown to improve patient outcomes and quality of life in rheumatoid arthritis and psoriatic arthritis and is now being increasingly adopted not only in SLE research https://t.co/PfnG0AeJsH
Dr. John Cush RheumNow ( View Tweet)
There is no criteria for infection-induced Antiphospholipid syndr (APS). aPL & aCL abs have been reported w/ COVID, HCV, HIV, EBV, varicella-zoster, & CMV. infections may induce transient aPL positivity without over APS, but may precipitate APS or catastrophic APS (CAPS).
Dr. John Cush RheumNow ( View Tweet)
GCs have potent anti-inflammatory effects but it’s long term complications can be catastrophic.
In SLE pts, it shows a 3-fold increased risk of organ damage for each addtl 1mg of Pred/day.
📌Aim for short duration of use with lowest effective dose
@RheumNow #APLAR25 https://t.co/UugrcX073Z
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sheila RHEUMarampa ( View Tweet)
SLE and Osteoporosis
Systemic Lupus Erythematosus (SLE) is a multisystem autoimmune disease that can present with a variety of signs and symptoms and organ involvement. Comorbidities further complicate the disease course that may lead to poor health-related quality of life and https://t.co/8ZmtLjzbqA
Dr. John Cush RheumNow ( View Tweet)
In lupus patients presenting with demyelinating symptoms, consider a probable disease overlap between NPSLE and NMOSD.
>>>> serum AQP4 is highly specific for NMOSD.
@RheumNow #APLAR25 @rheumarhyme @marklagacmd https://t.co/2Z8rbJ3a1c
sheila RHEUMarampa ( View Tweet)
Juvenile Lupus: some new mechanistic data
Circulating Treg population are expanded in SLE and in particular in Lupus Nephritis compared to HC
Naive Treg display specific molecular features in particular over expression of FCRL3 and TLR5 showing new pathways to explore in https://t.co/RuMtWRkpYB
Aurelie Najm AurelieRheumo ( View Tweet)
Dr. Alberta Hoi graphically presents the difference bet acute confusional states & chronic cognitive changes in #lupus patients presenting with NP symptoms.
NPSLE continues to pose a diagnostic challenge bec pts may present with more than one syndrome complex
@RheumNow #APLAR25 https://t.co/4nYTo1fzVz
sheila RHEUMarampa ( View Tweet)
‼️More reasons why we should avoid steroids in #lupus patients
@RheumNow #APLAR25 https://t.co/a5IeutJ5mi
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sheila RHEUMarampa ( View Tweet)
The overall prevalence of #osteoporosis in SLE is ~33-40% and is due to several factors with GC therapy being one of them.
Monitor DXA every 6-12 months (vs. 2 yrs for standard OP)
☝️Screen for GIOP
☝️Treat accordingly - once on GCs & esp w/long-term use
@RheumNow #APLAR25 https://t.co/E9FJDHrBUo
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sheila RHEUMarampa ( View Tweet)
Lessons Learned in Neuropsychiatric SLE
Dr. Sheila Reyes, The Philippines, reports highlights from a session on neuropsychiatric systemic lupus erythematosus, presented at the APLAR 2025 Congress in Fukuoka, Japan.
https://t.co/Dh1GQnBhvg https://t.co/wX5FgpIq7C
Dr. John Cush RheumNow ( View Tweet)
9 yr. study of anti-Ro52 & ILD pts -- 1,026 pts 15% Ro52+: interstitial pneumonia w/ autoimmune 48%, CTD-ILD 13%, idiopathic pulm fibrosis 10%, hypersens pneumonitis 6%, idiopathic ILD 24%. Ro52+ were younger w/ more autoimmune dz, +MSA Abs, ILD progression, death, & lung https://t.co/fuFfnaYIRd
Dr. John Cush RheumNow ( View Tweet)
Is it #lupus?
Interesting study by @escheriKYA et al. showing comparable diagnostic performance of SLERPI (93%) in 🇵🇭 patients vs. SLICC and EULAR/ACR criteria
A practical alternative tool that can be used by clinicians in a resource-limited setting 🤔
@RheumNow #APLAR25 https://t.co/xByBkjEr3r
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sheila RHEUMarampa ( View Tweet)
3 yr study of FDA Adverse Event Reporting on anifrolumab shows following AEs- URIs, herpes zoster, infusion reactions, and potential new risks like dyspnea and pyrexia, not in the label. https://t.co/vP2YWGT2vR https://t.co/BruGBtXEBu
Dr. John Cush RheumNow ( View Tweet)
A new player in AIRD
ThA age associated T helper cells
Displaying both Cytotoxic & APC functions
Correlation with disease activity in RA and SLE
More research is needed to better characterize function but could be a promising therapeutic target
@RheumNow #APLAR25 https://t.co/4SnY65tXpJ
Aurelie Najm AurelieRheumo ( View Tweet)
This slide reflects the rheumatologist’s goals for treating #lupus
Prof. Mosca also highlights the fact that achieving targets is as important as maintaining these treatment targets.
@RheumNow #APLAR25 https://t.co/u8fw3fThXI
sheila RHEUMarampa ( View Tweet)
Prof. Eric Morand on the SLE T2T approach.
Ultimate goal is remission but we know that not all patients achieve this state.
Thru the T2T approach, low dse activity (LLDAS) is an acceptable target & a protective alternative goal
@RheumNow #APLAR25 #Lupus https://t.co/vz7E5prps0
sheila RHEUMarampa ( View Tweet)
Optimizing outcomes of pregnancy in #lupus:
📌 all patients should undergo preconception counselling
📌 close monitoring by a multidisciplinary team
- a ⬇️ cerebroplacental ratio reflects placental dysfunction
#APLAR25 @RheumNow @rheumarhyme https://t.co/RSyqgpRTG5
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sheila RHEUMarampa ( View Tweet)
@Lupusreference reviews clinical trials in LES, highlights key limitations of current outcome measures and propose a novel a clinical outcome in SLE based on
« How patients feel function and survive »
Very relevant to the human experience of having a chronic illness
@RheumNow https://t.co/vM58C9KfQ3
Aurelie Najm AurelieRheumo ( View Tweet)
