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GLP-1 Receptor Agonists: Impacts Beyond Metabolism?

Mrinalini Dey, MD

The GLP-1 story has been hard to miss this year, and at ACR Convergence, it’s clear that these drugs are starting to make real waves in rheumatology. Across multiple abstracts, investigators have used a large real-world dataset, the TriNetX network, to explore how GLP-1 receptor agonists (GLP-1RAs) might influence cardiovascular, renal and immune-mediated outcomes in our patients.

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ACR25 - Day 1 Report

Jack Cush, MD

ACR 2025 began today in Chicago with throngs of rheumatologists, fellows, ARP members, APPs and pharma folk taking to the meeting halls and rooms for tons of novel content. 

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CART

The Rapidly Evolving Landscape of Cellular and Immune-based Therapies

Akhil Sood, MD

A transformation is now underway in rheumatology, where cellular and immune therapies are redefining how we treat autoimmune diseases.

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many heads

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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Big data

Rheumatoid arthritis and the ‘big bang’ at the ACR!

Janet Pope, MD, MPH, FRCPC

Is there ‘bang for the buck’ using big data to help predict who will develop RA in at-risk populations and similarly to predict response to csDMARDs, TNFi and JAKi in RA?

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Crisci et al. from CorEvitas. Alcohol, esp moderate use, associated lower CDAI. Most likely explanation appears to be residual confounders based on impact of adjustments however... @RheumNow #ACR25 Abstr#1340 https://t.co/cd0JLW8nGD

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Richard Conway RichardPAConway ( View Tweet)
What is the #frequency of #CTD #ILD in #USA? Data from #Marketscan >9K & #Optum ~20k CTD-ILD Pts 56-65 yrs, 3/4 F ?under ascertained #RA-ILD - low % but #SSc-ILD approx 16% clinically relevant Same as Ont, Canada #SSc-ILD % Not rare #ACR25 @RheumNow @ACRheum Abst#0154 https://t.co/imfSyOtYpC

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Janet Pope Janetbirdope ( View Tweet)
RA may age the immune system by nearly two decades. IgG glycome profiles showed inflammatory aging even in early RA, tied to low fitness & high inflammation. Improving muscle & fitness may help reverse this biologic clock. @RheumNow #ACR25 Abstract #0835

Jiha Lee JihaRheum ( View Tweet)

Could a sputum test predict risk for RA conversion in at-risk patients? 98 at risk pts, Converters had higher -BL sputum CCP levels -BL Sputum nucleosome and cit-nucleosome levels !although not asso after adjusting for sputum anti-CCP-IgA level In converters, correlation of https://t.co/bqmQqS1Jz5

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Aurelie Najm AurelieRheumo ( View Tweet)
More biomarkers predictive of conversion to clinical RA in at-risk pts Serum PAD4 & PAD 4 levels measured in CCP+ at-risk individuals -PAD4 (not PAD2) increased in RA Converters vs. non converters and HC -PAD4 levels Pre-RA = RA Within high CCP+ at risk individuals, higher https://t.co/LU5zUzui1G

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Aurelie Najm AurelieRheumo ( View Tweet)
Trying to reach RA, PsA patients on social media, to participate in studies? Simple, informational messages work for recruitment Message framing affects engagement but not recruitment The more we understand, the better we can reach the right people #ACR25 ABST0187 @RheumNow https://t.co/JoAthXhXvi

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David Liew drdavidliew ( View Tweet)
A simple flow cytometry analysis of peripheral blood monocytes to predicts progression to clinical RA or PsA in at-risk patients? Too good to be true! 284 RA 56 PsA 57 HC -HLA-DR higher in PsA -CD11c lower in RA But no clear difference between Converters and non Converters https://t.co/f3Sett4eXd

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Aurelie Najm AurelieRheumo ( 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)
Even when inflammation is quiet, fatigue often lingers. In 246 RA pts, 43% had significant fatigue—closely tied to PROMs, not labs. RAPID3 < 6 flagged the few truly “fatigue-free.” Don’t overlook the VAS_Fatigue—it tells a real story. @RheumNow #ACR25 Abstract# 0380

Jiha Lee JihaRheum ( View Tweet)

Real-world JAK persistence in RA is low: <30% at 2 years across Medicare & Marketscan data (n≈20K). Baricitinib lowest persistence; TOF & UPA slightly higher. Oral convenience hasn’t solved long-term adherence. Why? Safety, cost, access? @RheumNow #ACR25 A#0369

Jiha Lee JihaRheum ( View Tweet)

Only 32% of RA pts were satisfied with current txs. In a discrete choice experiment of 354 US pts, many preferred a vagus nerve stimulator over another biologic/JAKi, especially those with prior tx failures. Cost, function, and fatigue drove preferences. @RheumNow #ACR25 A#0370

Jiha Lee JihaRheum ( View Tweet)

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)

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

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David Liew drdavidliew ( View Tweet)
Novelli et al. Upadacitinib in male vs female PsA. Data from SELECT-PsA studies. Appears equivalent in males and females, contrasting with TNFi/IL17i data. @RheumNow #ACR25 Abstr#557 https://t.co/fMKsbCkju0

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Richard Conway RichardPAConway ( 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

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
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