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Remission in Axial Spondyloarthritis Unrelated to Gut Inflammation
MedPage Today
Most patients with early, active axial spondyloarthritis (axSpA) who quickly received a tumor necrosis factor (TNF) inhibitor experienced remission, and it didn't matter whether or not they had intestinal inflammation at baseline, a small single-arm study found.
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Add-on certolizumab in pregnant women with APS
Women with antiphospholipid syndrome and lupus anti-coagulant are at high risk of developing adverse pregnancy outcomes (APO). Usual care includes low molecular weight heparin (LMWH) and low dose aspirin (LDA). Despite these therapies, APO have been reported up to 40%.
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From Domains to Decisions: Personalizing PsA Care with Data
At EULAR 2025, Dr. Laura Coates (Oxford) took the plenary stage to reframe how we think about treating psoriatic arthritis. The message was clear: in 2025, PsA treatment is no longer about following a linear algorithm; it’s about understanding the unique constellation of domains, comorbidities, and patient factors that shape each clinical decision.
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Imaging and Early Detection in Psoriatic Arthritis
At EULAR 2025, there have been new developments in imaging in PsA.
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Increasing costs of biologics. X-sectional study of 76 781 psoriasis pts on biologics (TNFi, IL12/23, IL-17i, IL-23i) saw annual treatment cost increase from $21 236 in 2007 to $47 125 in 2021. AVG cost could have been 44% lower if lowest-cost Rx in same class was used https://t.co/IOaK75zsgg
Dr. John Cush RheumNow ( View Tweet)
What would it take for JAKs to ROCK the boat?
JAK inhibitors have taken a beating over the last three years. The excitement and potential has been tempered by mounting cardiovascular safety concerns, but specifically in at-risk patients, compared to TNF inhibitors. Once the https://t.co/JgmfxGa6TY
Dr. John Cush RheumNow ( View Tweet)
Secukinumab & Uveitis = Unclear? Post hoc study of 11 SEC RCTs finds lower uveitis risk in AxSpA (N 1980; SEC 150 1.29/100PYs vs 1.72/100PY in PBO), but not in PsA (N 2453; SEC 300 0.71/100PY vs zero w/ placebo) https://t.co/Gv9HheBU7l https://t.co/SlnrLRwmmn
Dr. John Cush RheumNow ( View Tweet)
Psoriatic Arthritis: Hit hard and Early
Two studies found no significant benefit of early biologics over standard methotrexate treatment, but they did not focus on poor prognosis cases. The SPEED trial, funded by the NIHR, aimed to compare disease activity in 192 PsA patients https://t.co/pS9DdOOVCV
Dr. John Cush RheumNow ( View Tweet)
Combination treatments in Psoriatic Arthritis
Psoriatic arthritis (PsA) is a complex inflammatory arthritis with multiple domains and associated comorbidities. Despite the advances in the treatment of PsA with biologic (bDMARD) and targeted synthetic (tsDMARD), less than half https://t.co/rSkoE236hR
Dr. John Cush RheumNow ( View Tweet)
Impact of TNFi on efficacy of Vunakizumab in AS.
-Post hoc analysis of Vunakizumab
(humanized monoclonal IgG1/k antibody targeting IL-17A) trial on AS pts.
-440 total pts, 163 had prior TNFi exposure
- At week 16, no significant differences in ASAS20 b/w TNFi exposed pts https://t.co/O9PFOuLa5l
Adela Castro AdelaCastro222 ( View Tweet)
In BIODOPT study (RA, PsA, axSpA), disease activity-guided tapering of biologics (incl. biosimilars) maintained QALY (Δ0.008, NS) while lowering biologic costs (Δ€–1,979 [95%CI –3,798;–161]) & total hospital costs (Δ€–1,936 [95%CI –3,753;–119]) over 18mo. Supports https://t.co/CJUpfU2oRA
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Biologic switching in PsA:
-Retrospective study on 3,851 PsA pts initiating bDMARDs, 1,848 (48%) switched therapy at least once.
-TNFis were the initial therapy.
-IL17i were the first switch in both single-switch and multi-switch scenarios.
-Subsequent switches: back to TNFi https://t.co/tJDJvPeu9T
Adela Castro AdelaCastro222 ( View Tweet)
Data from COAST-V study (post hoc)
🔹️Ixekizumab in #axSpA
🔹️Efficacy stratified by CRP level
🔹️Better treatment response in the elevated compared to the normal CRP group
OP0699
#EULAR2025
@RheumNow https://t.co/1mVoly3Gws
Nelly ZIADE 🍀 Nellziade ( View Tweet)
In RCT of RA pts in remission/low disease activity, spacing ozoralizumab (next gen TNFi) or reducing MTX led to more flares vs continued tx; but most pts in remission at baseline maintained LDAS.
Remission matters for subsequent Tx reduction.
@RheumNow #EULAR2025 #LB0006
Mrinalini Dey DrMiniDey ( View Tweet)
APEX study Ph3 RCT Guselkumab
In BioNaive active PsA w/ erosions>=2
wk 24
ACR20 GUS Q4W 67% Q8W 68% vs PBO 47%
Less Rx progression in both Q4W & Q8W vs. PBO
#EULAR2025 @RheumNow LB0010 https://t.co/OVDWWECtOZ
Aurelie Najm AurelieRheumo ( View Tweet)
APEX Phase 3b trial: #guselkumab (Q4W or Q8W) reduces joint damage in #PsA
✅ ACR20: 67–68% vs 47% (PBO)
✅ ↓radiographic progression (vdH-S: 0.55/0.54 vs 1.35)
No new safety signals identified.
@RheumNow #EULAR2025 #LB0010 https://t.co/LLN1TXvOC3
Mrinalini Dey DrMiniDey ( View Tweet)
Management and prognosis of RP by @Lupusreference
1. Pts with mild disease respond to GCs
2. NSAIDs/colchicine good alternatives
3. Most common biologics used: TNFi and IL6i
4. Consider CYP in life threatening dz/ICU pts
5. Dynamic CT assess tracheal collapse.
6. PET-CT can ≠ https://t.co/PNUecMZvkT
Links:
Adela Castro AdelaCastro222 ( View Tweet)
In the APEX Phase 3b RCT (N=1020), guselkumab (IL-23p19 inhibitor) significantly reduced radiographic progression (ΔvdH-S 0.55 & 0.54 vs 1.35 PBO; p≤0.002) and improved ACR20 (67–68% vs 47%) at W24 in biologic-naïve PsA. Safety consistent with prior data. Abstract LB0010 https://t.co/mFDsBsCg6m
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
NMA of 14RCTs (>2500 pts) eval relative efficacy of bDMARDs and tsDMARDs in mostly biologic naïve nr-axSpA pts.
-All therapies studied significantly improved ASAS40 response rates compared to placebo.
-Certolizumab and Golimumab were the most effective therapies, followed by https://t.co/BJLRpEDYrv
Links:
Adela Castro AdelaCastro222 ( View Tweet)
👁️Uveitis in axSpA:
-Up to 40% can present before SpA dx
-NMA of 44 RCTs showed tx with TNFi, JAKi and IL-17i protective effects against uveitis
-Low rates of uveitis in axSpA pts on BIME trials suggests its possible beneficial effects.
#EULAR2025
@RheumNow https://t.co/mPuSMnD1Zs
Links:
Adela Castro AdelaCastro222 ( View Tweet)
