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Stopping therapy in GCA

David Liew, FRACP Oct 29, 2025

They say the easiest bit about GCA, like PMR, is the first week after you start steroids. Those fond memories belie the challenge of ongoing treatment in GCA. In a steroid-only world, there is only misery. Steroid-sparing therapies have changed this completely.

Abstract 2687: GLP-1 RA in PsA In combined Toronto + NYU cohort, GLP-1 RA significantly associated with reduced: - Weight, CRP, and pain scores - Each 1% reduction in body weight associated w/ TJC, DAPSA, EQ-5D (QoL), LDL, Systolic BP @RheumNow #ACR25 https://t.co/30lPDkALKs

https://x.com/AkhilSoodMD/status/1983594178727571938/photo/1

McDermott et al. Target trial emulation of different b/tsDMARDs in RA-ILD. RTX as SOC. No significant differences seen in hospitalisation or death. Trends to abatacept and JAKi looking better... @RheumNow #ACR25 Abstr#2662 #ACRBest https://t.co/ghHEKztvgz

https://x.com/RichardPAConway/status/1983593423803154669/photo/1

#PD1 Ab looks good and safe in active RA Rosnilimab, a Selective and Potent Depleter of Pathogenic T Many failed several Rx already No safety signals compared to another PD1i Proof of benefit in biospecimens too! abst#LB19 #ACR25 @RheumNow @ACRheum #ACRBest https://t.co/TmEOCfuHZU

Biologic choice in PsA: consider factoring in obesity ⚖️ Abstract 2691: In a longitudinal cohort study, obesity associated with ↓ odds of achieving minimal disease activity (MDA) among pts on TNFi, but not with other DMARDs @RheumNow #ACR25 https://t.co/p4KaH6HKYj

https://x.com/AkhilSoodMD/status/1983591933143330833/photo/1

#2661 In >5000 veterans with RA-ILD, 8 distinct FVC trajectories were identified. >1/2showed a progressive decline (≥0.7%/yr). These progressive patterns predicted higher mortality & respiratory hospitalisations, underscoring major disease heterogeneity. @RheumNow #ACR25

TAC+MMF + GC vs TAC +GC in lupus nephritis (target trial emulation): 🔹Higher total renal response w/ TAC + MMF + GC at 12 mo (59.7% vs 33.3%) consistent in ITT & per-protocol 🔹similar adverse events reported (14.6% vs 16.4%) @RheumNow #ACR25 https://t.co/Yuql3O9C8X

https://x.com/AkhilSoodMD/status/1983590907095011839/photo/1

Abstract 2690: Food as a Medicine Mediterranean vs low-calorie DASH vs control diet in PsA (multicenter RCT): 🔹 All 3 groups showed significant weight loss & DAPSA by wk 24 🔹 Weight loss not diet type may be the driver of clinical improvement @RheumNow #ACR25 https://t.co/rBS3HR1HXl

https://x.com/AkhilSoodMD/status/1983589421267009836/photo/1

#2702 @ClevelandClinic Vascular ultrasound (VUS) for suspected GCA showed excellent specificity (100%) but low sensitivity (21%) compared with 6m confirmed diagnosis. Fair agreement with TAB (κ=0.64). Findings highlight need for standardised VUS protocols in US. @RheumNow #ACR25 https://t.co/LRFpFBnWWz

https://x.com/DrMiniDey/status/1983588138829467855/photo/1

Older Adults Underrepresented in RCTs Drs. Jiha Lee and Sebastian Sattui discuss abstract 1072, "Inclusion of Older Adults in Pharmacologic Randomized Controlled Clinical Trials of Autoimmune Rheumatic Diseases: A Systematic Review," presented at #ACR25 https://t.co/uzSPH5RbjM https://t.co/94Vw6qUOIL

Older Adults Underrepresented in RCTs | RheumNow

Sooner May Still Be Too Late: Kidney Biopsies in SLE #ACR25 kicked off with Plenary Session by Michelle Petri (Abstract 0772: Redefining When to Biopsy the Kidney in Patients with SLE. As part of a collaboration with the Accelerating Medicines Partnership, Petri and colleagues https://t.co/bU09vpcDew

In a 5-year EHR-based cohort, PsO patients initiating IL-17i had significantly lower incidence of PsA/IA vs IL-23i, IL-12/23i, or TNFi. IL-17i reduced time with PsA/IA by 45% vs IL-23i, 61% vs IL-12/23i, and 74% vs TNFi. Further research need investigate if IL-17i may delay https://t.co/0PTbXZpLbu

https://x.com/synovialjoints/status/1983587134218101066/photo/1

#ACR25 Abstr#2695 Inguinal lymph node biopsies pre- and post-OBI, RTX, BLIN & CD19 CAR-T showed complete tissue depletion with CAR-T. B-cells reduced but often incomplete with protein-based depleters; OBI being the best. Still don’t agree with “immune reset” @RheumNow #ACRBest https://t.co/Sq7m9sXlLP

#2660 In >8000 women, serum urate rose sharply during the menopausal transition, then plateaued after menopause. Hyperuricemia reached 4-5% post-menopause, up to 18% in obesity or low eGFR. Healthy body weight & kidney function pre-menopause may decrease HU later @RheumNow #ACR25 https://t.co/v6ai3lgAd2

https://x.com/DrMiniDey/status/1983586880403992588/photo/1

#2682 In a randomised trial of 320 RA patients, the recombinant zoster vaccine (RZV) was safe and did not trigger disease flares. But methotrexate use and older age significantly blunted antibody responses ➡️key factors to consider for vaccine strategies in RA. @RheumNow #ACR25

kids w 👇 Undifferentiated #systemic #autoinflammatory #disease Rx #IL1i N=33 =boys &girls 3.5 yrs Sx Abst#2151 #ACR25 @ACRheum @RheumNow There are many periodic fever syndromes 🤔some mutations are not yet discovered Access to &use of Anakinra canukinumab Rilonacept https://t.co/IyTx0nFxKC

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#2659 In a large real-world target trial (>1.3M with T2D), SGLT2 inhibitors, esp dapagliflozin & empagliflozin, were assoc with lower risks of RA, lupus, vasculitis & other autoimmune rheumatic diseases vs DPP-4 inhibitors. Possible immune benefits of SGLT2i? @RheumNow #ACR25

#ACR25 Please find my video summary on the Phase 3 RCTs results of Ianalumab in moderate to severe disease activity in #Sjogren Disease presented during Late Breaking Abstract session Abstr#LB24 #SjD @RheumNow https://t.co/ngCAglwAO0 https://t.co/PaUYsxhBKS

Abstract 2697: Compared to MMF, tacrolimus showed - similar SRR by week 96 (58.5% vs. 69.2%, OR 0.62; 95% CI 0.29-1.29) - similar time to renal AE/deaths (HR 0.70; 95% CI 0.37-1.35) - serious AEs less frequent (12.3% vs. 30.8%) @RheumNow #ACR25 https://t.co/o3LtgOp7St

https://x.com/AkhilSoodMD/status/1983581595979117052/photo/1

In PsA patients, GLP-1 RA therapy led to significant weight loss and improvements in CRP, pain, lipids, and blood pressure. PsA outcomes improved proportionally with weight loss. Regression analyses revealed that each 1% reduction in body weight was associated with significant https://t.co/Pph1PjfOve

https://x.com/synovialjoints/status/1983579582700654723/photo/1

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Stopping therapy in GCA

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