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EULAR 2025 Update for Behçet’s syndrome
EULAR has updated its recommendations for the management of Behçet’s syndrome, the last being published in 2018. The current update carries no recommendations from the previous version: seven recommendations have content modifications, four have minor wording amends, and one is entirely new.
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Rheumatology Pitfalls (3.20.2026)
Dr. Jack Cush reviews the regulatory actions, news and journal reports from this past week on RheumNow.com.
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FDA Approves Icotrokinra for Plaque Psoriasis
Today the FDA approved an oral IL-23 inhibitor, icotrokinra (Icotyde), for use in moderate-to-severe plaque psoriasis in adults and children 12 years of age and older (who weigh at least 40 kg) who are candidates for systemic therapy or phototherapy.
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Hydralazine and the Rare Risk of Vasculitis
Since the 1980s, hydralazine has been a notable cause of drug-induced lupus, and inferred to cause vasculitis as well.
phase 3 VALOR trial of 6-valent OspA-based Lyme dz vaccine (LB6V) vs placebo; 4 doses given @ Mos 0, 2, 5-9, & 12 mos later. LB6V reduced Lyme Dz risk by 73.2% @28d after 4th dose. But it was only 15.8% effective (falling short of prespecified 20%) because of fewer than expected https://t.co/TcX0GV05gY
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Mortality in Rheumatoid Arthritis: A Story of Decline, Delay, or Plateau? Dr. Elena Myasoedova
https://t.co/YoQmrXHZif https://t.co/7v82hHvvZv
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Predictors of Response in Lupus
A systematic review suggests that traditional measures (serologies and disease activity) are superior to biomarkers in predicting response to biologics in systemic lupus erythematosus (SLE) patients.
https://t.co/7YuYpoDctR https://t.co/J5VLrkDQ6G
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Long-Term Bimekizumab Safety Data
Adverse effects from bimekizumab through 2 years or more of treatment for psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) were about as expected from shorter-term data, results from long-term extension studies indicated. https://t.co/AaJxewNQmQ
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Prednisone use in Alberta primary care 546 #RA pts - 40% of PCP RA Rx w/ 1 or more prednisone Rx. 41% Rx w/ both Pred + DMARD, w/ 44% on Pred median 124 day before DMARD. 66% continued Pred >1 yr after DMARD initiation. https://t.co/wrxQRP2TWN https://t.co/XxWpjafBsk
Links:
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A retrospective cohort study of 195 renal Bx from 135 Lupus Nephritis pts, Mod-Severe interstitial fibrosis and tubular atrophy (IFTA) strongly assoc w/non-renal response & ESRD progression (HR 8.9) (also w/ age, SLE duration, prior LN flares, higher chronicity index) https://t.co/3JGLi5R5Fs
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RA pt on 7.5 mg/d Prednisone need hip replacement. What do you advise re: pred dose before TKR?
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Pitfalls of autoimmune serologic testing
Misuse of laboratory testing may lead to misdiagnoses and mismanagement; this is particulary prevalent when clinicians consider the use of the diagnostic use of serological autoimmune markers.
https://t.co/QDWTRgdlOh https://t.co/3hvM1OBcMC
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NEJM: Obinutuzumab in Active Systemic Lupus Erythematosus
A phase 3 trial of obinutuzumab, an anti-CD20 monoclonal antibody, showed potent B-cell depletion and clinical efficacy active systemic lupus erythematosus without evidence of nephritis.
https://t.co/OEuNAZlgzp https://t.co/yjUmJITAmQ
Dr. John Cush RheumNow ( View Tweet)
FDA Approves Icotrokinra for Plaque Psoriasis
The FDA approved an oral IL-23 inhibitor, icotrokinra (Icotyde), for use in moderate-to-severe plaque psoriasis in adults and children 12 years of age and older who are candidates for systemic therapy or phototherapy, according to a https://t.co/q5b3TceFHx
Dr. John Cush RheumNow ( View Tweet)
Retrospective Japanese study of 544 pts w/ GPA or microscopic polyangiitis (MPA) followed > 48 wks; only 29 (5.3%) achieved steroid free remission (GFCR) at wk 48. Predictors of GFCR: rituximab induction (OR 3.9) & avacopan use (OR 24.3). MP pulse RX had lower likelihood of GFCR https://t.co/EMRqA5oHJQ
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Prospective multinational cohort of 1180 lupus pts, followed ~2.7 yrs. 37% had renal biopsies (Class III/IV 56%). They achieved mCRR 46%, mPERR 53%, LLDAS 60%, & REMission 46% at least once. renal response highest @ 2 yrs. New organ damage 11% @ 1yr; 33% by 5yr. https://t.co/ugh60M08Xf
Dr. John Cush RheumNow ( View Tweet)
Hydralazine and the Rare Risk of Vasculitis
Since the 1980s, hydralazine has been a notable cause of drug-induced lupus, and inferred to cause vasculitis as well. A retrospective cohort study from Canada has shown that vasculitis resulting from hydralazine is possible, but https://t.co/ewqCesatbm
Dr. John Cush RheumNow ( View Tweet)
Urinary biomarkers improve w/ anifrolumab in TULIP-LN (lupus nephritis) trial; 112 pts, 197 uriniary proteins assessed. Urinary CD163 and MCP-1 signif improved as early as wk 12. Anifrolumab reduced the proteomic inflammatory signature, regardless of responder status https://t.co/n6fIJVDCN1
Dr. John Cush RheumNow ( View Tweet)
Pitfalls of autoimmune serologic testing
Misuse of laboratory testing may lead to misdiagnoses and mismanagement; this is particulary prevalent when clinicians consider the use of the diagnostic use of serological autoimmune markers.
https://t.co/VKosO3bVL2 https://t.co/4FTvTcrGJa
Dr. John Cush RheumNow ( View Tweet)
ILD found in 3% of #PsA pts. Metanalysis of 6 studies, 14,272 pts found ILD pooled prevalence was 3% in PsA; highers ((6%) in studies w/ CT, HRCT. Smoking was a signif. risk factor for ILD in PsA (OR 2.94, 95% CI: 1.22–7.12; I2 = 1.8%). https://t.co/9mY4Eiqc9d
Dr. John Cush RheumNow ( View Tweet)
