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RNL25 Weschler 2

EGPA in 2025

d Richard Conway, MBBChBAO, PhD

Formerly classified as an ANCA-associated vasculitis, EGPA is both most commonly ANCA negative and clinically different to the other two ANCA-associated vasculitis conditions, GPA and MPA. The management of EGPA has frequently fallen into the trap of being copied from its more common and well-known cousins. Now, however, we are seeing a discordance and following GPA/MPA management will potentially lead to both over-treatment and suboptimal treatment for EGPA. In this context, the Sunday morning session at RNL 2025 on “EGPA management in 2025 and beyond” by Dr. Michael Wechsler was both timely and clinically relevant.

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question mark

That's not my problem - or is it? Multimorbidity in RA

d Eric Dein, MD

Traditionally, rheumatologists have often been deferential to the non-articular concerns in RA to other providers, though these issues are often left unaddressed. What role do rheumatologists have in the management of multimorbidity in our patients?

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AI

Will AI put me out of a job?

d Adela Castro, MD

The development of AI and other technologies brings new possibilities for optimizing diagnosis, management and has potential for improving outcomes in RA. At RheumNow Live 2025, Dr. Jeff Curtis, University of Alabama at Birmingham, presented a talk on, "AI applied to Rheumatoid Arthritis Care: Practically (Not) Perfect".

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lupus SLE

Obinutuzumab Efficacy in Active Lupus Nephritis

d Jack Cush, MD

A phase 3, randomized controlled trial of an anti-CD20 monoclonal antibody, obinutuzumab, was shown to be effective and safe in patients with active lupus nephritis.

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TheDaoIndex @KDAO2011 @UnaMakris wants us to shift our approach to #GeriRheum. #RNL2025– remember the 5 M’s Multimorbidity Mind Medications Mobility what Matters most https://t.co/MIVnpw87rW https://t.co/D4AmrYhyWH

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Dr. John Cush RheumNow ( View Tweet)
Adela Castro @AdelaCastro222 Are your patients aging with RA, or are they diagnosed with Late Onset RA (LORA)? -LORA pts tend to present acutely -High inflammatory markers~PMR Like -Seronegative/Decreased titers of RF/CCP @UnaMakris #RNL2025 https://t.co/tLrGBV6P1i https://t.co/53HVvUmrG4

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Dr. John Cush RheumNow ( View Tweet)
TheDaoIndex @KDAO2011 Late onset RA (LORA) aka RA diagnosed at an older age — pts have higher inflammatory markers, presents like PMR; they also have polypharmacy, comorbidities, frailty, etc that can complicate management @UnaMakris #RNL2025 @RheumNow #GeriRheum… https://t.co/E2WFwfCsWD https://t.co/tKF0OnUFQH
Dr. John Cush RheumNow ( View Tweet)
Eric Dein @ericdeinmd J Curtis #RNL2025 AI Will Not Replace You - AI cannot replace human interaction, examination, procedures, interpreting guidelines for an individual, providing empathy, and facilitate good patient education Will become a tool... but not a replacement to a… https://t.co/FVe8CtcxfK https://t.co/0mXjEikN1K
Dr. John Cush RheumNow ( View Tweet)
#Benralizumab vs #Mepolizumab both work for #EGPA Which to use? 🤷‍♀️ perhaps some advantage of more steroid sparing w Benralizumab? ? JAKi ?long acting #IL5i #RNL2025 ⁦@RheumNow⁩ https://t.co/UkthHpNRIq

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Janet Pope Janetbirdope ( View Tweet)
Obinutuzumab Efficacy in Active Lupus Nephritis A phase 3, randomized controlled trial of an anti-CD20 monoclonal antibody, obinutuzumab, was shown to be effective and safe in patients with active lupus nephritis. https://t.co/e1cDvJcC9g https://t.co/HUDd1ocAvc

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Dr. John Cush RheumNow ( View Tweet)
“Preventing” Arthritis in Psoriasis Prevention of the development of our systemic rheumatic diseases in individuals deemed at risk, or with some form of precursor disease process, has been a hot topic in recent years. https://t.co/nGKGUkKVUl https://t.co/PruJZLAq9n

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Dr. John Cush RheumNow ( View Tweet)
Eric Dein @ericdeinmd AI models require good Positive Predictive Value (PPV) But: PPV decreases as prevalence decreases - In choosing a successful biologic: Harder to predict more challenging patients (multiple failures, co-morbidities, etc) - ACR50 non-response is higher J… https://t.co/eAOR0jFmO3 https://t.co/TB6Ecd8nZh
Dr. John Cush RheumNow ( View Tweet)
Adela Castro @AdelaCastro222 How can AI be useful for RA pts and rheumatologists? -AI models have the potential for improving diagnosis, management and outcomes in RA pts. -Can also improve efficiency and clinic workflow. -Not so perfect as it sounds (hallucinations, limited… https://t.co/YA4A990p2v https://t.co/YnHtbP83Nm
Dr. John Cush RheumNow ( View Tweet)
Dr Rhee @RennieRhee mimics of medium/large vessel vasculitis. Increase in cross-sectional imaging use has increased the number of these we get referred. Segmental arterial mediolysis also pops up a fair bit. @RheumNow #RNL2025 https://t.co/yozRGE9Ncl

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Richard Conway RichardPAConway ( View Tweet)
ICYMI: Treatment of sclerosing skin disease: -Progression: inflammation➡️sclerosis➡️ atrophy -Existing therapies target inflammation not sclerosis-poorly developed ttx for sclerosis -First aspect is determining disease state, depth of involvement, extracutaneous manifestations… https://t.co/lYQRW2yDRG https://t.co/DQZjYKS2Ks

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Adela Castro AdelaCastro222 ( View Tweet)
🆕 slide from @Official_ASAS HLA-B27 strongly associated with Anterior #Uveitis in #SpA #AAU #AxSpA #B27 https://t.co/lq19vIys9x

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Dr Gurdeep S Dulay gurdeep_dulay ( View Tweet)
@RichardPAConway on PMR #RNL2025 @RheumNow PMR mimics: look for mimics in unusual/refractory cases - Suspect the mimics to avoid undertreatment or over-treatment Conway: PMR is NOT easy. Easy to misdiagnosis, easy to mistreat. "One of our most challenging cases" https://t.co/WqPWwCuutF

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Eric Dein ericdeinmd ( View Tweet)
Eric Dein @ericdeinmd 🏈Kick-off of @RheumNow w Jeff Curtis #RNL2025 🏈 AI in RA? Can help with Rheum Boards Questions, though AI is not confident in answers May not be better than paper charts for triage Other roles: pt chatbot, AI scribe, research populations, generate DDx,… https://t.co/3vJ2gON6tR https://t.co/3ArtaRkhJp
Dr. John Cush RheumNow ( View Tweet)
TheDaoIndex @KDAO2011 Potential uses of #AI for #RA -office workflow (scribe, triage) -research (match eligible pts for trials) -help with diagnosis (and likelihood of risk) -consume guidelines for disease mgmt @RADoctor #RNL2025 https://t.co/k2nOytpKBH https://t.co/7Y2OvBv9pP

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Dr. John Cush RheumNow ( View Tweet)

QD Clinic - Recurrent Acute Oligoarthritis Recurrent Acute Oligoarthritis in a 40 yr. old man https://t.co/5D5qE05u1w https://t.co/tunU955MkH

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Dr. John Cush RheumNow ( View Tweet)
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