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Introducing Polyrefractory RA: A New Frontier in Difficult-to-Treat RA
At a EULAR 2025 session titled “What makes ‘Difficult-to-treat RA’ so difficult to treat? And what can we do?”, Drs. Paula David and Dennis McGonagle introduced the emerging concept of polyrefractory rheumatoid arthritis (RA), a term now being used to describe a subset of patients who have failed to respond to five or more biologic or targeted synthetic DMARDs. This new classification, derived from recent multinational registry data, represents a significant step in refining our understanding and management of the most treatment-resistant forms of RA.
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KORAIL cohort: new RA-ILD progression model (inc. DLCO, ILD pattern/extent, anti-CCP, ± KL-6) stratified risk with high sensitivity & specificity. Adding KL-6 boosted AUC to 0.75.
A step toward personalised care in RA-ILD.
@RheumNow #EULAR2025 #OP0328 https://t.co/AHqNFw40gk
Mrinalini Dey DrMiniDey ( View Tweet)
In real-world PsA, IL-23 inhibitors (guselkumab/risankizumab) showed clinical response in axial/mixed PsA. Best response seen in pts meeting ASAS axial SpA criteria (RR 7.64) & baseline ASDAS-CRP >2.1. Supports role of patient stratification in axial PsA. Abstract#POS0113 https://t.co/qowZZmJOpM
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#EULAR2025 Abstr#OP0281 Not just shredding the weight but now also the pain! Another potential benefit of GLP-1 agonists - reducing symptoms of patients with Fibromyalgia. Propensity matched analysis using TrinetX database showed reduction on opiates, fatigue and pain @RheumNow https://t.co/oh6ecJmM5e
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Efficacy and Safety of Xeligekimab in AS
Dr. Adela Castro reports on abstract OP0102 at the EULAR 2025 meeting in Barcelona, Spain
https://t.co/xpzeV0oZOr https://t.co/wmTnFbFcum
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Dr. John Cush RheumNow ( View Tweet)
Are we missing axial/SIJ lesions in PsA or are we misdiagnosing AxSPA + PSO pts for PsA?
5 register studies including 580+ pts w/ PsA/AxSPA+PSO
1/3 PsA routine care patients had SIJ MRI = SPA
29% Rx SII r-mNY criteria+
of which 38% MRI lesions AxSPA
@RheumNow #EULAR2025 https://t.co/DJljlm7T9m
Aurelie Najm AurelieRheumo ( View Tweet)
Depression and anxiety in PsA is higher and has more consequences than in general population
Swedish and Danish clinical registers 23000+ PsA pts
HR 1.4 specialised psychiatric out/ inpatient care vs. general pop
HR for psychiatric in patient care numerically higher but ns.
No https://t.co/qduMcwGK0S
Aurelie Najm AurelieRheumo ( View Tweet)
Prediction of PsA in PSO pts: does it work?
First predictive model using mainly clinical data and labs extracted from primary care
Performs well in the cohort it was trained w/ but not in validation cohort.
Often an issue with prediction models!
Needs more granularity than https://t.co/5cVgqfd4fX
Aurelie Najm AurelieRheumo ( View Tweet)
‼️Diagnosis of axSpA is clinical
-MRI is a tool but still has a lot of limitations.
-Improve reports by directly communicating with radiology and be specific on pt clinical info.
-Unified algorithms are needed to apply AI in dx of SIJ inflammation on MRI.
#EULAR2025 @RheumNow https://t.co/9GR6FsgIcL
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Adela Castro AdelaCastro222 ( View Tweet)
Is #PDE5i protective in development of
#SSc #ILD?
Maybe
444 w ILD of >4000 #EUSTAR Pts over 1 to 2 yrs f/u
#immunesuppressive use maybe or not
🤷♀️channeling bias
Reduction in new #ILD in #scleroderma
PDE5i ✅
Immunesuppression ?
@RheumNow #EULAR2025 @eular_org #OP0334 https://t.co/6dtLfybkRV
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Janet Pope Janetbirdope ( View Tweet)
#EULAR2025 Take Home message from Updated EULAR Recommendations @eular_org for #Lupus Nephritis:
-Kidney Biopsy vital
-Early use of Combination Therapies (HCQ + GC + Immunosuppressant + CNI/Belimumab/Obinutuzumab)
-Severe: High dose Cyclo + GC
@RheumNow https://t.co/jHFqdT1TLf
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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
🔍MRI lesions in early axSpA vs non axSpA with chronic back pain:
-Data from SPACE cohort
-n 318 (214 axSpA vs 108 non-axSpA).
-Baseline imaging (CR and MRI) and at 2y f/u
-Minimal progression on CR in both early axSpA and non-axSpA CBP.
-On MRI, significant increase in the https://t.co/m5YOAiFUz1
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Adela Castro AdelaCastro222 ( View Tweet)
E3N cohort 78000+ women >30yrs follow up
698 incident RA cases)
In non smokers, RA asso w/
-tall at birth HR=1.55
In smokers, RA risk associated w/
-prematurity HR=1.63
-in utero exposure to tobacco HR=1.83 (ns)
#EULAR2025 @RheumNow POS0226 https://t.co/xC3k3kiKsZ
Aurelie Najm AurelieRheumo ( View Tweet)
PsA asso w/ higher risk of preterm births in women
Scandinavian registries
688 PsA pregnancies
8% preterm births vs. 4.5% general population OR 1.8
16.4% if bDMARD combination OR 4
3.1% if bDMARD monotherapy OR 0.7
bDMARDs combo probably a surrogate of high disease activity
Aurelie Najm AurelieRheumo ( View Tweet)
Difficult-to-Manage AxSpA: Global Prevalence and Associated Factors
The concept of D2M axSpA is a recent development, with the first expert consensus definition published by the Assessment of SpondyloArthritis International Society (ASAS) earlier this year. https://t.co/KmfJvAtwp0
Dr. John Cush RheumNow ( View Tweet)
RheumNow’s expanded coverage of the #EULAR2025 Annual meeting is sponsored in part by Johnson & Johnson and UCB. All content chosen by RheumNow & its Faculty.
Dr. John Cush RheumNow ( View Tweet)
Live Daily Eular 2025 Recap Day 2 https://t.co/78NYTcFPG6
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Dr. John Cush RheumNow ( View Tweet)
Secukinumab promise in PMR is real
GCA is getting steroid-sparing therapy choices, and PMR doesn’t want to miss out. Most PMR patients with current therapy approaches incur multiple grams of cumulative prednisolone exposure, even though they’re often exactly the kind of https://t.co/GuD0l7zSfj
Dr. John Cush RheumNow ( View Tweet)
Among 200 #axSpA pts from Rheumazentrum Ruhrgebiet
🔴Performance tests (SPPB)
were associated with
🔴Global functioning and health (ASAS-HI and other PROs)
What does this mean?
Improving physical performance could enhance PROs & QOL
#EULAR2025
POS#
@RheumNow
@XBaraliakos https://t.co/P3Q5NDvtoj
Nelly ZIADE 🍀 Nellziade ( View Tweet)
#D2M_axSpA_saga 🇬🇷
Prevalence of D2M axSpA in 395 patients: 10.1%
Associated factors:
🔹️High disease activity at diagnosis
🔹️Comorbidities (high BMI, smoking, depression)
🔹️Unemployment
Kougkas et al.
POS#0121
#EULAR2025
@rheumnow https://t.co/vcPcTATTx5
Nelly ZIADE 🍀 Nellziade ( View Tweet)
