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APLAR 2025: What’s New in RA Management?
The unveiling of the updated 2025 recommendations for RA treatment, presented by Josef Smolen in the plenary session on the first day of the conference, sparked attention. Although not yet formally published, these updated recommendations represent a refined consensus that simplifies decision-making while reinforcing the importance of treat-to-target principles in RA.
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Based on a survey in Japan, resolution of dry mouth was the most important symptom resolution reported by SJD pts.
The JCR CPG for SjD suggests RTX for glandular involvement while BEL for extra-glandular involvements.
#APLAR25 @RheumNow https://t.co/SsUvQIM9Eu
Links:
sheila RHEUMarampa ( View Tweet)
Is it D2T RA or Clinical inertia?
Concept introduced by Dr Kaneko, Japanese Keio RA cohort, followed for 5yrs
5% patients not fitting the D2T RA definition have MDA or HDA
The drivers of persistent DA in RA:
-overestimation of treatment effectiveness
-avoidance of treatment https://t.co/0pkDaUFH4R
Aurelie Najm AurelieRheumo ( View Tweet)
Interesting data shared by Dr. Sandhya Pulukool on Asian pts with SjD vs. Caucasians:
- Younger age of onset except in Japan
- Higher female to male ratio
@RheumNow #APLAR25 https://t.co/RPM9zI4tVQ
sheila RHEUMarampa ( View Tweet)
Peter Taylor on Pre-RA:
If Pre-RA is too late for interception, shall we start screening general population?
We have to remember RA is a RARE disease
Pre-test of RA per year per person would be 0.00025% for primary prevention:
A needle in a haystack?
@RheumNow @APLAR_org https://t.co/LKGtz1P7sl
Aurelie Najm AurelieRheumo ( View Tweet)
Peter Taylor describing the range of potential benefits of Interception strategies in Pre-RA: A) From Ideal: full interception B) To Good outcome: stratified intervention based on high risk population for delay/interception C) To ?Beneficial: attenuate severity of established RA https://t.co/6mqA9tV7ME
Aurelie Najm AurelieRheumo ( View Tweet)
Prof Takeuchi on DMARDs treatment and regional disparities
For similar dose, serum concentration of the polyglutamate (active) form of MTX is much higher in Japanese than US patients
And also high levels achieved much quicker in Japanese than US patients
This is strong https://t.co/ikp63wWifj
Aurelie Najm AurelieRheumo ( View Tweet)
What’s new in RA Pathogenesis in #APLAR25 by Ellen Gravellese
Take home message: there is still hope for synovial biopsies to be a biomarker for prediction of response to treatment
As a synovial biopsy expert, I am not convinced of this one, but time will tell
@APLAR_org https://t.co/EEw5ncKa1r
Aurelie Najm AurelieRheumo ( View Tweet)
Can we prevent #rheumatoidarthritis?
Dr. Gravallese shares this interesting slide that summarizes the different disease prevention trials in RA…..they have managed to delay disease onset but prevention is still in question.
@RheumNow #APLAR25 @rheumarhyme @marklagacmd https://t.co/qhGYnNL5Ek
sheila RHEUMarampa ( View Tweet)
📍Smoking, obesity and low Vit D are significant risk factors for Pre-RA.
📍Subdoligranulum arthritogenic strain is a newly described infectious agent implicated in the pathogenesis of pre-RA
@RheumNow #ACR25 @rheumarhyme https://t.co/ZzZZlfdKmk
sheila RHEUMarampa ( View Tweet)
QD Clinic: Rapidly progressive RA ILD - or not?
Dr. Richard Conway, a rheumatologist in Dublin, Ireland, discusses whether this case shows rapidly progressing RA-ILD, or not, as part of RheumNow's Rheum to Breathe: ILD campaign, presented throughout the month of September 2025. https://t.co/YC8XFiqZmd
Dr. John Cush RheumNow ( View Tweet)
Rheumatoid Arthritis ILD Complications
https://t.co/gAZCGTwHLB https://t.co/qcMmDuxXYx
Links:
Dr. John Cush RheumNow ( View Tweet)
Abatacept and Methotrexate may Lower Risk of Interstitial Lung Disease in RA
A post hoc, pooled analysis of of rheumatoid arthritis (RA) clinical trials shows those received abatacept had a lower rate of Interstitial lung disease (ILD).
https://t.co/3AISriCUeC https://t.co/nN03e4ZBDU
Dr. John Cush RheumNow ( View Tweet)
🌐 ILD Treatment Guidelines – LIVE Webinar
📅 Sept 9 (TOMORROW!) | ⏰ 7PM EST
An expert panel reviews ACR & EULAR guidance and looks ahead at emerging therapies.
Speakers: Drs. Sindhu Johnson, Anna-Maria Hoffmann-Vold, Scott Matson & Jack Cush, Moderator
https://t.co/iQj8OstJDU https://t.co/WsN5vntKhH
Dr. John Cush RheumNow ( View Tweet)
Ellen Gravallese update on RA pathogenesis
Her take on RA interception studies
“While drug repurposing has not proven capable of preventing transition from Pre RA to RA, we need to better understand disease mechanisms to offer other interventions”
@RheumNow #APLAR25 @APLAR_org https://t.co/d39ihVvWyA
Aurelie Najm AurelieRheumo ( View Tweet)
One of the most impt updates recommended to add a bDMARD if tx target is not achieved by the 1st csDMARD (no more prognostic stratification)
But, accdg to Dr. Smolen, adding a 2nd csDMARD should still be considered especially in resource-limited countries.
@RheumNow #APLAR25 https://t.co/ZQiviGcrYp
sheila RHEUMarampa ( View Tweet)
Dr. Josef Smolen discusses 2025 EULAR updates for RA.
He highlighted the importance of OP A - that tx should be a shared decision making between px and rheuma in order to ensure better care and disease control.
@RheumNow #aplar25 #APLAR25 https://t.co/KOJbiK87TS
sheila RHEUMarampa ( View Tweet)
Methotrexate significantly lowers Systolic BP
Australian researchers have shown that methotrexate (MTX) has another secondary, beneficial effect by significantly lowering systolic blood pressure, and contributes to its well docuented cardioprotive effecs. https://t.co/HDnDWahuul
Dr. John Cush RheumNow ( View Tweet)
SSc-ILD ABs & LESSONS:
30% of won't progress.
Triple negatives (ATA, ACA, ARA) wont progress.
Males & diffuse dz > predictive than Abs.
Great read on if Abs are biomarkers to predict Rx effect. https://t.co/YcZt4aAvL0 https://t.co/wOknKRfRHf
Dr. John Cush RheumNow ( View Tweet)
ACR Concerns on the Scientific Integrity at the CDC
On behalf of the American College of Rheumatology (ACR), we express deep concern over recent developments at the Centers for Disease Control and Prevention (CDC) that appear to undermine the agency’s longstanding commitment to https://t.co/P2J7eZN07W
Dr. John Cush RheumNow ( View Tweet)
