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ACR25 - Day 1 Report
ACR 2025 began today in Chicago with throngs of rheumatologists, fellows, ARP members, APPs and pharma folk taking to the meeting halls and rooms for tons of novel content.
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ACR25 Best Abstracts - Day 1
The RheumNow Faculty have run through day one at ACR25 and come with a few of their favorites - some what you expected but some of these are gems.
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Open label noninferiority RCT "METOGiA" in GCA
TCZ improved relapse free survival (83% vs 67% MTX) & pred free remission (81% vs 61% MTX) wk 52. Ignore the weird primary endpt at week 78
Everyone also got pred; are we sure MTX works at all?
@RheumNow #ACR25 #ACRBest Abstr#0891 https://t.co/i48JBnawB7
Links:
Mike Putman EBRheum ( View Tweet)
SGLT-2 inhibitors and the prevention of autoimmune rheumatic disease
SGLT-2 inhibitors offer benefits beyond glycemic control, such as cardioprotective and nephroprotective effects, and modest weight loss. A recent study also suggests they may have immunomodulatory effects and https://t.co/grsgHFQic5
Dr. John Cush RheumNow ( View Tweet)
Is tocilizumab equally effective in ischemic vs. non-ischemic GCA?
Ischemic = vision, jaw claudication, or CVA
Remission at 6 mo higher in non-ischemic group then with equalization at month 12
No major difference in GCs at month 12
@RheumNow #ACR25 #Abst0739 https://t.co/OeYggSQYx8
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
2 year extension data from SELECT-GCA:
Patients in remission who remained on upadacitinib 15mg daily after 1 year had 90% reduced risk of flare compared to those who switched to placebo
Higher rates zoster, CK elevation in UPA group
#ACR25 @RheumNow #ACRBest https://t.co/jf8Dh2wCBj
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
#ACR25 Abstr#803 We need more data to justify biologics before conventional immunosuppressant in #SLE. Post-hoc analysis of 5 Phase 3 RCTs = improved efficacy & GC reduction in BEL+No IS vs PBO+IS. Potential selection bias as control group might be doomed to fail @RheumNow https://t.co/kXmrOUbJzj
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Real-world Indian cohort of 290 axSpA patients, generic tofacitinib achieved low/inactive disease in 89% after 25 months. Most adverse events were mild (e.g., transaminitis 14.5%) and manageable. No serious infections or MACE reported. A cost-effective alternative to bDMARDs in https://t.co/JBHfNq7kYt
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Nice SRMA evaluating HCQ dosing
>5mg/kg associated w/3.8x risk of retinopathy...
...but <5mg/kg associated w/1.8x risk of SLE flares
Morbidity from one of those is easily avoided by regular screening; morbidity from the other can be devastating
@RheumNow #ACR25 Abstr#805 https://t.co/1vJXxXqiRC
Mike Putman EBRheum ( View Tweet)
What is #nonadherence in #SLE associated with?
115 Pts w #lupus in Spain
Overall medication adherence 58%!
👇Reduced if
Male
Low education
No partner -NS adjusted analysis
Unemployed
Comorbidities
3 or more drugs/pills -NS adjusted
#ACR25 @RheumNow @ACRheum
#abst0216 https://t.co/CkG6gpiCw3
Janet Pope Janetbirdope ( View Tweet)
CE study BEL vs csDMARDs in TriNetX
Mortality ~3-4% for MTX/AZA/MMF vs ~1.5% for BEL, ~50% reduction in adjusted analysis
Pretty surprising given mediocre results from BLISS RCTs, but strong research group & lotsa fancy stats
Do you believe it?
#ACR25 @RheumNow Abstr#0804 https://t.co/Yex98EYDjP
Links:
Mike Putman EBRheum ( View Tweet)
Effect of BioDMARDs on Diabetes risk in 6400+ Psoriasis pts
IL-23i and IL-17Ai associated w/
-lower risks of diabetes
-Diabetic nephropathy
-Stage 3–5 CKD
and reduced risk compared to TNFi treated and bionaive pts
Adjustment on several variables, but not disease severity https://t.co/TDIHXJOC2T
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Leflunomide - a perennial question in GCA, that we still haven’t answered (as this meta-analysis shows), despite clear potential.
We are getting a clearer idea of the strengths/limitations of MTX in GCA, is it now time to get better clarity for LEF?
#ACR25 ABST0731 @RheumNow https://t.co/ycuvPx8Xdg
David Liew drdavidliew ( View Tweet)
Avacopan in the real world: we need to be braver
If we want to get steroid-sparing benefit in AAV, we need to trust it
claims data shows modest PNL reduction with avacopan
some manifestations are harder to taper in, but others we just need to be bolder
#ACR25 ABST0726 @RheumNow https://t.co/51nGdpR2db
David Liew drdavidliew ( View Tweet)
A systematic review by Dr. SRamiro et al evaluated efficacy of b/tsDMARDs on peripheral axSpA
Majority on bDMARDs (TNFi, n=24; IL-17, n=13)
Most of the SMDs were small --> b/tsDMARDs showed small to moderate effects on peripheral arthritis & enthesitis.
#ACR25 @RheumNow Abs0588 https://t.co/yGXcqhZ1Uv
sheila RHEUMarampa ( View Tweet)
ASAS recommends standardised reporting for 20 key outcomes in axSpA trials, 10 for all studies, 10 specific to DMARD trials. Formats include mean (±SD), mean change, and categorical thresholds for ASDAS, ASAS-HI, and extra-musculoskeletal manifestations. 85% of ASAS members https://t.co/VQwPaTRIOl
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#ACR25 Abstr#776 2-Year SELECT-GCA RCT showed that #GCA patients receiving continuous UPA15 to 2-yr maintained their remission (69%) vs those who switched to PBO after in remission for ≥24 weeks (29%). Lower serious infection but higher herpes zoster in UPA15. One VTE @RheumNow https://t.co/FCTNqCVxiZ
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Heydari-Kamjani et al. Risk of DILI with avacopan. Real world study, propensity score matching. Risk DILI 2% with avacopan vs 1.9% PBO @RheumNow #ACR25 Abstr#724 https://t.co/UhVkcXEYjF
Richard Conway RichardPAConway ( View Tweet)
2-Year data from SELECT-GCA Phase 3 UPA in GCA
Re-randomization & 52 weeks extension UPA 15mg vs. PBO
-Risk of flare 90% lower
-Complete remission 70% vs 20%
-Cumulative GC 1g difference
-No new safety signal
The quick relapse after stopping UPA indicates we are really looking https://t.co/c1khywnPNv
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Immune-Mediated Necrotizing Myopathy @EleniTiniakou #ACR25
*Younger pts tend to have a more aggressive disease
*IVIG and RTX can be considered first-line rx for anti-HMGCR and anti-SRP+, respectively
*CYC and plasmapheresis may be options in cases of aggressive disease https://t.co/zWDX79gqlf
Rheumatology Quarterly RheumQuarterly ( View Tweet)
