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The Decade Ahead: Predicting Long-Term Proteinuria Risk in SLE
The ACR Convergence 2025 in Chicago opens with engaging topics curated for the global rheumatologist. As a clinician, I always look forward to sessions that provide updates and practical key points that I can bring home and apply to my practice.
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Gender differences in p/axSpA in Turkiye from ASAS-PerSpA:
Males - early onset IBP (<45yrs); sacroiliitis on CR, HLA-B27+ (vs. females)
Females - peripheral dse, enthesitis, Pso, dactylitis; ⬆️dse activity, FM (vs. males)
Individualize & optimize tx.
#ACR25 @RheumNow Abs2322 https://t.co/vcisNguJLB
sheila RHEUMarampa ( View Tweet)
Great debate on GCA ultrasound vs biopsy. Wolfgang Schmidt making the case for GCA US with the rise of its use in guidelines @RheumNow #ACR25 https://t.co/ORxzzG8xnF
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Simulation modeling by Patel et al helps generate probability of remission, relapse, and adverse events in newly dx AAV
Projected risk by model were similar to observed rates in RCTs
@RheumNow #ACR25 Abst 1764 https://t.co/xevkJ2Ih0M
Links:
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Rotation or Change in Biologic post TNFi failure in axSpA. Switching biologic class after TNFi failure improved outcomes in axial SpA. In a randomized trial of axSpA patients with inadequate response to a first TNFi, switching to an IL-17Ai was not superior to cycling to a second https://t.co/MEsokWeT8e
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
This cohort study from Ontario of 🚺w/axSpA
✳️GDM, antepartum hem, SMM (severe maternal morbidity) -⬆️ in axSpA
✳️Neonat complications-preterm birth
Factors assoc w/SMM- age, comorbidity, gestational age at delivery
Better strategies for maternal care
#ACR25 @RheumNow Abs2200 https://t.co/LrVzJLnvWe
Links:
sheila RHEUMarampa ( View Tweet)
HCQ weight-based dosing: out
HCQ whole blood monitoring: in
Whole blood levels more precisely balance risks of SLE flare (under-dosing) vs. toxicitiy (over-dosing)
Many pt on <5 mg/kg had supra-therapeutic blood levels with risk for toxicity
@RheumNow #ACR25 #ACRBest Abst 1722 https://t.co/qIbACxAW39
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Mimics of ANCA-associated vasculitis: How can we tell?
With increased disease awareness and more regular, accessible testing for anti-neutrophil cytoplasmic antibodies (ANCA), ANCA-associated vasculitis (AAV) has become an increasingly recognized clinical entity in rheumatologic https://t.co/LYRk0rHlzx
Dr. John Cush RheumNow ( View Tweet)
#1727
360k+ postmenopausal women w osteoporosis: >1/3 untreated patients were at v high fracture risk, yet few received recommended anabolic or antiresorptive therapy.
Even among treated women at very high risk, >50% were still on oral bisphosphonates
@RheumNow #ACR25 https://t.co/9S66tAU68P
Mrinalini Dey DrMiniDey ( View Tweet)
“I never thought I’d live to old age with MCTD, now I plan for it.”
This patient’s journey highlights the power of evolving therapies, resilience, and lifestyle adaptation to age well with chronic autoimmune disease.
Patient perspectives abstract #PP04
@rheumnow #ACR25
Jiha Lee JihaRheum ( View Tweet)
#ClinicalPearl
Pts w #SpA ex #PsA May have
👇
#sicca #dry #eyes #dry mouth
Inflamed gallbladder without calculi
👇
Can be associated w #autoimmune disease
#POTS can be initial presentation of #SjD
IgA vasculitis—May have #cancer
#Secrets & #Pearls #ACR25 @RheumNow @ACRheum https://t.co/4SAqVYjnrD
Janet Pope Janetbirdope ( View Tweet)
Excited (and a little nervous!) to be presenting on a topic I’m very passionate about- social determinants of health & shared decision making, alongside some fantastic speakers & chairs.
Join us in room W184D, 10:00-11:30
Looking forward to a lively discussion!
#ACR25 @RheumNow https://t.co/FsDDrjisR3
Mrinalini Dey DrMiniDey ( View Tweet)
Passive transfer of Ab can occur w #IVIg
#Ab can occur from IVIg passive transfer incl HepB
IVIg - if pt has #cryoglobulins
👇
Can precipitate severe #cryo flare
#ClinicalPearl
Secrets & Pearls session
#ACR25 @RheumNow @ACRheum https://t.co/tTaSuVy1yQ
Janet Pope Janetbirdope ( View Tweet)
#1726 IA from immune checkpoint inhibitors (ICI) is a distinct autoimmune entity: T cell-driven but not antibody-mediated
irAE arthritis shows hyperactive, cytotoxic CD8+ T cells & metabolic reprogramming, unlike RA. IL-6, IL-12 & IFNα fuel this process. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
#ClinicalPearl
#seroneg #arthritis often has
👇
#involvement of
1st toe IP joint
Look at the feet 🦶
@RheumNow @ACRheum #ACR25
#28T08
Session secrets &pearls Tues https://t.co/EfqkLsTKmt
Janet Pope Janetbirdope ( View Tweet)
Overview of the use of SARD-ILD by @drdavidliew covering the challenges, professionalism, explainability and interpretability. Think of using and validating AI in the same way we train our residents. The human interface still needed @RheumNow #ACR25 https://t.co/TYKud057ag
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#1725 Functional NOTCH4 variants contribute to vasculopathy & fibrosis in SSc, particularly in African-American patients
NOTCH4 hyperactivation disrupts angiogenesis & drives EndoMT; inhibition (including with FDA-approved Nirogacestat) restores vascular repair @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
#1724 MAIT cells central in RA pathogenesis. These innate-like T cells accumulate in synovial fluid, driving fibroblast activation, cytokine release & joint damage. Blocking MAIT activation or deleting MR1 reduces arthritis in mice- a potential new target in RA. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
The Power of Gamma Delta T Cell for Autoimmunity https://t.co/wIMu5r7b3D
More on T Cell engagers , this time with gama delta T cell ( tiny but mighty ). Kate Roslin talks about advantages of this protocol. (No cytokines thus less toxicity).
@Yuz6Yusof
@RheumNow
#ACR25
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
Pooled data fr diff SLE cohorts by Dr SGarg et al were evaluated to determine an upper threshold tx range of HCQ
750-1150 ng/mL: safe & effective HCQ levels
>1150ng/mL-supratx, no added tx benefit
CKD st >/=3: 2x ⬆️odds of toxic hcq levels
#ACR25 @RheumNow Abs1722 #ACRBest https://t.co/RFx1VO0bov
Links:
sheila RHEUMarampa ( View Tweet)
