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ACR Convergence 2025 Sheds Light on Disparities, Age-Related Trends, and Epidemiology in Autoimmune Rheumatic Diseases
ACR Press Release
At ACR Convergence 2025, new research explored critical disparities and epidemiologic trends shaping outcomes in autoimmune rheumatic diseases across diverse populations and age groups. Studies presented at the meeting highlighted issues ranging from kidney transplant outcomes in lupus to medication disparities in rheumatoid arthritis and demographic patterns in systemic sclerosis and axial spondyloarthritis.
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Rheumatoid arthritis and the ‘big bang’ at the ACR!
Is there ‘bang for the buck’ using big data to help predict who will develop RA in at-risk populations and similarly to predict response to csDMARDs, TNFi and JAKi in RA?
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More biomarkers predictive of conversion to clinical RA in at-risk pts
Serum PAD4 & PAD 4 levels measured in CCP+ at-risk individuals
-PAD4 (not PAD2) increased in RA Converters vs. non converters and HC
-PAD4 levels Pre-RA = RA
Within high CCP+ at risk individuals, higher https://t.co/LU5zUzui1G
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Trying to reach RA, PsA patients on social media, to participate in studies?
Simple, informational messages work for recruitment
Message framing affects engagement but not recruitment
The more we understand, the better we can reach the right people
#ACR25 ABST0187 @RheumNow https://t.co/JoAthXhXvi
David Liew drdavidliew ( View Tweet)
A simple flow cytometry analysis of peripheral blood monocytes to predicts progression to clinical RA or PsA in at-risk patients?
Too good to be true!
284 RA 56 PsA 57 HC
-HLA-DR higher in PsA
-CD11c lower in RA
But no clear difference between Converters and non Converters https://t.co/f3Sett4eXd
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
#Cancers esp #hematologic & #lung are ⬆️in Pts w #inflammatory #rheum #diseases
Odds ratios of hem malignancies are wide
& risk stratification is imp
Are we doing a good job?
🤔skin cancer screening ??- not as per general standards
Abst#0172 #ACR25 @RheumNow @ACRheum https://t.co/Uve9knXD3o
Links:
Janet Pope Janetbirdope ( View Tweet)
Even when inflammation is quiet, fatigue often lingers. In 246 RA pts, 43% had significant fatigue—closely tied to PROMs, not labs. RAPID3 < 6 flagged the few truly “fatigue-free.”
Don’t overlook the VAS_Fatigue—it tells a real story.
@RheumNow #ACR25 Abstract# 0380
Jiha Lee JihaRheum ( View Tweet)
Real-world JAK persistence in RA is low: <30% at 2 years across Medicare & Marketscan data (n≈20K). Baricitinib lowest persistence; TOF & UPA slightly higher. Oral convenience hasn’t solved long-term adherence. Why? Safety, cost, access?
@RheumNow #ACR25 A#0369
Jiha Lee JihaRheum ( View Tweet)
Only 32% of RA pts were satisfied with current txs. In a discrete choice experiment of 354 US pts, many preferred a vagus nerve stimulator over another biologic/JAKi, especially those with prior tx failures. Cost, function, and fatigue drove preferences.
@RheumNow #ACR25 A#0370
Jiha Lee JihaRheum ( View Tweet)
Can the blood reflect what’s happening in the joint? In early RA, 11 synovial proteins mirrored serum levels, forming an inflammatory signature linked to disease activity and csDMARD response. High-signature pts had stronger treatment responses (AUC>0.8)
@RheumNow #ACR25 A#0070
Jiha Lee JihaRheum ( View Tweet)
Fascinating: tDR-1, a microbial sRNA, appears protective for RA in at risk ACPA+ pts:
- tDR-1 higher = less develop RA
- can predict seropos RA development
- in vitro type 1 IFN mapping checks out
Useful in itself, but importantly: why does it happen?
#ACR25 ABST0775 @RheumNow https://t.co/ep99dNAzFV
Links:
David Liew drdavidliew ( View Tweet)
Novelli et al. Upadacitinib in male vs female PsA. Data from SELECT-PsA studies. Appears equivalent in males and females, contrasting with TNFi/IL17i data. @RheumNow #ACR25 Abstr#557 https://t.co/fMKsbCkju0
Richard Conway RichardPAConway ( View Tweet)
#ACR25 Abstr#775 Previous study showed plasma tRNA-derived RNA (tDR-1), produced by bacteria from the phylum Proteobacteria, was assoc. with lower RA activity.
In 60 At-Risk CCP3+ people, Plasma tDR-1 improved prediction of RA. Need validation & adoption in practice @RheumNow https://t.co/XBmtohBEHc
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#0191 We found that in a large South London RA cohort, use of advanced therapy in moderate disease (DAS28 3.2-5.1) generally followed NICE guidance. Gaps often reflected telehealth limiting DAS assessment and patient hesitancy. Self-assessment tools may help. @RheumNow #ACR25 https://t.co/UMGtkfABHn
Mrinalini Dey DrMiniDey ( View Tweet)
Albach et al. CAR T-cells in D2T RA. 6 patients. Safety looks ok. ACR20 in 4/6, ACR50 in 2/6. ACPA and RF disappeared. Results maybe not as positive as we might have anticipated? @RheumNow #ACR25 Abstr#471 https://t.co/TaEVWiWsNm
Richard Conway RichardPAConway ( View Tweet)
tRNA-derived RNA (tDR-1), circulating microbial RNA
Associated w/ reduction in risk of RA conversion in asymptomatic CCP+ individuals (60 vs. 120+ ctrls),
‼️ tDR-1 alone over performs prediction model w/ smoking shared episode and RF w/ AUC 0.86
What is the mechanism? tDR-1 https://t.co/fuyk4NeOyA
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Ribeiro et al. Case series of combination bDMARD/tsDMARD in PsA from Toronto. 24 patients, median just over a year follow-up. Appear effective, especially for objective skin and joint measures. No major safety concerns but short follow-up to date. @RheumNow #ACR25 Abstr#565 https://t.co/Zk3odT2EX2
Richard Conway RichardPAConway ( View Tweet)
#0775
Higher circulating microbial small RNA tDR-1 linked to lower risk of developing RA in CCP3+ individuals (AUC 0.86).
tDR-1 downregulates interferon-response genes in vitro, suggesting microbiome-mediated anti-inflammatory mechanism in RA pathogenesis. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
SLE & arthritis: Is there a difference?
Abstract #0629:
- Non-deforming (ND): 73% | Jaccoud’s: 19% | Rhupus: 8%
- Vs ND, Rhupus had lower odds of type I IFN signature
- Time to deformities: Jaccoud's ~2 yrs vs Rhupus ~5 yrs
- RNP+ predictive of Jaccoud’s
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Why do some clinics excel at RA disease activity tracking while others struggle? In the VA, success came down to structure: RA-specific clinics, templates, and staff. Barriers? Time, missing labs, and workflow gaps.
@RheumNow #ACR25 Abstract#0222
Jiha Lee JihaRheum ( View Tweet)
