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ACR25 Best Abstracts - Day 4
Here's the last installment of our "ACR Best" abstracts as chosen by the RheumNow faculty. Most of these were from the final, day 4, but a few were noteworthy holdovers from day 3. Enjoy!
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Halloween ACR Guidance (10.31.25)
Dr. Jack Cush recaps ACR2025 with suggestions on how to best learn ACR25 content from RheumNow.com and our articles, videos and podcasts.
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IL-23 Blockade Goes Oral
A new player is entering the IL-23 arena — and it’s a tablet! Icotrokinra (ICO), a first-in-class peptide that binds and blocks the interleukin-23 receptor (IL-23R), is showing encouraging efficacy and safety across a range of psoriasis (PSO) and psoriatic disease (PsD) studies.
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Sjogren’s disease: two drugs with positive trials
After several failures of therapies in Phase 3 trials of Sjogren’s disease (SjD) over many years, all hope is not lost!
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SLE Conference Preview: progress in biologics at #ACR25
We now have four licensed targeted therapies (i.e., belimumab, voclosporin and obinutuzumab for active lupus nephritis and belimumab and anifrolumab for active non-renal SLE). What are other issues to be addressed and https://t.co/uvVICAsCzo
Dr. John Cush RheumNow ( View Tweet)
CAR T
Which cells to target
What patients & what disease
When is right time
In vivo (new) ex vivo
Premeds immune suppression
What to use, ?if anything
Cons
Is it safe
?long term effectiveness
What is failure rate
ICANs and other side effects
#ACRBest #ACR25 @RheumNow #26S21 https://t.co/TUSJh1hrPr https://t.co/JiqYzgBmYP
Links:
Janet Pope Janetbirdope ( View Tweet)
Prospective RCT on safety & efficacy of TAC+GC vs. MMF+GC
TAC+GC was comparable to MMF+GC as continuous induction maintenance treatment over 96 wks for LN.
AE rates comparable.
TAC - AKI & tremor
MMF - leucopenia
reassuring data.more tx options.
#ACR25 @RheumNow Abs2697 https://t.co/16Fd8zE5dL
sheila RHEUMarampa ( View Tweet)
Toxicity is the big question about CAR-T in RA - what did the CRS/ICANS profile look like in this German ph1 in RA?
Pretty good so far - but obviously will be under enormous scrutiny when we are looking at diseases with good existing therapies
#ACR25 ABST0471 @RheumNow https://t.co/xXyzOwLvx8
David Liew drdavidliew ( View Tweet)
Another toxicity signal to watch in the CAR T space: LICATs
Abstract 1537 reports a new immune-related toxicity distinct from CRS or ICANS:
🔹Affects organs prev involved in autoimmune dx: skin (35%) and kidneys (22%)
🔹Mostly mild (Grade 1–2); 3 cases Grade 3
@RheumNow #ACR25 https://t.co/mtZh47nWtv
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
CAR-T toxicity in hematology
(the things we have to look out for in rheumatology, as application of CAR-T potentially broadens)
@andrew02114 @MGHCancerCenter with the heme-onc point of view in the #ACR25 BCRC @RheumNow https://t.co/1YjadL7LCF
Links:
David Liew drdavidliew ( View Tweet)
#Urinary #biomarkers #lupus #nephritis
#Tenascin C -suggests repair, fibrosis, progress of #LN
#IL16, #CD163, & more for LN activity
Sometime a biomarker may replace repeat #kidney #biopsies?
#AMP group #Accelerated #Medicines #Program
#ACR24 @ACRheum @RheumNow abst#851
Janet Pope Janetbirdope ( View Tweet)
#GCA & #PMR @ACRheum #ACR25
#gamechangers #ACRBest
Yr 2 Select-GCA abst#776
#upadacitinib in yr2 of GCA REDUCES flares
HELPFUL info ?ability to get drug for 2 yrs hopefully
Failed Phase3 RCT of #secukinumab in #GCA helped #PMR abst#1175 &
+Ph3 for PMR REPLENISH RCT
@RheumNow https://t.co/5lH6HXhnfg
Links:
Janet Pope Janetbirdope ( View Tweet)
When should you order a renal bx in suspected #LN?
Active urinary sediment
Used to be #UPCR 500g/g or more
Abst#772 looked at UPCR 250g/g to 499
71% + LN and half needed Rx
esp if
Low C3,C4
Black race
Petri, Baltimore #lupus #cohort
#ACR25 @ACRheum @RheumNow
Janet Pope Janetbirdope ( View Tweet)
Phase 1 study of CAR-Treg in difficult to treat RA
4/6 pts had 50% reduction in TJC/SJC, no CYC/fludrabine required & good prelim safety data
CAR-T remains exciting, but less of the "totally magical everyone cured" stuff we saw w/initial CAR-T reports
@RheumNow #ACR25 https://t.co/kjBIkLCYpF
Links:
Mike Putman EBRheum ( View Tweet)
"Achieving good control of joint disease activity is probably the key objective of treatment of patients with RA-ILD"
- Gregory McDermott (Epi Abstracts, #2662)
Totally agree with this! SARD guidelines recommendingn drugs with mediocre activity in RA was surprising
@RheumNow
Mike Putman EBRheum ( View Tweet)
Excited about this target trial emulation in RA-ILD
Compared to RTX, NO significant difference in hospitalization/transplant/death for JAK, ABA, IL6 or TNF
Trends toward ABA and JAK looking better than RTX
Need trials for sure, but I like this project a lot
@RheumNow #ACR25 https://t.co/FQcphRvyHK
Links:
Mike Putman EBRheum ( View Tweet)
#2662
Using Medicare data to emulate real-world RA-ILD trials, investigators compared RTX vs ABA, TOC, JAKi & TNFi
No sig differences in mortality, resp, hospitalisation or lung transplant across groups, suggesting other b/tsDMARDs may be as safe as RTX for RAILD
@RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
McDermott et al. Target trial emulation of different b/tsDMARDs in RA-ILD. RTX as SOC. No significant differences seen in hospitalisation or death. Trends to abatacept and JAKi looking better... @RheumNow #ACR25 Abstr#2662 #ACRBest https://t.co/ghHEKztvgz
Richard Conway RichardPAConway ( View Tweet)
#PD1 Ab looks good and safe in active RA
Rosnilimab, a Selective and Potent Depleter of Pathogenic T
Many failed several Rx already
No safety signals compared to another PD1i
Proof of benefit in biospecimens too!
abst#LB19 #ACR25 @RheumNow @ACRheum
#ACRBest https://t.co/TmEOCfuHZU
Links:
Janet Pope Janetbirdope ( View Tweet)
TAC+MMF + GC vs TAC +GC in lupus nephritis (target trial emulation):
🔹Higher total renal response w/ TAC + MMF + GC at 12 mo (59.7% vs 33.3%) consistent in ITT & per-protocol
🔹similar adverse events reported (14.6% vs 16.4%)
@RheumNow #ACR25 https://t.co/Yuql3O9C8X
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
