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Antifibrotics - A New Class of Therapies in Rheumatology?
Rheumatologists typically manage systemic autoimmune rheumatic diseases (SARD) and associated interstitial lung disease (ILD) with immunosuppressants. However, evidence increasingly supports also the use of antifibrotic agents in this setting.
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Single center study of 47 RA-ILD pts (Dx Age 64.7 yrs; 30 mos F/U). Median 100 mos from RA Dx to RA-ILD. Nearly half (49%) recv Rx for RA-ILD; few w/ TCZ, nintedanib, pirfenidone. ~90% had RA-ILD stability/improve @ 6 & 12 mos. Progression assoc w/ tobacco use (P .025) @ 6 mos https://t.co/AK4zYgcxeK
Dr. John Cush RheumNow ( View Tweet)
Regional Disparities in DMARD Management for RA Treatment
Dr. Aurelie Najm, Glasgow, reports on a session on "Updates on DMARDs treatment: global standards and regional adaptations" from the APLAR 2025 Congress in Fukuoka, Japan.
https://t.co/zDo5NxKtbE https://t.co/kF9FxyWkIQ
Dr. John Cush RheumNow ( View Tweet)
A new player in AIRD
ThA age associated T helper cells
Displaying both Cytotoxic & APC functions
Correlation with disease activity in RA and SLE
More research is needed to better characterize function but could be a promising therapeutic target
@RheumNow #APLAR25 https://t.co/4SnY65tXpJ
Aurelie Najm AurelieRheumo ( View Tweet)
#APLAR2025 Prof Peter Taylor
RA patients have ⬆️ rates of CKD https://t.co/DZl9qpbLhH
Dr Gurdeep S Dulay gurdeep_dulay ( View Tweet)
Stay sharp in RA, PsA & SpA care. Get the latest breakthroughs + expert insights at RWCS 2026. Don’t miss 'Year in Review: Rheumatology Advances.' Register now: https://t.co/majEsY4tXK https://t.co/fgGniR1OGk
RWCS RWCSmtg ( View Tweet)
Metanalysis of 7 studies (1979-2023) shows RA pts on vegetarian or vegan diets achieved no improvement in disease activity or physical function, but did have a small significant improvement in pain. Insufficient Data on Fatigue. Overall, low certainty https://t.co/jeh6gN5Byg
Dr. John Cush RheumNow ( View Tweet)
Where are we now—and where are we going in ILD treatment?
📅 September 9 (TONIGHT!)| ⏰ 7PM EST (LIVE)
Rheumatology leaders Drs. Sindhu Johnson, Dr. Anna-Maria Hoffmann-Vold, Dr. Scott Matson, and Dr. Jack Cush will review the latest ACR & EULAR guidelines on interstitial lung https://t.co/E30AirP5WX
Dr. John Cush RheumNow ( View Tweet)
Multimorbidity predicts flares in rheumatoid arthritis
A study from Olmstead county and the Mayo Clinic shows that multimorbidity and social factors predict higher rheumatoid arthritis (RA) flares and lower remission rates.
https://t.co/yGrvDttcEq https://t.co/45LMtvsFor
Dr. John Cush RheumNow ( 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)
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)
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)
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)
