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After At-risk RA, time to discuss At-risk PsA patients
ARP-PsA
Prospective cohort 1400+ pts
8.4% met ARP-PsA criteria (arthralgia + Fam Hx +Pso, not referred via Dermatology)
Risk factors:
Pso >15 years
Pso + Family Hx
US synovitis/enthesitis
At 1 yr follow-up 30% progressed https://t.co/ZY2ezh8nZN
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Prednisone remains both lifeline and liability.
New PRED-SAFE SDM tool helps patients and clinicians navigate that tension—visualizing benefits and harms to guide tapering. In pilot testing, 93% had no residual decisional conflict.
@RheumNow #ACR25 Abstract#1052 #ACRbest https://t.co/CgQ75N7A1p
Jiha Lee JihaRheum ( View Tweet)
Abstract 1431: Radiographic sacroiliitis in #PsA: insights from an Indian cohort
- Cervical and lumbosacral spine syndesmophytes were common
- Levels C5, C6, and L4 vertebrae frequently involved including syndesmophyte damage w/ non-marginal bridging
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Picture this 👉radiographic joint damage tied to worse physical function in #PsA:
🔹 ↑ mSS → ↑ HAQ (β=0.003 [0.002–0.004])
🔹 ↑ mSS → ↓ SF-36 PF (β=−0.10 [−0.15 to −0.05])
🔹 ↑ # of damaged joints → worse physical function
@RheumNow #ACR25 Abstract 1425
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Abstrat 1414 Compared to #PsO, early #PsA showed:
🔹 ↑ Dactylitis (66%), Enthesitis (78%), CRP/ESR
🔹 Longer morning stiffness & ↑TJC/SJC
🔹 MRI/US: frequent tenosynovitis & bone changes
🔹 Predictive model combining these features showed Sens 89%, Spec 84%
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Abstract 0878: In PsA pts w/ lateral epicondyle enthesitis on secukinumab (n=11):
🔹 Improved DAPSA & SPARCC scores
🔹 entheseal tissue biopsy showing shift toward pro-resolving fibroblasts (↑DKK3/CD200⁺)
🔹 ↓ osteoblast-related pathways
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Kuzkina et al. Efficacy of IL-6i with olokizumab on depression in RA. There appear to be some benefit but anti-depressants still needed. Group 1 is olokizumab alone, other 2 groups have anti-depressants also. @RheumNow #ACR25 Abstr#1323 https://t.co/h2ExYQgKTL
Richard Conway RichardPAConway ( View Tweet)
Mayer et al. NSAIDs in IBD. Retrospective cohort study. 250000 individuals. Non-inferiority study. No increased IBD-related hospitalisation in UC, but an increase in all-cause hospitalisation. @RheumNow #ACR25 Abstr#1434 https://t.co/he2Xmcqslk
Richard Conway RichardPAConway ( View Tweet)
Post Hoc analysis from SELECT-GCA
Increased rate of herpes zoster for 26wk steroid-UPA 15mg (7.3% vs 4.2% 52wk steroid-plbo) but lower rate of SERIOUS infections (7.9% vs 12.7% 52wk steroid-plbo)
Zoster risk is real; steroids are the bigger problem
@Rheumnow #ACR25 Abstr#0895 https://t.co/IKzO2J4hLH
Links:
Mike Putman EBRheum ( View Tweet)
@RheumNow on virtual learning:
It’s integrated in clinical care, research and #MedEd
How to manage info overload?
- schedule, make use of tools
- use AI to curate, analyze & focus
#ACR25 @rheumarhyme https://t.co/ogCezlnxUP
Links:
sheila RHEUMarampa ( View Tweet)
X-sectional study by Dr Toledano et al showed that 20% (46/230) PsA pts had restless leg syndrome (RDS).
Pts w/ RDS:
- Polyarthritis
⬆️ Swollen jts
⬆️ Fatigue, anxiety, depression
⬆️ Dse activity
Poor sleep quality
Polyarthritis & Pso: assocd w/ RDS
#ACR25 @RheumNow Abs1413 https://t.co/8Ds3TgLjs1
sheila RHEUMarampa ( View Tweet)
In ICONIC-LEAD, adolescents (12 to <18 years) with moderate-to-severe psoriasis treated with icotrokinra (ICO) achieved Investigator Global Assessment (IGA) 0/1 in 84.1% vs 27.3% (placebo) and PASI 90 in 70.5% vs 13.6% at Week 16. Week 24 responses reached 88.6%. Safety profile https://t.co/L7h8BlnWaO
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Concerns using dupilumab in EGPA due to secondary eosinophilia
What about when combined with IL-5 therapy?
16 pt on dupi + IL5 agent
- if dupi alone caused eosinophilia -> quelled by IL-5
- no eosinophilia when dupi added to IL-5
- effective but slow
@RheumNow #ACR25 Abst 1605
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Case series of 5 patients with binutuzumab (CD20) in AAV
Short story short; it worked. Of course it worked. Obviously it worked. Everyone knew it would work.
Why aren't we doing more TRIALS with new/better B cell inhibitors in AAV?
#ACR25 @RheumNow Abstr#1601 https://t.co/H6Zz3Tf3xo
Mike Putman EBRheum ( View Tweet)
Don’t forget
👇
#lcSSc Pts can get and progress #ILD
1/3 of #limited #cutaneous #systemic #sclerosis #scleroderma GET ILD
From #EUSTAR
>14% progress
Esp +Scl70
Remember to screen #CREST Pts
& allow these Pts into lung disease trials
#ACR25 @RheumNow @ACRheum abst#0879 https://t.co/X15tUgClzN
Links:
Janet Pope Janetbirdope ( View Tweet)
Rural RA care looks different but not less intensive: DMARD and GC use matched urban rates, yet rural pts often managed by PCPs had twice the opioid use.
ACR's Rheum for Primary Care resource can help address access gap and improve RA care
@RheumNow #ACR25 Abstract#1025
Jiha Lee JihaRheum ( View Tweet)
Liraglutide had decreased synovial inflammation and fibrosis in mouse models, however dexamethasone didnt have changes in fibrosis scores
Abst#1734 #ACR25 @RheumNow https://t.co/O4JYGtDD5N
Bella Mehta bella_mehta ( View Tweet)
Analysis from FVSG identified 36pts with anti-rituximab antibodies
In AAV, lookout for this in pts who are MPO+ & w/higher CD19 at 6 mos. Worse relapse free survival in both AAV & CRYO!
@TerrierBen can you share the prevalence of these abs?
#ACR25 @RheumNow #ACRBest abstr#1604 https://t.co/Nyx6JxbvUk
Links:
Mike Putman EBRheum ( View Tweet)
A combined biomarker assay may predict which AAV patients will not respond to RTX therapy
A next step towards precision / personalized rheumatology?
@RheumNow #ACR25 Abst 1602 https://t.co/gcrZUNV0b9
Links:
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Safety & benefit of #Deucravacitinib in #SLE #LTE #PAISLEY #RCT
👇
over 4 yrs
Stable response sustained over 4 yrs
No new Safety signals
Await Ph3 RCT results - fully enrolled
#SoTyktu
Abst#LB10 #ACR25 @RheumNow @ACRheum https://t.co/ZpmzOYVnq9
Janet Pope Janetbirdope ( View Tweet)
