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ACR25 - Day 1 Report
ACR 2025 began today in Chicago with throngs of rheumatologists, fellows, ARP members, APPs and pharma folk taking to the meeting halls and rooms for tons of novel content.
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The CLASSIC study (n=1015, 27 countries) validated revised ASAS-SPARTAN axSpA criteria. Final model achieved 79.5% sensitivity & 90.4% specificity vs global diagnosis. MRI SIJ (active + structural) was strongest predictor. HLA-B27, CRP, IBD, uveitis also included. Abstract#0854 https://t.co/GjSHE2ihVI
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#0853 Olink proteomics in anti-Ro+ pregnancies identifies macrophage-derived IL-6 & CCL3 as serum predictors of foetal AV block
These pro-inflammatory proteins predicted fAVB independent of maternal diagnosis or Ab titres, pointing to new pathogenic pathways. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
What is the #frequency of #CTD #ILD in #USA?
Data from #Marketscan >9K & #Optum ~20k CTD-ILD Pts
56-65 yrs, 3/4 F
?under ascertained #RA-ILD - low % but #SSc-ILD approx 16% clinically relevant
Same as Ont, Canada #SSc-ILD %
Not rare
#ACR25 @RheumNow @ACRheum
Abst#0154 https://t.co/imfSyOtYpC
Links:
Janet Pope Janetbirdope ( View Tweet)
We need more biomarkers in GCA - what about fibrinogen?
Miller et al retrospectively compared CRP, ESR, and fibrinogen at different points in GCA dx
Fibrinogen (and ESR/CRP) only helpful prior to initiation GC with comparable performance
@RheumNow #ACR25 Abst #0750 https://t.co/q5gFxDMnTy
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Abstract 0842
💡 Urinary biomarkers as the next frontier for monitoring lupus nephritis activity
🔹 Proteinuria didn’t track w/ histologic activity
🔹 IL-16 & sCD163 correlated at baseline only
🔹 Urinary Tenascin C & BAFF correlated w/ activity at 1 yr
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Could a sputum test predict risk for RA conversion in at-risk patients?
98 at risk pts, Converters had higher
-BL sputum CCP levels
-BL Sputum nucleosome and cit-nucleosome levels !although not asso after adjusting for sputum anti-CCP-IgA level
In converters, correlation of https://t.co/bqmQqS1Jz5
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
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)
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)
Urinary proteomics reveals promising biomarkers for ankylosing spondylitis. PIK3IP1 & SDC1 levels were significantly elevated in AS patients, showing strong diagnostic performance (AUCs: 0.852 & 0.875). Combined with AMY1A, the multiplex panel reached an AUC of 0.973. Abstract https://t.co/YUulKFqj8V
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Redefining When to Biopsy the Kidney in Patients with SLE # Petri et al. ACR 2025 - Lupus nephritis may be seen in lower proteinuria too (69%)
Happy to share similar results from our study-Padiyar S, As C, Gowri M, Mathew J. Lupus. 2024;33(13):1511-1517.
@RheumNow
Dr Shivraj Padiyar DrPadiyar ( View Tweet)
New biomarkers 14-3-3η multiplex autoantibody assay improves axSpA diagnosis, especially in HLA-B27– patients. Combined with CRP & HLA-B27, detection rose to 99% (training) & 91.4% (evaluation). In HLA-B27– cases, 14-3-3η lifted detection to 70.6% & 55%. Abstract 0531 @RheumNow
Antoni Chan MD (Prof) synovialjoints ( 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)
Miller et al. Fibrinogen for GCA diagnosis and flare identification. Similar to ESR/CRP in diagnosis. For flares, lower sensitivity (79%) but better specificity (96%) @RheumNow #ACR25 Abstr#750 https://t.co/SIkAkEeYh1
Richard Conway RichardPAConway ( 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)
Observational study of fibrinogen for diagnosis of GCA
At a cutoff of 4.7, roughly similar diagnostic performance as compared to ESR/CRP
Kind of neat, but does not appear to have additive benefit
#ACR25 @RheumNow Abstr#0750 https://t.co/xy2qn4jHXP
Mike Putman EBRheum ( View Tweet)
ILD found in 30% of Sjögren’s pts w/ HRCT.
A new nomogram-based tool (AUC 0.8) predicts ILD risk using age, ESR, C3, hypergammaglobulinemia & anti-La/SSB.
Goal: guide HRCT referrals & catch ILD earlier.
@RheumNow #ACR25 Abstract #0510 https://t.co/FvAprq8eol
Jiha Lee JihaRheum ( 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)
Post-hoc PEXIVAS study, estimating risk of relapse from baseline variables
Lotsa fancy stats, mostly corroborated known risk factors, but model predicted relapse reasonably well!
Probably useful for approach to monitoring... mayyybe treatment?
#ACR25 @RheumNow #Abstr0722 https://t.co/XI9y8KgDNR
Links:
Mike Putman EBRheum ( 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)
