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ACR 2025 – Day 2 Report

d Jack Cush, MD

Here are 3 abstracts that caught my eye on Day 2 at ACR25. Notably these have takeaway messages that should support your current practices.

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ACR Best

ACR25 Best Abstracts - Day 2

d Jack Cush, MD

After a full day at the Chicago Convention center the RheumNow faculty have posted some of their favorite reports included these that they labeled as being the "best' of day 2.

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CAR-T

Are we putting the CAR-T before the horse?

d Richard Conway, MBBChBAO, PhD

CAR T-cells have been a revolutionary development in rheumatology. We have seen a population of patients with severe refractory autoimmune conditions almost overnight presented with the prospect of not just improvement, but of a cure.

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Psoriatic Arthritis: Which biologic agent is the best first choice?

d Brian Jaros, MD

A growing arsenal of therapeutic targets in psoriatic arthritis (PsA) has enhanced the landscape of treatment in patients with this disease.

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Stress Raises the Risk of Psoriasis New longitudinal research reveals that severe stress caused by changes in family structure like divorce or separation experienced during the first year of life may triple the risk of developing psoriasis later in life. https://t.co/TSXoQKjRPN
Dr. John Cush RheumNow ( View Tweet)
In a retrospective study of TAK patients, ~about 1/3 developed new lesions on imaging over time Most lesions: - stenotic - L carotid - Abdominal aorta - SMA 50% of the 1/3 = 2 or more lesions Serial imaging is crucial! @RheumNow #ACR25 Abst 1631

Brian Jaros, MD Dr_Brian_MD ( View Tweet)

How does DADA2 present? Ten studies provided data on a total 225 patients 1) skin findings 2) fever 3) stroke 4) cytopenias @RheumNow #ACR25 Abst 1615 https://t.co/xZuTk6YFdJ

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Brian Jaros, MD Dr_Brian_MD ( View Tweet)
PET and histologic discordance in aortitis Of 5 aortitis patients who had PET/CT prior to aortic surgery with path, only 1 showed concordance (neg PET, neg biopsy) 4/5 patients had inflammatory biopsy with neg PET Small # but PET is not perfect! @RheumNow #ACR25 Abst 1620

Brian Jaros, MD Dr_Brian_MD ( View Tweet)

ACR2025 Day 2 Recap https://t.co/TtGVddjsyJ

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Dr. John Cush RheumNow ( View Tweet)

Delay in PsA diagnosis Meta Analysis of 32000+ pts Median diagnostic delay 2.5 years Median delay in referral 1 year Increase odds of Rx damage from 50% Geographic variation We need to do better #ACR25 @RheumNow #ABSTRACT1713 https://t.co/CWwqosa5NT

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Aurelie Najm AurelieRheumo ( View Tweet)
PMR patients need healthcare professionals who know a bit about their disease. Survey of US HCPs, amongst responders: - 68% were not aware/unsure about PMR - of those who were aware, knowledge was… not great (see below) PMR needs everyone’s respect #ACR25 ABST1617 @RheumNow https://t.co/SpyEnAW8lI

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David Liew drdavidliew ( View Tweet)
A largely understudied area: Impact of peri-menopause in PsA Toronto Cohort 473pts, HRT 1.5% Peri menopause = increase DAPSA, TJC, SJC, FACIT-fatigue, HAQ compared to pre- and post-menopause No association w/ BMI, but with fatigue Less impact when education level increases https://t.co/bSuGxZCbGn

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Aurelie Najm AurelieRheumo ( View Tweet)
“The true master clinicians I know have an exceptional tolerance for uncertainty” - @LCalabreseDO, #ACR25 (Gary Hoffman and Carol Langford got a specific name check there too) ‘Fake Rheum: Case-Based Approach to Rheumatology Mimics” @CCalabreseDO @RheumNow https://t.co/VkKXoMn1Ls

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David Liew drdavidliew ( View Tweet)
Abstract 1718: Immune checkpoint inhibitors (ICI) in pre-existing #SLE Compared to non-SLE pts, those with SLE receiving ICIs had: 🔹 ↑ risk of thrombocytopenia & pancytopenia 🔹 No significant difference in all-cause mortality @RheumNow #ACR25 https://t.co/N1iOvxbsAZ

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Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
IL-5 agents may in fact work for severe EGPA manifestations Although severe pt were excluded from enrollment in MANDARA, post-hoc and OLE data suggest development of severe manifestations is rare in benra treated patients @RheumNow #ACR25 https://t.co/slUpAT9mWo

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Brian Jaros, MD Dr_Brian_MD ( View Tweet)
The first father-daughter session at ACR? Brilliant session in diagnostic thinking and mimics in rheumatology from @LCalabreseDO and @CCalabreseDO, teasing apart heuristics, biases, and examples straddling the ID-Rheum divide. Well worth catching on the replay #ACR25 @RheumNow https://t.co/16FEqVyDGg

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David Liew drdavidliew ( View Tweet)
ANCA status does not inform IL-5 agent response in EGPA patients Terrier et al. analyzed the OLE of MANDARA and compared ANCA+ and ANCA- subgroups: - similar rates of remission - similar rates of GC withdrawal - comparable relapse rates @RheumNow #ACR25 Abst 1594

Brian Jaros, MD Dr_Brian_MD ( View Tweet)

Abstract 1657: Can LLMs track medication history? GPT-4 outperformed most LLMs in identifying TNFi start/stop events and reasons for switch. 💊 Common reasons for TNFi switching: lack of effectiveness, adverse events, and insurance/cost barriers. @RheumNow #ACR25 https://t.co/5FUR9tBoyu

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Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
When MAS is suspected. Soluble IL2 receptor alpha and CXCL9 may be useful (however t cell lymphomas and viral infections like hepatitis may also have them) #ACR25 @RheumNow Key takeaways below https://t.co/wJv1dvwU88

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Bella Mehta bella_mehta ( View Tweet)
Functional MRI studies have been out there for a while, but mechanisms and significance underlying fMRI findings are unclear fMRI study in 38 active PsA pts w/ significant fatigue Altered functional connectivity between posterior insula to cerebellum & superior frontal gyrus https://t.co/3s9CJUg2uN

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Aurelie Najm AurelieRheumo ( View Tweet)
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