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RheumNow Podcast – Ro, Ro, Ro52 (9.12.2025)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Are there benefits to diet or vegan diets? What's the effect of menopause on CTD? Ro52 makes a big entrance with all our ILD coverage this month.
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ERS/EULAR guidelines for CTD-related interstitial lung disease
The European Respiratory Society (ERS) and European Alliance of Associations for Rheumatology (EULAR) have published clinical practice guidelines for the evaluation and management of connective tissue diseases (CTD) associated interstitial lung disease (ILD) in two simultaneous publications in the European Respiratory Journal and Annals of Rheumatic Diseases.
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September to Remember (9.5.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow. This week - unemployment, diagnosing Sjogren's and a lot of ILD.
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What's new in sjogren's?
Promising phase III data of telitacicept (dual BLyS + APRIL neutralization)
Pt in both dosing groups with decrease in ESSDAI compared to PBO but best results at higher (160mg) dose
Similar rates of adverse events
@RheumNow #ACR25 Abst LB11 https://t.co/r9JaVKzedH
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Sjögren’s, decoded by Ab -->ESSDAI domains:
• anti-SSA → glandular
• anti-Ro52 / SCL70 → biologic activity
• anti-nucleosome → pulmonary
• anti-histone → pulmonary + cutaneous
Distinct serologic–ESSDAI patterns may guide monitoring and management
@RheumNow #ACR25 A#2295
Jiha Lee JihaRheum ( View Tweet)
#ACR25 Abstr#LB11 2025 belongs to Sjogren! In patients with ESSDAI=>5, a Phase 3 RCT of Telitacicept (BAFF/APRIL-i) in China met primary endpoint; change in ESSDAI vs PBO. ESSPRI improved too!
Wow! That PBO response was a flat line! Will need Global study @RheumNow #ACRBest https://t.co/LXxpBZPCtF
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#ClinicalPearl
Pts w #SpA ex #PsA May have
👇
#sicca #dry #eyes #dry mouth
Inflamed gallbladder without calculi
👇
Can be associated w #autoimmune disease
#POTS can be initial presentation of #SjD
IgA vasculitis—May have #cancer
#Secrets & #Pearls #ACR25 @RheumNow @ACRheum https://t.co/4SAqVYjnrD
Janet Pope Janetbirdope ( View Tweet)
Who talks to their neighbour?
+SSA / Ro talk differently to nearby cells in #SjD #salivary #glands vs NEG Ro SjD
Ro52 acts differently than Ro60
?implications for Rx response? 🤷♀️
#ACR25 @RheumNow @ACRheum #Sjogren’s
Abst#1684
#ACRBest!
Elegant work from Sara McCoy https://t.co/UWUKAxi0UW
Links:
Janet Pope Janetbirdope ( View Tweet)
#ACR25 Abstr#1401 Sjogren’s #SjD is definitely not a benign disease! Real world study using US database showed high disease burden within 12 mths of diagnosis (i.e. healthcare resource use). GC use was high (~50%). Better therapy is needed to improve outcomes @RheumNow https://t.co/MI3vQ5LByr
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Need better lymphoma biomarkers in Sjögren’s?
APRIL joins BAFF as a promising candidate—high APRIL levels linked to ↑ B-cell activation, disease activity & future lymphoma.
Easily measurable, potentially targetable.
@RheumNow #ACR25 Abstract #1683
Jiha Lee JihaRheum ( View Tweet)
In Sjögren’s, cancer risk is real.
>9yr multicenter cohort (n=314), overall cancer risk ↑ (SIR 1.68), NHL >15× expected
Predictors: older age, smoking, LAD, splenomegaly, cryoglobulinemia (strongest for lymphoma).
Malignancies = 24% of deaths
@RheumNow #ACR25 Abstract #1681
Jiha Lee JihaRheum ( View Tweet)
Pregnancy risk in Sjögren’s & scleroderma
Meta-analysis (n=4,820) shows ↑ risk of miscarriage in Sjögren’s (RR 1.8) & ↑ preterm birth in SSc (RR 2.4).
Calls for preconception counseling & multidisciplinary high-risk OB care.
@RheumNow #ACR25 Abstract #1398
Jiha Lee JihaRheum ( View Tweet)
#Cancers esp #hematologic & #lung are ⬆️in Pts w #inflammatory #rheum #diseases
Odds ratios of hem malignancies are wide
& risk stratification is imp
Are we doing a good job?
🤔skin cancer screening ??- not as per general standards
Abst#0172 #ACR25 @RheumNow @ACRheum https://t.co/Uve9knXD3o
Links:
Janet Pope Janetbirdope ( 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)
Not just for salivary glands—lacrimal ultrasound helps too.
In early Sjögren’s, lacrimal + salivary US clearly distinguished SjD from sicca (AUC up to 0.97).
Noninvasive, reproducible, and highly diagnostic.
@RheumNow #ACR25 Abstract #0507
Jiha Lee JihaRheum ( View Tweet)
#Sjogren disease is here to stay.
“The name has caught up to the science of SD and this can translate to better treatment outcomes for patients” - Dr. Bryant England
#ACR25 @RheumNow https://t.co/M4r0XXkswv
sheila RHEUMarampa ( View Tweet)
September to Remember (9.5.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow. This week - unemployment, diagnosing Sjogren's and a lot of ILD.
https://t.co/dPdweMaJuN https://t.co/aExU5kV26Q
Dr. John Cush RheumNow ( View Tweet)
EULAR & European Respiratory Society have published clinical practice guidelines for ILD assoc w/ connective tissue diseases (SSc, RA, SjD, IIM, SLE, MCTD). 2 publications included Dz specific ILD management algorithms; use of Hi Res CT over Lung Bx; ILD risk factors
Dr. John Cush RheumNow ( View Tweet)
Prospective study of 171 suspected Sjogrens (130 dx w/ SjD) pts compared Dx accuracy - Labial gland Bx best Dx efficacy (AUC 0.90), followed Ro/SSA (AUC 0.79), Omeract score (AUC 0.78). Salv gland US grade 3 strongly predicted +Bx (AUC 0.77) & correlated w/ salivary flow ~-0.5
Dr. John Cush RheumNow ( View Tweet)
EHR analysis of Alaska Tribal Health System finds the prevalence of Sjögren's disease at 199 per 100K adults (primary SjD 129; secondary 70 (RA,SLE)). The age-adjusted incidence 16.6 per 100K Pt-Yrs. Only 5% had salivary gland Bx & 3% met 2016 ACR/EULAR or 2012 ACR criteria https://t.co/4tMdWIGTEi
Dr. John Cush RheumNow ( View Tweet)
