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Rheumatology’s Blind Spot: The Persistent Exclusion of Older Adults
As the population ages globally, rheumatologists are caring for an increasingly older patient population more than ever before. In RA alone, nearly 40 percent of patients are now aged 65 years or older. Yet the evidence guiding our treatment decisions continues to come from studies that rarely include them, giving rise to a fundamental question: do we really know how best to treat older adults with rheumatic diseases?
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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)
#1639
In 2 lupus cohorts (n=619), 1 in 4 had mismatch between self-reported & measured physical function.
Higher BMI, disease activity & depression linked to underreporting ability ➡️ self-report ≠ performance! Important for SLE care & research. @RheumNow #ACR25 https://t.co/kMlChreJPh
Mrinalini Dey DrMiniDey ( View Tweet)
Avouac et al. Lipid changes after JAKi initiation. 85 patients. Increases at 6 months. Largely appeared driven by HDL increase, and correlated CRP decrease. Appeared transient with return to baseline with time. @RheumNow #ACR25 Abstr#1333 https://t.co/CQ6u3ck1Ch
Richard Conway RichardPAConway ( View Tweet)
Ultra-low dose (ULD) RTX in AAV maintenance
200mg q6 mo vs. 500mg q6 mo interim analysis
No major difference in infection risk or hypogammaglobulinemia thus far but both doses appeared similarly efficacious
#ACR25 @rheumnow Abst 1609 https://t.co/ZGYNVGY3dr
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
ADA-biosimilar use surged just before CVS formulary change then dropped sharply after. In RISE data, uptake reached 25% of users overall. Formulary policies reshape prescribing, but sustaining adoption needs alignment with patient access and preferences.
@RheumNow #ACR25 A#1042
Jiha Lee JihaRheum ( View Tweet)
In this MTX+PNL vs TCZ+PNL in GCA study, we saw 5 pts on MTX+PNL get PJP, very surprising.
@EBRheum asked what I knew/hoped he’d ask: why did this happen?
PJP is v rare in GCA
(https://t.co/oPN0dpvG8Q) & with MTX in other diseases.
Worth interrogation!
#ACR25 ABST0891 @RheumNow https://t.co/rsbScryIFR
Links:
David Liew drdavidliew ( View Tweet)
GLP-1 receptor agonists reduce mortality in PsA
Tsibadze et al retrospectively compared ~4k PsA on GLP-1 to ~86k PsA not
After propensity matching, those treated with GLP-1:
- lower risk MACE
- lower risk overall death
@RheumNow #ACR25 Abst 0849 https://t.co/EuojrDq0Fj
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Is MTX worth anything in GCA?
METOGiA: MTX 52w vs TCZ 52w for GCA
MTX didn’t achieve non-inferiority to TCZ, but:
- clearly it does something
- continue both >1y: after MTX/TCZ therapy ended, they ended up with same relapse-free survival, cumulative GC
#ACR25 ABST0891 @RheumNow https://t.co/WvvkHKIXuQ
Links:
David Liew drdavidliew ( View Tweet)
Open-label MTX vs. Toci in GCA in METOGiA
Wk 78:
37% w/o relapse in MTX arm
46% w/o relapse in Toci arm
MTX was NOT non-inferior to Toci
Toci superior in 2ndary endpoints
Cumulative doses GC not significantly different
#ACR25 #ACRBest @RheumNow Abst 0891 https://t.co/lCaP4EdJ9C
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
REPLENISH - Secukinumab Works in Polymyalgia Rheumatica
Novartis announced the results of their REPLENISH trial showing the efficacy of secukinumab (Cosentyx) (SEC) in adults with polymyalgia rheumatica (PMR).
https://t.co/CLmCdBXiOf https://t.co/z20nWd2NSM
Dr. John Cush RheumNow ( View Tweet)
Next Generation T-Cell Engager: The Future https://t.co/gcrfzV6MSJ via @YouTube
@alhkim great to see you and hearing all about new T cell Engager , feasibility and less toxicity.
@RheumNow
#ACR25
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
#0851
Urinary Tenascin C predicts kidney function loss in lupus nephritis
170 AMP-LN patients: Tenascin C (from renal myofibroblasts) was the top predictor of eGFR decline (HR 4.6)
Proteomic 11-marker risk score (AUC 0.91) outperformed proteinuria for prognosis #ACR25 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
#0852 LEVI-04, a novel p75NTR-Fc fusion protein, significantly reduces MRI bone marrow lesions in knee #OA 🦵📉
Phase II RCT (n=518): dose-dependent BML reduction (p<0.001) + correlated improvement in pain & function. Promising structure-modifying OA therapy
@RheumNow #ACR25 https://t.co/huA8OaFGSd
Mrinalini Dey DrMiniDey ( View Tweet)
#1614 Another SLR informing the 2025 EULAR recommendations for PMR & LVV 🧭
Fast-track clinics cut blindness & diagnostic delays; multimodal imaging pathways outperform biopsy alone. Key data shaping future referral & diagnosis guidance. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
Key slide and takeaways on the ACR 2025 extrarenal SLE guideline. Presented by Lisa Sammaritano @RheumNow #ACR25 #ACRBest https://t.co/Xa97O6RdBY
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#ACR25 Abstr#0773 Anti-MDA5 ab is assoc. with progressive DM-ILD. But MDA5 expression is also upregulated in IPF. Any new biomarker which can link these ILD?
Measuring reactivity to MDA5 (aa 201-300) epitope peptide may help identify poor ILD prognostics (with/out DM) @RheumNow https://t.co/rziwihKfIr
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Is tocilizumab equally effective in ischemic vs. non-ischemic GCA?
Ischemic = vision, jaw claudication, or CVA
Remission at 6 mo higher in non-ischemic group then with equalization at month 12
No major difference in GCs at month 12
@RheumNow #ACR25 #Abst0739 https://t.co/OeYggSQYx8
Brian Jaros, MD Dr_Brian_MD ( 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)
