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Rheumatoid arthritis and the ‘big bang’ at the ACR!
Is there ‘bang for the buck’ using big data to help predict who will develop RA in at-risk populations and similarly to predict response to csDMARDs, TNFi and JAKi in RA?
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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)
Cool study using vasculitis patient-powered reserach network (VPPRN)
"SNOT-22" tool captures sinonasal symptoms; associated with disease activity (expected) but also worse among pts even in remission
Very important impacter of QOL in AAV
#ACR25 @RheumNow Abstr0725 https://t.co/NQBW8VnYFS
Links:
Mike Putman EBRheum ( View Tweet)
ASAS recommends standardised reporting for 20 key outcomes in axSpA trials, 10 for all studies, 10 specific to DMARD trials. Formats include mean (±SD), mean change, and categorical thresholds for ASDAS, ASAS-HI, and extra-musculoskeletal manifestations. 85% of ASAS members https://t.co/VQwPaTRIOl
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
2-Year data from SELECT-GCA Phase 3 UPA in GCA
Re-randomization & 52 weeks extension UPA 15mg vs. PBO
-Risk of flare 90% lower
-Complete remission 70% vs 20%
-Cumulative GC 1g difference
-No new safety signal
The quick relapse after stopping UPA indicates we are really looking https://t.co/c1khywnPNv
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Immune-Mediated Necrotizing Myopathy @EleniTiniakou #ACR25
*Younger pts tend to have a more aggressive disease
*IVIG and RTX can be considered first-line rx for anti-HMGCR and anti-SRP+, respectively
*CYC and plasmapheresis may be options in cases of aggressive disease https://t.co/zWDX79gqlf
Rheumatology Quarterly RheumQuarterly ( View Tweet)
Real world effectiveness of voclosporin for SLE
Reduction in UPCR from 2.1 at b/l to 0.9 at 6 months, no improvement in eGFR; as expected based on trials
Wonder about market share of BEL vs voclo vs ANI - anyone seen pubs on this?
#ACR25 @RheumNow Abstr#0661 https://t.co/l7i7IWhLSe
Mike Putman EBRheum ( View Tweet)
From the FOREMOST study factors predicting progression from oligo to polyarticular PsA: Female sex, enthesitis and dactylitis found to increase the risk of progression. Among patients in FOREMOST receiving PBO, prior csDMARD use was protective. Abstract#0576 @RheumNow #ACR25 https://t.co/CFMhAFgFBa
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Accdg to this retro analysis of their prospective cohort study from Toronto, 47 pts (10%) had D2M axSpA of whom 14 had tx-refractory dse.
D2M pts - longer symptom duration; ⬆️ASDAS, BASDAI, BASMI, BASFI & ⬆️CRP
💡Consider non-dse factors in D2M pts
#ACR25 @RheumNow Abs0547 https://t.co/MUUyyELbw8
sheila RHEUMarampa ( View Tweet)
#0191 We found that in a large South London RA cohort, use of advanced therapy in moderate disease (DAS28 3.2-5.1) generally followed NICE guidance. Gaps often reflected telehealth limiting DAS assessment and patient hesitancy. Self-assessment tools may help. @RheumNow #ACR25 https://t.co/UMGtkfABHn
Mrinalini Dey DrMiniDey ( View Tweet)
Real-world T2T strategy from MONITOR-PsA cohort:
🎯 At 48 weeks - 33.6% (49/146) of pts achieved PASDAS 'moderate' response & 37% (54/146) achieved a 'good' response
This was close to the T2T outcomes of the TICOPA trial
Adapt a T2T approach in PsA tx
#ACR25 @RheumNow Abs0572 https://t.co/FPiFIiO8Oe
Links:
sheila RHEUMarampa ( View Tweet)
SELECT-GCA (upadacitinib in GCA for 52w)
we hoped it might have ongoing effect post-cessation
Do we need to continue upa?
Extension data (second year) flare survival curves are clear:
continuing upa far outperforms placebo
It seems >2y toci/upa for GCA
#ACR25 ABST0776 @RheumNow https://t.co/uJA3uQyWxb
David Liew drdavidliew ( 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)
Mease et al. Sometimes perspective is all important! We worry about apremilast causing GI effects, anorexia, weight loss. Here we see reported benefits for weight loss and HbA1c. @RheumNow #ACR25 Abstr#581 https://t.co/CJjS0VZxWH
Richard Conway RichardPAConway ( View Tweet)
Tracking RA disease activity got a measurable boost in the VA: a 3-month multimodal rollout (feedback, EHR tools, just-in-time lists) raised DAM documentation up to 10%. Small structural changes, big data gains.
@RheumNow #ACR25 Abstract#0221
Jiha Lee JihaRheum ( View Tweet)
Why do some clinics excel at RA disease activity tracking while others struggle? In the VA, success came down to structure: RA-specific clinics, templates, and staff. Barriers? Time, missing labs, and workflow gaps.
@RheumNow #ACR25 Abstract#0222
Jiha Lee JihaRheum ( View Tweet)
Managing lupus is complex. How do we ensure quality care?
Abstract #0218 convened 8 focus groups:
✅ Support for patient navigators
⚠️ Barriers: low resources, staff turnover
💻 Solution: EHR outreach workflow to flag missed visits & labs
@RheumNow #ACR25 https://t.co/BWaIMMEPit
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Damen et al. 10-year follow-up of CRESPA study. Treatment withdrawl trial in early peripheral SpA. 38% in drug free remission. 82% in remission. @RheumNow #ACR25 Abstr#568 https://t.co/KOVW5pSbJg
Richard Conway RichardPAConway ( View Tweet)
DESIR cohort of early axSpA:
✳️Factors assoc w/ D2M axSpA - female sex, ⬆️ASDAS-CRP ⬆️BASFI ⬆️ASQOL at baseline.
✳️ Low prevalence of pts meeting D2M definition (15 pts - 8.4% bDMARD-treated)
#ACR25 @RheumNow Abs0544 https://t.co/fBUh3myKcz
sheila RHEUMarampa ( View Tweet)
Abstract #0189: Rheumatologists are early adopters and high utilizers of #AI scribes.
📊 Adoption: 41%
🧑💻 Retention: 100%
💬 High utilizers (> 70% visits): 83%. The highest among IM subspecialties
🕒 AI scribes reduced EHR time across all measures.
@RheumNow #ACR25 https://t.co/TBurWUKhMl
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
