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New Gout Therapies Show Promise in Phase III Trials
ACR Press Release
At ACR Convergence 2025, the American College of Rheumatology’s annual meeting, researchers presented pivotal Phase III studies highlighting novel therapeutic options for patients with gout, particularly those with limited treatment choices or uncontrolled disease.
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2 year extension data from SELECT-GCA:
Patients in remission who remained on upadacitinib 15mg daily after 1 year had 90% reduced risk of flare compared to those who switched to placebo
Higher rates zoster, CK elevation in UPA group
#ACR25 @RheumNow #ACRBest https://t.co/jf8Dh2wCBj
Brian Jaros, MD Dr_Brian_MD ( 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)
CMV is a worry with high-dose steroids, especially in certain settings.
The risk is far from universal, though: in this Korean cohort treated with high dose pred, almost no-one without risk factors got it.
Meds are rarely the only infection risk factor
#ACR25 ABST203 @RheumNow https://t.co/zLYhLVKgYL
Links:
David Liew drdavidliew ( View Tweet)
#ACR25 Abstr#803 We need more data to justify biologics before conventional immunosuppressant in #SLE. Post-hoc analysis of 5 Phase 3 RCTs = improved efficacy & GC reduction in BEL+No IS vs PBO+IS. Potential selection bias as control group might be doomed to fail @RheumNow https://t.co/kXmrOUbJzj
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Upadacitinib in GCA doesn't just affect IL-6, it alters IFNg, known to be important in vascular change in GCA.
If UPA in GCA has some cardiovascular concerns extrapolated from RA, it also has some plausible cardiovascular benefits too that TCZ may not
#ACR25 ABST0751 @RheumNow https://t.co/rMetLPP9z6
David Liew drdavidliew ( View Tweet)
A closer look in skin toxicity of GCs in RMDs
GC Toxicity Index, LONG TOX prospective cohort
Frequent:
-Easy bruising 35%
-Atrophy 22%
-Hirsutism 17%
-Acneiform rash 15%
-Erosion/Tear 12%
GC-related Neuropsychiatric toxicity highly associated with/ skin, something to look out https://t.co/NfxG8JkxSP
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Nice SRMA evaluating HCQ dosing
>5mg/kg associated w/3.8x risk of retinopathy...
...but <5mg/kg associated w/1.8x risk of SLE flares
Morbidity from one of those is easily avoided by regular screening; morbidity from the other can be devastating
@RheumNow #ACR25 Abstr#805 https://t.co/1vJXxXqiRC
Mike Putman EBRheum ( View Tweet)
CE study BEL vs csDMARDs in TriNetX
Mortality ~3-4% for MTX/AZA/MMF vs ~1.5% for BEL, ~50% reduction in adjusted analysis
Pretty surprising given mediocre results from BLISS RCTs, but strong research group & lotsa fancy stats
Do you believe it?
#ACR25 @RheumNow Abstr#0804 https://t.co/Yex98EYDjP
Links:
Mike Putman EBRheum ( View Tweet)
#ACR25 Abstr#802 In #SLE pts with CLASI-A ≥8, pooled post-hoc analysis of Phase 2 RCT showed enpatoran, oral small molecule toll-like receptor 7/8-i impoved cutaneous response vs PBO as early as WK4. First-in-class promising therapy & warrant investigation in Phase 3 @RheumNow https://t.co/rn6NXdiGjD
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Effect of BioDMARDs on Diabetes risk in 6400+ Psoriasis pts
IL-23i and IL-17Ai associated w/
-lower risks of diabetes
-Diabetic nephropathy
-Stage 3–5 CKD
and reduced risk compared to TNFi treated and bionaive pts
Adjustment on several variables, but not disease severity https://t.co/TDIHXJOC2T
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
#ACR25 Abstr#801 Post-hoc analysis of Phase 2 RCT showed longer duration on Ianalumab (IAN) is beneficial. More #SLE pts achieved LLDAS or DORIS remission and GC taper in IAN in blinded 28-wk phase + open label IAN for the next 24-week group vs PBO-Open Label IAN @RheumNow https://t.co/I1Ugfj3BBl
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
A retrospective study from Spain assessed the relationship bet HPV infxn & biologic tx in SLE pts
🔅 Prevalence of HPV 9.9%
🔅 No significant assocs bet HPV infxn, biologic tx, SLE-related dse variables & HPV RF progression
Still, emphasize HPV screening
#ACR25 @RheumNow Abs0659 https://t.co/1YusM1nYPr
sheila RHEUMarampa ( View Tweet)
FDA Approves Obinutuzumab for Active Lupus Nephritis
The FDA has approved obinutuzumab (Gazyva) for the treatment of lupus nephritis. This is good news for the more than 1.7 million people worldwide with lupus nephritis.
https://t.co/Wr3tG5izCi https://t.co/P8A5PUCIX0
Dr. John Cush RheumNow ( View Tweet)
#ACR25 Beyond blinatumomab, A-319, CD3xCD19 BiTE in 12 patients with #SLE in China reported dose-dependent depth of B-Cell depletion but not efficacy or safety. One withdrew due to AE. No CRS/ICANS. Be interested to see results in larger trials & longer follow-up @RheumNow https://t.co/e5RuZlFI6i
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Leflunomide - a perennial question in GCA, that we still haven’t answered (as this meta-analysis shows), despite clear potential.
We are getting a clearer idea of the strengths/limitations of MTX in GCA, is it now time to get better clarity for LEF?
#ACR25 ABST0731 @RheumNow https://t.co/ycuvPx8Xdg
David Liew drdavidliew ( View Tweet)
After propensity matching, this retrospective cohort study showed that #lupus nephritis patients on GLP-1 agonists had ⬇️ CKD progression, mortality & AMI risk vs. LN pts on SGLT2is.
Interesting data but what could explain it? Further studies are needed
#ACR25 @RheumNow Abs0841 https://t.co/FtsGbMDcCv
sheila RHEUMarampa ( View Tweet)
#ACR25 Abstr#645. Dapirolizumab, anti-CD40L-i met primary endpoint, BICLA in Phase 3 RCT non-renal SLE. Key secondary endpoints showed higher rates of & time in LLDAS and remission in DAP vs PBO. Meaningful targets re: damage accrual & better longterm outcomes @RheumNow https://t.co/IxesXhi34R
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#ACR25 Abstr#641 Phase 1/2 CASTLE Basket Trial fully recruited N=24 (10 SLE, 9 SSc, 5 IIM). Short-term data of autologous CD19-CAR T
Zorpocabtagene-autoleucel/MB19.1:
- 22/24 high degree efficacy
- no relapse
- no high grade CRS/ICANS
*Need larger Phase prior approval @RheumNow https://t.co/sp1nieeCvl
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)


