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If We Can’t Prevent RA, Can We at Least Prevent Difficult-to-Treat RA?

Aurelie Najm, MD, PhD

Two new studies presented this year tackle a key question: can our initial treatment choices influence who ends up in the difficult-to-treat category?

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#1726 IA from immune checkpoint inhibitors (ICI) is a distinct autoimmune entity: T cell-driven but not antibody-mediated irAE arthritis shows hyperactive, cytotoxic CD8+ T cells & metabolic reprogramming, unlike RA. IL-6, IL-12 & IFNα fuel this process. @RheumNow #ACR25

Mrinalini Dey DrMiniDey ( View Tweet)

#ClinicalPearl #seroneg #arthritis often has 👇 #involvement of 1st toe IP joint Look at the feet 🦶 @RheumNow @ACRheum #ACR25 #28T08 Session secrets &pearls Tues https://t.co/EfqkLsTKmt

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Janet Pope Janetbirdope ( View Tweet)
Overview of the use of SARD-ILD by @drdavidliew covering the challenges, professionalism, explainability and interpretability. Think of using and validating AI in the same way we train our residents. The human interface still needed @RheumNow #ACR25 https://t.co/TYKud057ag

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
The Power of Gamma Delta T Cell for Autoimmunity https://t.co/wIMu5r7b3D More on T Cell engagers , this time with gama delta T cell ( tiny but mighty ). Kate Roslin talks about advantages of this protocol. (No cytokines thus less toxicity). @Yuz6Yusof @RheumNow #ACR25

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Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)

#ACR25 Please find my video interview with Dr Kate Rochlin on a novel Bi-specific T-cell engager (BiTE) in development which binds to pan-gamma delta T-cell instead of CD3 to minimise risk of cytokine release syndrome side effect. Abstr#1535 @RheumNow https://t.co/MOmUm41cyA https://t.co/TgIUGgWGw5

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
🎥 LIVE from #ACR25 Join us daily at 5 PM CST for RheumNow’s ACR Recap Live - Your must-watch debrief of the day’s biggest breakthroughs, hot abstracts, and real-time clinical takeaways. Streaming on YouTube Live, Facebook Live, X-Live & LinkedIn Live. Save the time. Be part of https://t.co/ZgZM14L6ta
Dr. John Cush RheumNow ( View Tweet)
Management of cardiac and joint sarcoidosis. Use of TNFi in treatment refractory cases. Alana Nevares-Berrios @RheumNow #ACR25 https://t.co/hXOfkgQHP9

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
GLP-1 in Knee Osteoarthritis https://t.co/SxyVEAK1CZ @bella_mehta Discusses role of GLP1 in OA and possible mechanisms of effectiveness ? weight reduction ? or doses it have anti-inflammatory -anti-fibrotic role ? @RheumNow #ACR25

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Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)

Progressive BiTE in SLE 2 https://t.co/ykMQmSAdlb More on BiTES in SLE by the one and only @Yuz6Yusof Bi specific Tcell engager ( CD3-CD19). @RheumNow #ACR25

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Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)

Day 2 Recap: ACR Convergence 2025 Highlights https://t.co/b8XvrEsoLW Such a great time to be a rheumatologist. Fake rheumatology sounds like a great topic! Daily challenges and unusual presentations. @DrMiniDey @synovialjoints @drdavidliew @RheumNow #ACR25

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Nouf Al hemmadi NoufAhmedAlham2 ( 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)
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)

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)
Simultaneous measurements if S100, Ferritin and IL-18 increase diagnostic utility of these biomarkers in Stills disease. @RheumNow #Acr25 https://t.co/3wmijNcpVY

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Bella Mehta bella_mehta ( View Tweet)
Biomarkers in Stills disease and MAS. #ACR25 @RheumNow IL 6 may not be helpful compared to CRP, and IL 1 beta is difficult to measure IL-18 seems to be the best one. https://t.co/u3oBTd4eaP

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Bella Mehta bella_mehta ( View Tweet)
IL- 18 go together sometimes with glycolytic enzymes such as aldolase Also MAS may not be a switch on and off mechanism. Lastly MAS with Stills may have increased IL18 levels but not in other disease like SLE #ACR25 @RheumNow https://t.co/BW1fD7usBT

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Bella Mehta bella_mehta ( View Tweet)

#ACR25 Abstr#1537 Beyond T-cell malignancy, we should be vigilant re: Local immune effector cell-associated toxicity syndrome (LICATS) with CAR-T. - Mostly afect skin & kidneys - Med time of onset 10 days; duration 11 days -Most LICATS were mild & without sequelae @RheumNow https://t.co/EnAWL936oh

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
AOSD And sJIA aren't the same disease!!!. Another take on this by Scott Canna..because the clinical syndrome might have somethings distinct!! #acr25 @RheumNow

Bella Mehta bella_mehta ( View Tweet)

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