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From Fitbit to first diagnosis: AI is rewriting the RA playbook

Mrinalini Dey, MD

Artificial intelligence isn’t a distant frontier anymore. It’s here, and it appears able to detect signs of rheumatoid arthritis, possibly before we can clinically detect it. Two studies presented at this year’s ACR meeting highlight just how close we may be to a future where algorithms flag disease before we can and monitor activity with minimal patient burden.

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New pieces added to the Pre-RA puzzle

Aurelie Najm, MD, PhD

We know that pre-RA is a definition that stands under a large umbrella, ranging from asymptomatic individuals with ACPA positivity to individuals with symptomatic pre-clinical synovitis. How can we predict the transition from the at-risk state to clinical RA outside the realm of clinical, conventional serological (RF/anti-CCP) or imaging (US/MRI synovitis) biomarkers?

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Pre-ACR25 (10.24.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and info reports the day before ACR 2025

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Stress Raises the Risk of Psoriasis

EurekAlert!

New longitudinal research reveals that severe stress caused by changes in family structure like divorce or separation experienced during the first year of life may triple the risk of developing psoriasis later in life.

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Can Steroids Be Stopped in Lupus Nephritis?

MedPage Today

Patients with lupus nephritis were more likely to get off chronic corticosteroid treatment, and stay off, when certain factors were in place, researchers said.

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This retrospective cohort analysis by Dr. Lihi Eder et al showed that among patients with PsA, those w/ high dse activity & high 3VAS scores were assoc w/⬆️ risk of atrial tachyarrythmias. Main message: PsA conveys ⬆️CV risk; inflamm control is key! #ACR25 @RheumNow Abs0522 https://t.co/7sRM7K4V1c

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sheila RHEUMarampa ( View Tweet)
Come to our first #HealthLiteracy poster of #ACR25! #0190 Cluster analysis >900 people with IA Lowest health literacy cluster assoc w: 4× ⬆️anxiety/depression 2× ⬆️disease activity, vs highest HL Higher HL assoc w older age & ⬆️comorbidities but fewer mental health Sx @RheumNow https://t.co/iIRXaOl4qZ

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Mrinalini Dey DrMiniDey ( View Tweet)
How does cMRI change over time in cardiac EGPA? Cheng et al. retrospectively reviewed: - 11 EGPA pt with LGE on initial cMRI Despite treatment: - 10/11 persistent LGE on 2nd cMRI - 4/4 on 3rd - 2/2 on 4th Unclear use as a monitor of tx response @RheumNow #ACR25

Brian Jaros, MD Dr_Brian_MD ( View Tweet)

#ACR25 Abstr#0772. Should we be worried of #SLE patients with low uPCR 0.25-0.49? Kidney biopsy in N=28 + poor prognostic (Non-White, active serology or active sediment) - 71% had LN (No class IV or Mixed) - 46% actionable LN Cost-effectiveness data needed. #ACRBest @RheumNow https://t.co/Bt3fuA3aJh

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
AI-enhanced MRI integrating STIR and T1-weighted MRI with BME data reflecting both inflammatory and structural changes, enabling the AI model to predict clinical diagnoses of axSpA with accuracy of 82%. Successfully identified axSpA patients who did not meet the ASAS criteria for https://t.co/dLlGj0ZFpj

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Plenary session at #ACR25! #0772 When should we biopsy in SLE? In pts with uPCR 0.25-0.49 g/g + LN predictors, 69% already had LN (many Class III/V). Low C3/C4 were most important factors. 0.5 g/g cutoff may delay diagnosis and treatment. Time to rethink thresholds? @RheumNow

Mrinalini Dey DrMiniDey ( View Tweet)

Early, low level proteinuria is a harbinger in SLE. ~50% with elevated UPCR but <0.5 had actionable LN on early bx. Risk factor = low c3/c4 Urine biomarkers promising #ACRBest #ACR25 @RheumNow https://t.co/WuNPKeqeid

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Brian Jaros, MD Dr_Brian_MD ( View Tweet)
From Dr. Petri at Plenary - even small amounts of proteinuria are a PROBLEM. Reduction of microalbuminuria by even 10% improves mortality! #ACR25 @RheumNow https://t.co/hjmH26vXIb

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Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Year in Review: Regency Trial showed that LN pts given obinutuzumab achieved CRR at 76 wks (46.4%) vs. PBO. Take note: the Regency trial did not evaluate the extrarenal effects of Obinutuzumab in #SLE, thats for a diff study. #ACR25 @RheumNow https://t.co/WJssU1DbzZ

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sheila RHEUMarampa ( 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

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sheila RHEUMarampa ( View Tweet)
Rheum guidelines balance data & context. Beyond evidence, factors like cost, equity & feasibility shape recs. GRADE-ADOLOPMENT = global tool to adopt, adapt, or design local guidance for more rapid integration and with less $$$ @RheumNow #ACR25 #GlobalRheumSummitt https://t.co/Sfsqxsqpt4

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Jiha Lee JihaRheum ( View Tweet)
Colchicine Ineffective in Long COVID Management of long COVID has been perplexing with symptoms having functional and possibly inflammatory origins. Colchicine has been studied in long COVID and failed to improve functional capacity, respiratory function, or inflammatory https://t.co/9E3dvUFqJP
Dr. John Cush RheumNow ( View Tweet)
Single center study ANCA-assoc. vasculitis. From 78 pts had poor outcomes (16 ESKD, 15 deaths). Elevated BUN was a risk factor (adj HR 1.07). Risk factors for ESKD were baseline BUN & WBC. Risks for death included CV Dz (HR 8.7), NLR (1.04) &anti-PLt Rx (HR 6.8) https://t.co/QQrDmja0zo
Dr. John Cush RheumNow ( View Tweet)
6-week intensive smoking cessation prg studied in 94 RA daily smokers in remission or low Dz activity (DAS28-CRP=2.9). At 3 mos the intervention group had higher cessation rates; but had no effect on EULAR responses, TJC, or CRP (result actually favoured the controls) https://t.co/HPJYeyPCPQ
Dr. John Cush RheumNow ( View Tweet)
From the plenary to posters, RheumNow is your companion for ACR Convergence 2025. Expect: • KOL videos • Clinical trial highlights • Daily faculty recaps • Live streaming #ACR25 #Rheumatology #ClinicalTrials https://t.co/IdH5HIQAQX
Dr. John Cush RheumNow ( View Tweet)
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