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Dr. Gensler gave a fantastic talk on SpA mimics
☝️Not all IBP is axSpA - interpret in the appropriate context + imaging
WOF other mimics
🔸 Sacral insufficiency fractures
🔸 Infections
🔸DISH
#ACR25 @RheumNow https://t.co/7TIqyp5rYe
Links:
sheila RHEUMarampa ( View Tweet)
Who talks to their neighbour?
+SSA / Ro talk differently to nearby cells in #SjD #salivary #glands vs NEG Ro SjD
Ro52 acts differently than Ro60
?implications for Rx response? 🤷♀️
#ACR25 @RheumNow @ACRheum #Sjogren’s
Abst#1684
#ACRBest!
Elegant work from Sara McCoy https://t.co/UWUKAxi0UW
Links:
Janet Pope Janetbirdope ( View Tweet)
DYK?
A bipartite ilium is a common SIJ variant.
More common among women.
SpA mimics involving biomechanical stress: BME & sclerosis
🔸OCI - assoc w/ multiparity, obesity
🔸Degenerative dse
#ACR25 @RheumNow https://t.co/IoZepAJKJ6
Links:
sheila RHEUMarampa ( View Tweet)
~1 in 6 pts with #sarcoidosis May have #cardiac involvemt
1/3 respond to #MTX + #steroids
Followed by repeat #PET
Failures get
👇
#infliximab >#adalimumab
👇
#JAKi
Better survival >yrs ago
R heart involved ⬆️risk of MTX nonresponse
#ACR25 @RheumNow @ACRheum abst#1664 #ACRbest https://t.co/kYt9JRNSVH
Links:
Janet Pope Janetbirdope ( View Tweet)
New tx for IPF/autoimmune ILD, nerandomilast (PDE4Bi)
Subgroup analysis from FIBRONEER-ILD, marginally less FVC worsening (-65mL tx grp vs -107mL plbo grp) & no clear improvements in dyspnea/fatigue/cough
But also... 6% absolute reduction in overall, persisted (small n) in https://t.co/Faf26UZuDx
Links:
Mike Putman EBRheum ( View Tweet)
In the SERENA study (n=292), secukinumab reduced PsA incidence to 0.49/100 PY over 5 years in PsO patients with nail involvement, an ~82% drop vs historic non-biologic rates (2.7/100 PY). 98.3% remained PsA-free; PASI 90 achieved in 63%. Abstract#1463 @RheumNow #ACR25 https://t.co/ySOuFJiwge
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Survival outcomes in patients with axial SpA and concomitant cancer are the same as those without. #abst1429 #ACR25 @RheumNow https://t.co/wicN3s9JrR
Bella Mehta bella_mehta ( View Tweet)
Classification of sacrioilitis using new york criteria vs a convolutional neural network. Abst#1421 #acr25 @RheumNow
Yes no results - accuracy was 70 percent. But the exact grade was right 22 percent times only! https://t.co/9o8OGesH0n
Bella Mehta bella_mehta ( View Tweet)
Fragoulis et al. Real world study of bimekizumab demonstrates equal efficacy in IL-17i naive and exposed. @RheumNow #ACR25 Abstr#1439 https://t.co/aCcLgnKvFJ
Richard Conway RichardPAConway ( View Tweet)
Gensler et al. Bimekizumab in male and female axSpA patients. Greater benefit in males at week 16, but similar responses at week 52 @RheumNow #ACR25 Abstr#1449 https://t.co/zDYI2zItqT
Richard Conway RichardPAConway ( View Tweet)
Mac Gearailt et al. Depression in axSpA. Depression in 10%. Associated higher disease activity, worse functional status, and increased peripheral manifestations. @RheumNow #ACR25 Abstr#1409 https://t.co/8pnoQiaiQr
Richard Conway RichardPAConway ( View Tweet)
Bimekizumab showed sustained 1-year efficacy in axSpA across age, BMI, CRP, and HLA-B27 subgroups. ASAS40, ASDAS, BASDAI, ASQoL, and MRI scores improved in most groups—especially age ≤35, BMI 25–30, CRP >5, and HLA-B27+. Abstract 1451 @RheumNow #ACR25
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Really useful observational study, 305 pts with TAK
Out of 205 pts w/subsequent imaging, 72 (35%) w/NEW lesions in previously-unaffected territory
Majority of lesions stenotic. Emphasizes importance of regular monitoring
#ACR25 @RheumNow Abstr#1631 https://t.co/zoWjH0lEym
Links:
Mike Putman EBRheum ( View Tweet)
After At-risk RA, time to discuss At-risk PsA patients
ARP-PsA
Prospective cohort 1400+ pts
8.4% met ARP-PsA criteria (arthralgia + Fam Hx +Pso, not referred via Dermatology)
Risk factors:
Pso >15 years
Pso + Family Hx
US synovitis/enthesitis
At 1 yr follow-up 30% progressed https://t.co/ZY2ezh8nZN
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Mayer et al. NSAIDs in IBD. Retrospective cohort study. 250000 individuals. Non-inferiority study. No increased IBD-related hospitalisation in UC, but an increase in all-cause hospitalisation. @RheumNow #ACR25 Abstr#1434 https://t.co/he2Xmcqslk
Richard Conway RichardPAConway ( View Tweet)
Concerns using dupilumab in EGPA due to secondary eosinophilia
What about when combined with IL-5 therapy?
16 pt on dupi + IL5 agent
- if dupi alone caused eosinophilia -> quelled by IL-5
- no eosinophilia when dupi added to IL-5
- effective but slow
@RheumNow #ACR25 Abst 1605
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Don’t forget
👇
#lcSSc Pts can get and progress #ILD
1/3 of #limited #cutaneous #systemic #sclerosis #scleroderma GET ILD
From #EUSTAR
>14% progress
Esp +Scl70
Remember to screen #CREST Pts
& allow these Pts into lung disease trials
#ACR25 @RheumNow @ACRheum abst#0879 https://t.co/X15tUgClzN
Links:
Janet Pope Janetbirdope ( View Tweet)
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)
GLP1 receptors are present on cartilage, synovial and specific cells such as macrophages.
Also endogenous GLP1 seemed to protect the cartilage in animal models
#ACR25 @RheumNow https://t.co/ekNWbtPO4b
Links:
Bella Mehta bella_mehta ( View Tweet)
The axSpA Registry of Ireland (ASRI): 10% reported depression, w/ higher prev in older cohorts.
Pts w/ depression had ⬆️peripheral involvement, ⬆️dse activity & poor functional status
💡Consider the impact of non-inflamm factors in dse burden
#ACR25 @RheumNow Abs1409 https://t.co/yDfHA24M6e
sheila RHEUMarampa ( View Tweet)
