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Two recent studies suggest there is no significant benefit of early biologics over standard step-up care with methotrexate2,3, but these did not select for poor prognosis.
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Nelly ZIADE 🍀
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✨️ New Definition Alert
The GRAPPA definition of
C2M (Complex to Manage)
&
D2T (Difficult to Treat)
#Psoriatic_arthritis
A hope for having a homogeneous and widely accepted definition for future clinical research
Presented at #EULAR2025
Proft et al.
OP#0175
@RheumNow https://t.co/et9cuMROkb
Aurelie Najm
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Combination of LEF and MTX in RA: Yay or Nay?
#EULAR2025 @RheumNow
Jiha Lee
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OP0195: MTX+LEF isn’t commonly used—but could it be a viable option after all?
In >1,100 RA pts, no link to liver fibrosis (FIB-4/APRI), modest ALT ↑, and fewer hospitalizations.
real-world safety data worth a second look.
@RheumNow #EULAR2025
Jiha Lee
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OP0179: In a psoriasis cohort, 68% of PsA onset sites showed prior subclinical inflammation (26% tender, 32% US+, 42% both).
Should we redefine when PsA truly begins?
@RheumNow #EULAR2025
Mrinalini Dey
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ACQUIVAS: RTX-treated AAV patients had poor response to #pneumococcal vaccine PCV-13 (8% vs 45% in non-RTX). Boosting w/ PPV-23 helped a few but 48% failed to mount robust response. Time to rethink vaccine strategies in RTX-treated patients?
@RheumNow #EULAR2025 #OP0173 https://t.co/soU5qfwRib
Aurelie Najm
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Premature death in RA still exists, and varies according to race/ethnicity demographic groups
Nationwide US CDC's MCoD database analysis
-Mortality rates
11x higher American Indians
3x higher Black or African American people
-Median age at death with RA
9-10 years younger https://t.co/FTRWPk7Wz0
Mrinalini Dey
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#MITIGATE subgroup analysis: Inebilizumab reduced flares & boosted remission across all #IgG4-RD subgroups. HR for flare vs PBO: 0.12-0.16 across sex/race. Similar results for all subgroups in achieving flare-free, treatment-free complete remission.
@RheumNow #EULAR2025 #OP0189
Mrinalini Dey
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RA-related premature mortality highest in American Indians--> 3.6x odds of death in <65 vs White peers, w/ no improvement over 22 yrs. COVID widened the gap. Need to address structural & social drivers of early death in RA, & wider health disparities.
@RheumNow #EULAR2025 #OP0197
Aurelie Najm
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Yes, it is relevant to ask patients about physical joint strain in RA and propose strain specific interventions
In ACPA+ RA pts for each 10% increase in strain, 7% increase in SJC44 and 5% MRI inflammation
POS0166 #EULAR2025 @RheumNow https://t.co/jwpi7S8JTW
Aurelie Najm
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We should address patients anxiety at RA diagnosis:
cohort 250+ newly diagnosed RA pts
-49% reported anxiety
-41% by 3 months
Anxiety asso w/ CDAI, PROs and 3-5 fold increase in prescription of bio/tsDMARDs
Analysis reasonably adjusted
POS0163 #EULAR2025 @RheumNow https://t.co/2gejEkRQhO
Aurelie Najm
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BioDMARDs reduce polyimmunity in RA
Danish Registry based cohort study 5 yrs follow up
25000+ pts
Polyimmunity in csDMARDs treated group 2.2% vs. 1.7% in bioDMARDs group
HR 0.74
Most frequent autoimmune thyroid disease
POS0161 #EULAR2025 @RheumNow https://t.co/9T0mhoUuqs
Antoni Chan MD (Prof)
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In D2T-PsA (10%), 57% had persistent inflammation (PIPsA), 43% non-inflammatory (NIPsA). Ultrasound distinguished phenotypes: median US activity score 3.22 vs 0.88.,swollen joints 2.5 vs 0, tender points higher in NIPsA.
Abstract OP0176 @RheumNow #EULAR2025 https://t.co/k7m8gAzbAZ
Antoni Chan MD (Prof)
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Nordic registries (n=13,872): D2T-PsA varied 37% (≥2 b/tsDMARDs failed) to 0.6% (strictest). Female predominance increased with therapy failures (≥4 failures: 67% female). Median time to failure: 5–7 years.
Abstract OP0177 @RheumNow #EULAR2025 https://t.co/lchPnTCEx7
Aurelie Najm
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There is still hope for vagal nerve stimulation in RA!
RCT RESET-RA 240+pts multibioIR
Implantable cervical device
Meets Primary endpoint ACR 20 wk12
Subgroup 1 prior bioDMARD ACR 20 wk12 46% vs 19% sham
EULAR Good response 61% vs 42% sham Wk 12
SAE rate 1.7%
#OP0190 #EULAR2025 https://t.co/DCON01XXgd
Mrinalini Dey
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2-year #MANDARA data: Benralizumab shows durable remission, eosinophil suppression & OGC-sparing in EGPA. ~62-68% in remission at wk104. Low relapse rate, no loss of asthma control or decline of lung function. No new safety signals.
@RheumNow #EULAR2025 #OP0166 https://t.co/kXh2q2ilJF
Antoni Chan MD (Prof)
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Difficult-to-treat & early PsA at #EULAR2025
GRAPPA definitions: D2T-PsA (≥3 therapies incl ≥2 b/tsDMARDs with persistent inflammation); C2M-PsA (broader: comorbidities, pain, intolerance). 95% GRAPPA consensus.
Abstact OP0175 @RheumNow #EULAR2025 https://t.co/eqKmMPh80x
Dr. John Cush
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Leeds study of 223 ACPA+ Arthralgia pts w quant. MRI of hand showing tenosynovitis (34% at baseline) doubled the risk of progression to RA. Total tenosynovitis Volume = incr. RA risk #EULAR2025 POS0472 https://t.co/eT0wbhp1uN
Dr Gurdeep S Dulay
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▶️Erosive hand OA
🔺Gull-wing erosion @ DIPJs ✅
🔺Saw-tooth erosions @ PIPJs ✅
#OA #Osteoarthritis #EULAR2025 https://t.co/5Hh4Ki9P8V
David Liew
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Fast track PMR clinics in Denmark led to more patients seen, and time to referral went down.
If we don’t get in early with a right diagnosis (and maybe early steroid-sparing) then PMR patients deteriorate.
We shouldn’t let PMR be an end stage disease #EULAR2025 POS0136 @RheumNow https://t.co/pqwveamhJP
