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SARD-ILD and serious infection risk: The elephant in the room

Jeffrey Sparks, MD, MMSc

Interstitial lung disease (ILD) remains one of the largest unmet clinical needs across many systemic autoimmune rheumatic diseases (SARD). Clinicians are already keenly aware of the complexity of patients with SARD-ILD. The “elephant in the room” for all these issues: serious infection.

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When Myositis Hits the Lungs: What Every Rheumatologist Should Know About ILD

Rohit Aggarwal, MD,  , Shiri Keret, MD

When idiopathic inflammatory myopathies (IIM) affect the lungs, the consequences can be serious. ILD is not only common in IIM, but also one of the leading causes of death, contributing to up to 80% of mortality in this patient group. For rheumatologists, two subsets stand out: anti-synthetase syndrome (ASyS) and anti-MDA-5 positive dermatomyositis (MDA5-DM). These patients present with distinct clinical clues, very different disease trajectories, and unique treatment challenges. Recognizing ILD early and acting decisively can make the difference between stabilizing a chronic course and facing a rapidly progressive, often fatal decline.

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Target

Hitting the Target: T2T Therapy in SLE

Sheila Reyes, MD

Treat-to-target strategies are not a new concept in rheumatology. It has shown to improve patient outcomes and quality of life in RA and PsA, and is now being increasingly adopted not only in SLE research but also in clinical practice. This article reviews key highlights from Dr. Eric Morand’s plenary session lecture on Treat to Target in SLE: Current Evidence and Future Directions, presented during the recent APLAR 2025 Congress.

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August 29, 2025, FDA has terminated the Arthritis Advisory Committee, citing infrequent meetings & that the effort and expense of maintaining the committee “is no longer justified.” The committee last met on 5/6/21 to review avacopan - that was subsequently approved. REALLY? https://t.co/w3Z6TszeWZ
Dr. John Cush RheumNow ( View Tweet)
RheumNow Podcast – Ro, Ro, Ro52 (9.12.2025) Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.Are there benefits to diet or vegan diets? What's the effect of menopause on CTD? Ro52 makes a big entrance with all our ILD coverage this month. https://t.co/T68Cprogm3
Dr. John Cush RheumNow ( View Tweet)
Call to Update the Classification Criteria in Idiopathic Inflammatory Myopathies (IMM), Why? - EULAR/ACR myositis criteria dont cover specific myositis subtypes - Polymyositis is rare - antisynthetase & necrotizing myopathy & Jo1 Dz not well represented - Need to include MSA, https://t.co/LUfF0VCeJ7
Dr. John Cush RheumNow ( View Tweet)
My article 👇 summarizing the 2025 update of EULAR recommendations by @eular_org, presented by Josef Smolen at @APLAR_org https://t.co/QFWZmqm6IR @RheumNow #APLAR25 https://t.co/ctQdu8gQEO

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Aurelie Najm AurelieRheumo ( View Tweet)

A self learning program to train non Rheumatologists to interpret pelvic X-rays and identify sacro-iliitis? It works, but it seems the participants were already well trained as pre test scores were already reaching 60+% Surprised to see radiologists constituting 1/4 of the test https://t.co/mRcFRSuAws

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Future Perspectives of Rheumatoid Arthritis Dr. Kuni Yamaoka, shares highlights from the Future Perspectives of Rheumatoid Arthritis session at the APLAR 2025 Congress in Fukuoka, Japan. https://t.co/LGLqe48R2L https://t.co/Kwp3cFPtyw

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Dr. John Cush RheumNow ( View Tweet)
Different B cells depletion strategies in SARDs highlighted by Georg Schett From low and short lived depletion achieved w/ drugs to sustained deep tissular depletion with CAR T cells leading to potential immune reset @RheumNow #APLAR25 https://t.co/t35lrzEomF

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Aurelie Najm AurelieRheumo ( View Tweet)
Dr. Alberta Hoi graphically presents the difference bet acute confusional states & chronic cognitive changes in #lupus patients presenting with NP symptoms. NPSLE continues to pose a diagnostic challenge bec pts may present with more than one syndrome complex @RheumNow #APLAR25 https://t.co/4nYTo1fzVz

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sheila RHEUMarampa ( View Tweet)
How to treat CTD ILD? A comparative slide summarizing ACR/BSR and EULAR treatment guidelines Emphasis on combination of Immunosuppressant and Antifibrotics @RheumNow #APLAR25 https://t.co/gLSht6QKh5

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Aurelie Najm AurelieRheumo ( View Tweet)
“Listen to the patient, he is telling you the diagnosis”. – Sir William Osler

Dr. John Cush RheumNow ( View Tweet)

Prof. Aletaha shares their AutoPiX project - using AI to develop quantitative biomarkers. Something to look forward to since imaging remains an important diagnostic tool in #rheumatology @RheumNow #APLAR25 @rheumarhyme https://t.co/WExT9amazz

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sheila RHEUMarampa ( View Tweet)
Update on Rheumatology workforce shortage in Asia-Pacific Date presented by Dr Ahmad Number of Rheumatologists per 100000 inhabitants across @APLAR_org countries -3 in Japan -1.3 in Australia, Hong Kong, Singapore -0.03 in Pakistan As a result: delayed diagnosis for patients! https://t.co/Hycqtp8BtY

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Aurelie Najm AurelieRheumo ( View Tweet)
🆕 Intro to ILD (Part I): the essentials 🫁 Definition & basics 🔬 Key pathology patterns 🧑⚕️ Clinical approach 📋 What rheums need to know ⬇️ Download & learn more: https://t.co/7RzpTDOjwa Created by @MithuRheum | via @RheumNow for our Rheum to Breathe: ILD Campaign https://t.co/D9d97bqcD5

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Dr. John Cush RheumNow ( View Tweet)
💥 New week, new quiz. Take 90 seconds. Prove you're the rheum news MVP. 📈 Track your accuracy 🏁 Race to the top of the leaderboard 🎯 Review what you missed Take the RheumIQ quiz ➡️ https://t.co/CASRQjoYrB https://t.co/FCjkqud0y4

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Lessons Learned in Neuropsychiatric SLE Dr. Sheila Reyes, The Philippines, reports highlights from a session on neuropsychiatric systemic lupus erythematosus, presented at the APLAR 2025 Congress in Fukuoka, Japan. https://t.co/Dh1GQnBhvg https://t.co/wX5FgpIq7C

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Dr. John Cush RheumNow ( View Tweet)
TNR: Future Treatment of ILD This Tuesday Night Rheumatology webinar reviewed ACR and EULAR guidelines on interstitial lung disease, with a focus on ‘where are we now and where are we going?’ in regards to treatment strategies and emerging therapies in ILD care. https://t.co/F1fJhWgR5O
Dr. John Cush RheumNow ( View Tweet)
2025 Update of EULAR RA management recommandation Summary slide inspired from Josef Smolen’s presentation @RheumNow #APLAR25 https://t.co/wRzeX9OIry https://t.co/djrd7O9G9H

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Aurelie Najm AurelieRheumo ( View Tweet)
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