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The 2025 Rheumatology Year in Review

Jack Cush, MD

The year 2025 presented numerous advances in rheumatology and related inflammatory and autoimmune disorders ranging from several new groundbreaking FDA approvals/indications, drug developments, game-changing guidelines and practices that will impact patient care for rheumatic diseases.

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Advanced Practitioner Biologic Prescriptions for Psoriasis

Jack Cush, MD

Advanced practice clinicians (APCs; nurse practitioners and physician assistants) deliver a large share of US dermatologic care, accounting for 37% of clinicians and 27% of dermatology visits by 2020. A current JAMA Dermatology reports APC drug spending trends in dermatology, with a focus on specialty medications (eg, biologics).

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Diffuse Alveolar Hemorrhage in Rheumatic Disease A retrospective, cross-sectional, single-center study of adult rheumatic disease patients with diffuse alveolar hemorrhage (DAH), demonstrates a high proportion have coexistent pulmonary infection and significant mortality risk. https://t.co/K1fLo5iHpd
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Subcutaneous Anifrolumab in SLE Manzi et al. have published the results of the TULIP-SC trial that showed that weekly subcutaneous (SC) anifrolumab, when given to severe SLE patients, had comparable efficacy and safety to the approved intravenous (IV) anifrolumab. https://t.co/ruZM3Qftxb
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Rheum Survey> 40 yoF RA pt on Prednisone 5 mg/d is at increased risk for ?
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FDA & Administration are deregulating artificial intelligence & promote widespread use, includes use of wearables & other AI-enabled devices. Commissioner Marty Makary updated two guidance docs defining use general wellness devices, clinical decision support software https://t.co/KnkYqCiroa
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Retrospective study of recombinant zoster vaccine Rheumatic (RMD) pts on DMARDs (32% JAKi) (114) vs 65 normals. HZoster reactivation: no controls vs 1in RMD. 1 Dz flare requiried steroids. Minor AE (ISR, HA, myalgia) seen in 17.5% & 21.5% w/ 1st & 2nd dose. RZV is safe in RMD https://t.co/Mu3OyA4EOD
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In Dec 2025, the FDA qualified total hip bone mineral density (BMD) assessed by DXA as a validated surrogate endpoint for osteoporosis clinical trials. Previously OP trials required fracture endpoints as primary efficacy measures, necessitating large 2-5 yr studies https://t.co/5t9rftwX4A
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FIBROSCANS in 60 RA pts on #MTX for 5 yrs w/ liver studies. Mean age = 39.5yrs, w/ Dz Dur 8.2 yrs, mean BMI 24.4 & MTX 12.5–25 mg for ~8 yrs (cum dose 6728mg). All had normal AST, ALT, APRI, Abd US; fibroscan score = 170 ((steatosis grade 0). Only 4(6.7 %) had mild, fibrosis https://t.co/7SACsEYi37
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Diffuse Alveolar Hemorrhage in Rheumatic Disease A retrospective, cross-sectional, single-center study of adult rheumatic disease patients with diffuse alveolar hemorrhage (DAH), demonstrates a high proportion have coexistent pulmonary infection and significant mortality risk. https://t.co/vpzF8Dnspr
Dr. John Cush Tweet
RheumNow
Subcutaneous Anifrolumab in SLE Manzi et al. have published the results of the TULIP-SC trial that showed that weekly subcutaneous (SC) anifrolumab, when given to severe SLE patients, had comparable efficacy and safety to the approved intravenous (IV) anifrolumab. https://t.co/3DWNEXaO2x
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Systematic review of cardiovascular death in systemic immune-mediated Dz (SIDs): 39 studies, 171,748 pts - SIDs assoc w/ signif. higher CV mortality (HR 1.26; 1.09-1.47; p = 0.002), especially for RA, SLE, GPA & females. 92% of CV deaths from acute coronary syndrome (ACS) https://t.co/ogLhqKMwON
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Metanalysis of Tramadol included 19 PBO-RCTs, 6506 pts, showing a very modest benefit on chronic pain (low certainty of evidence), but a doubling of risk for serious adverse events (OR 2.13); including nausea (NNH 7), dizziness (NNH 8), constipation (NNH 9), somnolence (NNH 13) https://t.co/0ZEIoy1gqC
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Retrospective study of recombinant zoster vaccine Rheumatic (RMD) pts on DMARDs (32% JAKi) (114) vs 65 normals. HZoster reactivation: no controls vs 1in RMD. 1 Dz flare requiried steroids. Minor AE (ISR, HA, myalgia) seen in 17.5% & 21.5% w/ 1st & 2nd dose. RZV is safe in RMD https://t.co/Hf7HaGOLXd
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