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Rheumatology’s Blind Spot: The Persistent Exclusion of Older Adults
As the population ages globally, rheumatologists are caring for an increasingly older patient population more than ever before. In RA alone, nearly 40 percent of patients are now aged 65 years or older. Yet the evidence guiding our treatment decisions continues to come from studies that rarely include them, giving rise to a fundamental question: do we really know how best to treat older adults with rheumatic diseases?
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New Gout Therapies Show Promise in Phase III Trials
ACR Press Release
At ACR Convergence 2025, the American College of Rheumatology’s annual meeting, researchers presented pivotal Phase III studies highlighting novel therapeutic options for patients with gout, particularly those with limited treatment choices or uncontrolled disease.
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REPLENISH - Secukinumab Works in Polymyalgia Rheumatica
Novartis announced the results of their REPLENISH trial showing the efficacy of secukinumab (Cosentyx) (SEC) in adults with polymyalgia rheumatica (PMR).
https://t.co/CLmCdBXiOf https://t.co/z20nWd2NSM
Dr. John Cush RheumNow ( View Tweet)
Next Generation T-Cell Engager: The Future https://t.co/gcrfzV6MSJ via @YouTube
@alhkim great to see you and hearing all about new T cell Engager , feasibility and less toxicity.
@RheumNow
#ACR25
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
#0851
Urinary Tenascin C predicts kidney function loss in lupus nephritis
170 AMP-LN patients: Tenascin C (from renal myofibroblasts) was the top predictor of eGFR decline (HR 4.6)
Proteomic 11-marker risk score (AUC 0.91) outperformed proteinuria for prognosis #ACR25 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
#0852 LEVI-04, a novel p75NTR-Fc fusion protein, significantly reduces MRI bone marrow lesions in knee #OA 🦵📉
Phase II RCT (n=518): dose-dependent BML reduction (p<0.001) + correlated improvement in pain & function. Promising structure-modifying OA therapy
@RheumNow #ACR25 https://t.co/huA8OaFGSd
Mrinalini Dey DrMiniDey ( View Tweet)
#1614 Another SLR informing the 2025 EULAR recommendations for PMR & LVV 🧭
Fast-track clinics cut blindness & diagnostic delays; multimodal imaging pathways outperform biopsy alone. Key data shaping future referral & diagnosis guidance. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
Key slide and takeaways on the ACR 2025 extrarenal SLE guideline. Presented by Lisa Sammaritano @RheumNow #ACR25 #ACRBest https://t.co/Xa97O6RdBY
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#ACR25 Abstr#0773 Anti-MDA5 ab is assoc. with progressive DM-ILD. But MDA5 expression is also upregulated in IPF. Any new biomarker which can link these ILD?
Measuring reactivity to MDA5 (aa 201-300) epitope peptide may help identify poor ILD prognostics (with/out DM) @RheumNow https://t.co/rziwihKfIr
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Is tocilizumab equally effective in ischemic vs. non-ischemic GCA?
Ischemic = vision, jaw claudication, or CVA
Remission at 6 mo higher in non-ischemic group then with equalization at month 12
No major difference in GCs at month 12
@RheumNow #ACR25 #Abst0739 https://t.co/OeYggSQYx8
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
We need more biomarkers in GCA - what about fibrinogen?
Miller et al retrospectively compared CRP, ESR, and fibrinogen at different points in GCA dx
Fibrinogen (and ESR/CRP) only helpful prior to initiation GC with comparable performance
@RheumNow #ACR25 Abst #0750 https://t.co/q5gFxDMnTy
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Abstract 0842
💡 Urinary biomarkers as the next frontier for monitoring lupus nephritis activity
🔹 Proteinuria didn’t track w/ histologic activity
🔹 IL-16 & sCD163 correlated at baseline only
🔹 Urinary Tenascin C & BAFF correlated w/ activity at 1 yr
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
2 year extension data from SELECT-GCA:
Patients in remission who remained on upadacitinib 15mg daily after 1 year had 90% reduced risk of flare compared to those who switched to placebo
Higher rates zoster, CK elevation in UPA group
#ACR25 @RheumNow #ACRBest https://t.co/jf8Dh2wCBj
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Could a sputum test predict risk for RA conversion in at-risk patients?
98 at risk pts, Converters had higher
-BL sputum CCP levels
-BL Sputum nucleosome and cit-nucleosome levels !although not asso after adjusting for sputum anti-CCP-IgA level
In converters, correlation of https://t.co/bqmQqS1Jz5
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
More biomarkers predictive of conversion to clinical RA in at-risk pts
Serum PAD4 & PAD 4 levels measured in CCP+ at-risk individuals
-PAD4 (not PAD2) increased in RA Converters vs. non converters and HC
-PAD4 levels Pre-RA = RA
Within high CCP+ at risk individuals, higher https://t.co/LU5zUzui1G
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
CMV is a worry with high-dose steroids, especially in certain settings.
The risk is far from universal, though: in this Korean cohort treated with high dose pred, almost no-one without risk factors got it.
Meds are rarely the only infection risk factor
#ACR25 ABST203 @RheumNow https://t.co/zLYhLVKgYL
Links:
David Liew drdavidliew ( View Tweet)
#ACR25 Abstr#803 We need more data to justify biologics before conventional immunosuppressant in #SLE. Post-hoc analysis of 5 Phase 3 RCTs = improved efficacy & GC reduction in BEL+No IS vs PBO+IS. Potential selection bias as control group might be doomed to fail @RheumNow https://t.co/kXmrOUbJzj
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Upadacitinib in GCA doesn't just affect IL-6, it alters IFNg, known to be important in vascular change in GCA.
If UPA in GCA has some cardiovascular concerns extrapolated from RA, it also has some plausible cardiovascular benefits too that TCZ may not
#ACR25 ABST0751 @RheumNow https://t.co/rMetLPP9z6
David Liew drdavidliew ( View Tweet)
A closer look in skin toxicity of GCs in RMDs
GC Toxicity Index, LONG TOX prospective cohort
Frequent:
-Easy bruising 35%
-Atrophy 22%
-Hirsutism 17%
-Acneiform rash 15%
-Erosion/Tear 12%
GC-related Neuropsychiatric toxicity highly associated with/ skin, something to look out https://t.co/NfxG8JkxSP
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Nice SRMA evaluating HCQ dosing
>5mg/kg associated w/3.8x risk of retinopathy...
...but <5mg/kg associated w/1.8x risk of SLE flares
Morbidity from one of those is easily avoided by regular screening; morbidity from the other can be devastating
@RheumNow #ACR25 Abstr#805 https://t.co/1vJXxXqiRC
Mike Putman EBRheum ( View Tweet)
