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What we need in very early arthritis

David Liew, FRACP

It's easy to think that in our current world that we've done it all for rheumatoid arthritis, that there's nothing left to be done after b/tsDMARDs have become relatively widespread and accessible. If we aren’t satisfied that we’ve done all we can for our RA patients, how can we make their treatment and their lives better?

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Trends and Innovations from Barcelona (6.20.2025)

Jack Cush, MD

Dr. Jack Cush reviews highlights, trends and novel studies from EULAR 2025 in Barcelona from last week.

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Striking a ‘nerve’ in RA: understanding neuromodulation

Janet Pope, MD, MPH, FRCPC

Over the last 50 years, discoveries of connections between inflammation and the nervous system have been better understood.

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What would it take for JAKs to ROCK the boat?

David Liew, FRACP

JAK inhibitors have taken a beating over the last three years. The excitement and potential has been tempered by mounting cardiovascular safety concerns, but specifically in at-risk patients, compared to TNF inhibitors. So it is an intriguing idea to pair JAK inhibitors with something that might have a cardioprotective effect. It is therefore worth excitement that we have a therapeutic option to follow which does just that. At EULAR 2025, we have seen phase 2 results for CPL’116, and a simultaneous publication in The Lancet Rheumatology.

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Persistent Burden in Early RA Despite Disease Control: insights from CareRA Trials

Mrinalini Dey, MD

Advances in the treatment of rheumatoid arthritis, particularly the treat-to-target strategy and the introduction of effective DMARDs, have improved the management of inflammation in RA. However, improved inflammatory markers do not always translate into a resolution of patients’ symptoms or improvements in functional capacity. A recent pooled analysis from the CareRA and CareRA2020 randomized controlled trials shed new light on this dissociation between biological disease control and patient-reported outcomes.

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Persistent Burden in Early RA Despite Disease Control: insights from CareRA Trials Advances in the treatment of rheumatoid arthritis (RA), particularly the treat-to-target strategy and the introduction of effective disease-modifying antirheumatic drugs (DMARDs), have improved https://t.co/cMiF6POKGS
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Global burden of dz study - UN statistics show post-Menopausal women (PMW) are 20% of all women in 2021 (vs 13.7% 1990). From 1990 to 2021, the prevalence of MSK Dz in PMW significantly risen, especially for RA, OA, and gout. https://t.co/HdkopkxLdv https://t.co/wsGhg0P1tL

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Survey of 154 Saudi established #RA pts on MTX >3mos; 64% claiming #MTX intolerance & 36% w/ MTX Intolerance Severity Score (MISS) >6. But MTX intolerance was NOT related to dose or route of administration, meal or time of day. These were not new MTX starters https://t.co/6KWGcZvx4o
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Why is RA Difficult to Treat? Dr. Jonathan Kay shares his perspective on five posters presented at EULAR 2025 in Barcelona, Spain. Posters reviewed: POS0027, POS0028, POS0185, POS0030, POS0163 https://t.co/Ad4hVN21MJ https://t.co/d0BfQWjjL0

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Does Abatacept Buy You Time Off RA? Dr. David Liew reports on abstract OP0325 presented at the 2025 EULAR meeting in Barcelona, Spain. https://t.co/t8NLvPjcju https://t.co/bloTKQ87rv

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How to properly use steroids in early RA Guidelines differ on the early treatment of RA – ACR suggests not to use glucocorticoids (GC) and EULAR updated recommendations for RA treatment presented at #EULAR2025 continued to suggest early treatment with MTX and glucocorticoids. https://t.co/FakKxRot0p
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Methotrexate and Leflunomide combination in RA/PsA: Is it safe? Save I asked the EULAR Twitter community about the combination of Methotrexate (MTX) and Leflunomide (LEF). Opinions are split, with 50% prescribing it often and 50% concerned about side effects. In my practice, https://t.co/SZjLaEH1h2
Dr. John Cush RheumNow ( View Tweet)
Rheumatoid arthritis incidence has risen to 17.9 million people globally -13.2% increase from 1990-2021. Fewer people are dying from RA, but disability-adjusted life Yrs have doubled. high sociodemographic index bore the heaviest burden. Smoking control policies is forecasted to https://t.co/YmWcinVdmE
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ALTO: Long-term Outcomes of APIPPRA Dr. Mrinalini Dey interviews Professor Andrew Cope about abstract OP0004, on the long term outcome of APIPPRA patients - the ALTO study, at the EULAR 2025 meeting in Barcelona, Spain. https://t.co/9wVZSXbi6r https://t.co/fm77qDoTwm

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Dr. John Cush RheumNow ( View Tweet)
EULAR 2025 – Day 4 Report Saturday was the final day of EULAR, and included several lectures, but mostly late breaking abstracts and new EULAR guidelines - notably on Rheumatoid Arthritis and another on Interstitial Lung disease in connective tissue disorders. https://t.co/ZJ1pHQJTbK
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Toward Long-Term Prevention of Rheumatoid Arthritis: Are We Closer? As earlier diagnosis and treatment of rheumatoid arthritis (RA) have resulted in greatly improved clinical outcomes, the focus of current research has now shifted to preventing the development of RA altogether. https://t.co/HGbXVLVuSC
Dr. John Cush RheumNow ( View Tweet)
DMARD Combinations in RA Treatment Dr. Jiha Lee discusses abstract OP0195 presented at the EULAR 2025 meeting in Barcelona, Spain. https://t.co/lrZRDvWD0z https://t.co/PS4k2bCqet

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Dr. John Cush RheumNow ( View Tweet)
EULAR 2025 – Day 3 Report Highlights from Day 3 included presentations on imaging in vasculitis, a debate on treating high-risk pre-clinical RA, and EULAR Recommendations on ILD treatment, physical activity for arthritis, the EULAR disease activity score for antiphospholipid https://t.co/FAaj443wPX
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Introducing Polyrefractory RA: A New Frontier in Difficult-to-Treat RA At a EULAR 2025 session titled “What makes ‘Difficult-to-treat RA’ so difficult to treat? And what can we do?”, Drs. Paula David and Dennis McGonagle introduced the emerging concept of polyrefractory https://t.co/35cWYRehdd
Dr. John Cush RheumNow ( View Tweet)
Several studies have shown predictive value to monocyte counts in RA responses. UK study of 246 #RA pts showed pretreatment absolute monocyte count [ORadj 9.56; 1.61-59.86, p = 0.01) predicted bDMARD nonresponse @ 6 mos. Replicates other reports! https://t.co/GqGj8R0wq1 https://t.co/HJ7wFBoxGE

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