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Accelerated Aging in Rheumatic Disease: From Biology to Lifestyle Intervention
At ACR 2025, the session “27M02: Nutrition for Rheumatic Disease: Where Aging Biology, Sarcopenia, and Diet Intersect” invited the audience to view rheumatic disease through the lens of biological aging and to consider how nutrition and exercise can serve as integrative lifestyle interventions.
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CDAI appropriately guided therapy escalation in RA, but not for everyone. Treatment adjustments were less likely in pts with public or no insurance. Even data-driven care can fall short when access barriers persist.
@RheumNow #ACR25 Abstract#2616
Jiha Lee JihaRheum ( View Tweet)
Large Canada ICES dataset- DMARD use is not associated with adverse pregnancy outcomes. In pts with RA, SlE and other rheumatic diseases.
Abst#2627 #ACR25 @RheumNow https://t.co/T9Ll1FNjT7
Links:
Bella Mehta bella_mehta ( View Tweet)
#1748 Higher air pollution, esp PM2.5, linked to ⬆️RA disease activity and more flares in >1000 Korean patients. Each rise in PM2.5 significantly boosted DAS28, CDAI & joint counts.
Does cleaner air mean calmer joints?
@RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
US Electronic Health Record cohort 2000+pts
Incidence Heart Failure over 10 yrs 6.8%
HF asso w/
Older
Male
Lower eGFR
Hypertensive medication
Diabetes
TTMTS MTX, TNFi
Higher CRP
Probably surrogates for High Disease Activity...
How do we detect it?
Maybe not by using the https://t.co/s9SjEyk3WF
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Agrawal et al. Case study of tofacitinib + bDMARDs in refractory IA. 7 SpA, 2 RA, 1 JIA. Effective and safe. @RheumNow #ACR25 Abstr#2338 https://t.co/Y0B3W4csJX
Richard Conway RichardPAConway ( View Tweet)
In RA, “strong bones” can give false reassurance.
Pts with higher baseline BMD had faster bone loss, often tied to GC use and less osteoporosis treatment. Undermanagement, not biology, may drive decline.
@RheumNow #ACR25 Abstract#2244 https://t.co/N421ESAUy9
Jiha Lee JihaRheum ( View Tweet)
After melanoma, should RA patients stop DMARDs?
These VA data (n=644) showed no mortality signal, and trending to survival benefit with b/tsDMARDs
Provisos over methotrexate, invasive disease etc, but don’t hold off treating the RA because of melanoma
#ACR25 ABST2237 @RheumNow https://t.co/l9n1V6YVln
David Liew drdavidliew ( View Tweet)
Can a Fitbit track RA?
This Japanese clinic is using Fitbit data and have seen it correlate with CDAI across their RA clinic.
Maybe instead of asking about our patients mobility and sleep, we should be measuring it?
#ACR25 ABST2253 @RheumNow https://t.co/rg2SKgn7K2
David Liew drdavidliew ( View Tweet)
#1751 In early RA, higher disease activity, inflammation & older age linked to more ILD changes on machine-learning chest CT. Even subtle QCT abnormalities correlated with reduced lung function pointing to early inflammatory pathways in RA-ILD. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
Are the clues of RA there in the EMR, before the diagnosis is made?
Jina off-the-shelf AI with subsequent retraining found the digital fingerprint of RA in @MayoClinic medical notes, years before formal diagnosis.
The clues are there
#ACR25 ABST2260 @MyasoedovaElena @RheumNow https://t.co/onGlKUmefd
David Liew drdavidliew ( View Tweet)
In the CLOSE-UP study of UPA in RA
- 61% in remission with responses sustained to 24 mo
- Benefit consistent irrespective of prior DMARD use
- No new safety signals
@RheumNow #ACR25 Abstract#2281
Jiha Lee JihaRheum ( View Tweet)
Serrano-Combarro et al. Abatacept in RA-ILD. 343 patients. Progressive ILD in 23%. Similar to the numbers progressing on baricitinib by same group. Previous MTX treatment appears to REDUCE risk (OR 0.45). Disease activity increases risk (OR 1.29). @RheumNow #ACR25 Abstr#2265 https://t.co/0tl0kGgm5p
Richard Conway RichardPAConway ( View Tweet)
Starting biologic early could save more than joints. In 329 RA pts, first-line anti-TNF reduced testing and hospitalization costs vs csDMARDs across Europe. Earlier targeted therapy pay off in outcomes and economics.
@RheumNow #ACR25 Abstract#2271 https://t.co/zZ32CpT36d
Jiha Lee JihaRheum ( View Tweet)
#1747 Serious infections ~2× more common in RA-LD, esp RA-ILD. Pulmonary, bacterial, viral & fungal infections all increased, underscoring need for tailored prevention and vaccination. @RheumNow #ACR25 https://t.co/soyzqLk7Vj
Mrinalini Dey DrMiniDey ( View Tweet)
#1746 In large US RA cohort, elevated GDF-15 & pentraxin-3 levels linked to prevalent RA-ILD; high GDF-15 predicted future ILD risk.
Other fibrosis-related mediators from IPF or heart failure were not associated, suggesting RA-ILD has distinct pathogenic pathways @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
STOP RA Cellular & Serologic Predictors
Dr. Jack Cush discusses abstract 0774, "Longitudinal peripheral blood multi-omic profiling in at-risk individuals uncovers immune signatures and predictive models for future RA conversion", presented at #ACR25
https://t.co/fS3sFmQJIh https://t.co/V1dVHhUeqF
Links:
Dr. John Cush RheumNow ( View Tweet)
New insights into Pre-RA: It ranges from asymptomatic individuals with ACPA positivity to those with symptomatic pre-clinical synovitis. Predicting who will develop RA is difficult, and there is a need for reliable biologic tools. Focusing on high-risk patients could https://t.co/SPOP7f0t7y
Dr. John Cush RheumNow ( View Tweet)
When every option fails, bold moves remain.
In 5 multi-resistant RA pts, TNFi + JAKi combo brought remission in most without major AEs.
Not standard, not risk-free, but in young, low-infection-risk pts, it may offer a path forward.
@RheumNow #ACR25 Abstract#2272
Jiha Lee JihaRheum ( View Tweet)
Mulcaire-Jones et al. Changes in PFTs over 1 year in early RA. Improved 31%, worsened 25%. No difference based on baseline disease activity, or MTX use. Those with baseline ILD were MORE likely to improve. ?due to effect of treatment @RheumNow #ACR25 Abstr#2235 https://t.co/bJeLYN9oN7
Richard Conway RichardPAConway ( View Tweet)
