Formerly classified as an ANCA-associated vasculitis, EGPA is both most commonly ANCA negative and clinically different to the other two ANCA-associated vasculitis conditions, GPA and MPA. The management of EGPA has frequently fallen into the trap of being copied from its more common and well-known cousins. Now, however, we are seeing a discordance and following GPA/MPA management will potentially lead to both over-treatment and suboptimal treatment for EGPA. In this context, the Sunday morning session at RNL 2025 on “EGPA management in 2025 and beyond” by Dr. Michael Wechsler was both timely and clinically relevant.
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Traditionally, rheumatologists have often been deferential to the non-articular concerns in RA to other providers, though these issues are often left unaddressed. What role do rheumatologists have in the management of multimorbidity in our patients?
TheDaoIndex @KDAO2011
A practical clinic-based approach to assessing CVD, CA screening, lung disease, infections for rheums by Dr Bryant England who offers us menus.. start by asking about symptoms. #RNL2025
https://t.co/AcQDJS870I https://t.co/UCyDOF2GRZ
Adela Castro @AdelaCastro222
Multimorbidity in Rheumatoid Arthritis:
-Affects >75% of pts
-Reduces quality of life and increases mortality
-Highly associated w/ D2T RA
-Requires multidisciplinary care teams (PCP, specialists, case management, PT)
-Management should start early… https://t.co/Sshm8CUWOA https://t.co/W9dojZT99T
Jeffrey Curtis @RADoctor
Great talk at #RNL2025 by Dr Una Makris on managing geriatric rheumatology patients. How often do we under-treat #Rheumatoid arthritis patients with advanced therapies because we fall into the trap of ageism? https://t.co/kWLxt15n4X https://t.co/cmLjqigNol
Janet Pope @Janetbirdope
Dispel the #myth #rheumatoid #arthritis is NOT Just a disease of Young and middle aged Elderly PREVALENT #RA Pts and 👇 INCIDENT Pts in >65yrs is skyrocketing 🚀 Need #Rx goals and equitable #Rx Uma Makris #RNL2025
https://t.co/3IsVKTSEyy
Will AI put me out of a job?
The advent of artificial intelligence (AI) continue to amaze us in this changing world and in multiple areas of medicine. As an evolving science, rheumatology has also been introduced to AI where interesting applications seem to enhance patient… https://t.co/W0ysHzxiRg https://t.co/rPOcjC2lyR
TheDaoIndex @KDAO2011
@UnaMakris wants us to shift our approach to #GeriRheum. #RNL2025– remember the 5 M’s Multimorbidity Mind Medications Mobility what Matters most
https://t.co/MIVnpw87rW https://t.co/D4AmrYhyWH
Adela Castro @AdelaCastro222
Are your patients aging with RA, or are they diagnosed with Late Onset RA (LORA)? -LORA pts tend to present acutely -High inflammatory markers~PMR Like -Seronegative/Decreased titers of RF/CCP @UnaMakris #RNL2025 https://t.co/tLrGBV6P1i https://t.co/53HVvUmrG4
TheDaoIndex @KDAO2011
Late onset RA (LORA) aka RA diagnosed at an older age — pts have higher inflammatory markers, presents like PMR; they also have polypharmacy, comorbidities, frailty, etc that can complicate management @UnaMakris #RNL2025 @RheumNow #GeriRheum… https://t.co/E2WFwfCsWD https://t.co/tKF0OnUFQH
Eric Dein @ericdeinmd
J Curtis #RNL2025 AI Will Not Replace You - AI cannot replace human interaction, examination, procedures, interpreting guidelines for an individual, providing empathy, and facilitate good patient education Will become a tool... but not a replacement to a… https://t.co/FVe8CtcxfK https://t.co/0mXjEikN1K
Janet Pope
Tweet
#Benralizumab vs #Mepolizumab
both work for #EGPA
Which to use? 🤷♀️
perhaps some advantage of more steroid sparing w
Benralizumab?
? JAKi ?long acting #IL5i
#RNL2025 @RheumNow https://t.co/UkthHpNRIq
Obinutuzumab Efficacy in Active Lupus Nephritis
A phase 3, randomized controlled trial of an anti-CD20 monoclonal antibody, obinutuzumab, was shown to be effective and safe in patients with active lupus nephritis.
https://t.co/e1cDvJcC9g https://t.co/HUDd1ocAvc
“Preventing” Arthritis in Psoriasis
Prevention of the development of our systemic rheumatic diseases in individuals deemed at risk, or with some form of precursor disease process, has been a hot topic in recent years.
https://t.co/nGKGUkKVUl https://t.co/PruJZLAq9n
Eric Dein @ericdeinmd
AI models require good Positive Predictive Value (PPV) But: PPV decreases as prevalence decreases - In choosing a successful biologic: Harder to predict more challenging patients (multiple failures, co-morbidities, etc) - ACR50 non-response is higher J… https://t.co/eAOR0jFmO3 https://t.co/TB6Ecd8nZh
Adela Castro @AdelaCastro222
How can AI be useful for RA pts and rheumatologists? -AI models have the potential for improving diagnosis, management and outcomes in RA pts. -Can also improve efficiency and clinic workflow. -Not so perfect as it sounds (hallucinations, limited… https://t.co/YA4A990p2v https://t.co/YnHtbP83Nm
Richard Conway
Tweet
Dr Rhee @RennieRhee mimics of medium/large vessel vasculitis. Increase in cross-sectional imaging use has increased the number of these we get referred. Segmental arterial mediolysis also pops up a fair bit. @RheumNow #RNL2025 https://t.co/yozRGE9Ncl
Adela Castro
Tweet
ICYMI: Treatment of sclerosing skin disease:
-Progression: inflammation➡️sclerosis➡️ atrophy
-Existing therapies target inflammation not sclerosis-poorly developed ttx for sclerosis
-First aspect is determining disease state, depth of involvement, extracutaneous manifestations… https://t.co/lYQRW2yDRG https://t.co/DQZjYKS2Ks
Dr Gurdeep S Dulay
Tweet
🆕 slide from @Official_ASAS
HLA-B27 strongly associated with Anterior #Uveitis in #SpA
#AAU #AxSpA #B27 https://t.co/lq19vIys9x
Eric Dein
Tweet
@RichardPAConway on PMR
#RNL2025 @RheumNow
PMR mimics: look for mimics in unusual/refractory cases
- Suspect the mimics to avoid undertreatment or over-treatment
Conway: PMR is NOT easy. Easy to misdiagnosis, easy to mistreat. "One of our most challenging cases" https://t.co/WqPWwCuutF


