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Rheumatoid arthritis and the ‘big bang’ at the ACR!
Is there ‘bang for the buck’ using big data to help predict who will develop RA in at-risk populations and similarly to predict response to csDMARDs, TNFi and JAKi in RA?
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Even when inflammation is quiet, fatigue often lingers. In 246 RA pts, 43% had significant fatigue—closely tied to PROMs, not labs. RAPID3 < 6 flagged the few truly “fatigue-free.”
Don’t overlook the VAS_Fatigue—it tells a real story.
@RheumNow #ACR25 Abstract# 0380
Jiha Lee JihaRheum ( View Tweet)
Using ChatGPT to diagnose axSpA, in 10 low back pain cases, it outperformed clinicians in diagnostic precision (75% vs. 60%) and sensitivity (85% vs. 80%), completing the task 5x faster. Specialty framing (e.g., Rheum vs Neuro) didn’t affect accuracy. Abstract 0530 @RheumNow https://t.co/YMMC4XIX9m
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
After propensity matching, this retrospective cohort study showed that #lupus nephritis patients on GLP-1 agonists had ⬇️ CKD progression, mortality & AMI risk vs. LN pts on SGLT2is.
Interesting data but what could explain it? Further studies are needed
#ACR25 @RheumNow Abs0841 https://t.co/FtsGbMDcCv
sheila RHEUMarampa ( View Tweet)
#ACR25 Abstr#645. Dapirolizumab, anti-CD40L-i met primary endpoint, BICLA in Phase 3 RCT non-renal SLE. Key secondary endpoints showed higher rates of & time in LLDAS and remission in DAP vs PBO. Meaningful targets re: damage accrual & better longterm outcomes @RheumNow https://t.co/IxesXhi34R
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Only 32% of RA pts were satisfied with current txs. In a discrete choice experiment of 354 US pts, many preferred a vagus nerve stimulator over another biologic/JAKi, especially those with prior tx failures. Cost, function, and fatigue drove preferences.
@RheumNow #ACR25 A#0370
Jiha Lee JihaRheum ( View Tweet)
Can the blood reflect what’s happening in the joint? In early RA, 11 synovial proteins mirrored serum levels, forming an inflammatory signature linked to disease activity and csDMARD response. High-signature pts had stronger treatment responses (AUC>0.8)
@RheumNow #ACR25 A#0070
Jiha Lee JihaRheum ( View Tweet)
Cool study using vasculitis patient-powered reserach network (VPPRN)
"SNOT-22" tool captures sinonasal symptoms; associated with disease activity (expected) but also worse among pts even in remission
Very important impacter of QOL in AAV
#ACR25 @RheumNow Abstr0725 https://t.co/NQBW8VnYFS
Links:
Mike Putman EBRheum ( View Tweet)
ASAS recommends standardised reporting for 20 key outcomes in axSpA trials, 10 for all studies, 10 specific to DMARD trials. Formats include mean (±SD), mean change, and categorical thresholds for ASDAS, ASAS-HI, and extra-musculoskeletal manifestations. 85% of ASAS members https://t.co/VQwPaTRIOl
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
2-Year data from SELECT-GCA Phase 3 UPA in GCA
Re-randomization & 52 weeks extension UPA 15mg vs. PBO
-Risk of flare 90% lower
-Complete remission 70% vs 20%
-Cumulative GC 1g difference
-No new safety signal
The quick relapse after stopping UPA indicates we are really looking https://t.co/c1khywnPNv
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Immune-Mediated Necrotizing Myopathy @EleniTiniakou #ACR25
*Younger pts tend to have a more aggressive disease
*IVIG and RTX can be considered first-line rx for anti-HMGCR and anti-SRP+, respectively
*CYC and plasmapheresis may be options in cases of aggressive disease https://t.co/zWDX79gqlf
Rheumatology Quarterly RheumQuarterly ( View Tweet)
Real world effectiveness of voclosporin for SLE
Reduction in UPCR from 2.1 at b/l to 0.9 at 6 months, no improvement in eGFR; as expected based on trials
Wonder about market share of BEL vs voclo vs ANI - anyone seen pubs on this?
#ACR25 @RheumNow Abstr#0661 https://t.co/l7i7IWhLSe
Mike Putman EBRheum ( View Tweet)
From the FOREMOST study factors predicting progression from oligo to polyarticular PsA: Female sex, enthesitis and dactylitis found to increase the risk of progression. Among patients in FOREMOST receiving PBO, prior csDMARD use was protective. Abstract#0576 @RheumNow #ACR25 https://t.co/CFMhAFgFBa
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Accdg to this retro analysis of their prospective cohort study from Toronto, 47 pts (10%) had D2M axSpA of whom 14 had tx-refractory dse.
D2M pts - longer symptom duration; ⬆️ASDAS, BASDAI, BASMI, BASFI & ⬆️CRP
💡Consider non-dse factors in D2M pts
#ACR25 @RheumNow Abs0547 https://t.co/MUUyyELbw8
sheila RHEUMarampa ( View Tweet)
#0191 We found that in a large South London RA cohort, use of advanced therapy in moderate disease (DAS28 3.2-5.1) generally followed NICE guidance. Gaps often reflected telehealth limiting DAS assessment and patient hesitancy. Self-assessment tools may help. @RheumNow #ACR25 https://t.co/UMGtkfABHn
Mrinalini Dey DrMiniDey ( View Tweet)
Real-world T2T strategy from MONITOR-PsA cohort:
🎯 At 48 weeks - 33.6% (49/146) of pts achieved PASDAS 'moderate' response & 37% (54/146) achieved a 'good' response
This was close to the T2T outcomes of the TICOPA trial
Adapt a T2T approach in PsA tx
#ACR25 @RheumNow Abs0572 https://t.co/FPiFIiO8Oe
Links:
sheila RHEUMarampa ( View Tweet)
SELECT-GCA (upadacitinib in GCA for 52w)
we hoped it might have ongoing effect post-cessation
Do we need to continue upa?
Extension data (second year) flare survival curves are clear:
continuing upa far outperforms placebo
It seems >2y toci/upa for GCA
#ACR25 ABST0776 @RheumNow https://t.co/uJA3uQyWxb
David Liew drdavidliew ( View Tweet)
Post-hoc PEXIVAS study, estimating risk of relapse from baseline variables
Lotsa fancy stats, mostly corroborated known risk factors, but model predicted relapse reasonably well!
Probably useful for approach to monitoring... mayyybe treatment?
#ACR25 @RheumNow #Abstr0722 https://t.co/XI9y8KgDNR
Links:
Mike Putman EBRheum ( View Tweet)
Mease et al. Sometimes perspective is all important! We worry about apremilast causing GI effects, anorexia, weight loss. Here we see reported benefits for weight loss and HbA1c. @RheumNow #ACR25 Abstr#581 https://t.co/CJjS0VZxWH
Richard Conway RichardPAConway ( View Tweet)
Tracking RA disease activity got a measurable boost in the VA: a 3-month multimodal rollout (feedback, EHR tools, just-in-time lists) raised DAM documentation up to 10%. Small structural changes, big data gains.
@RheumNow #ACR25 Abstract#0221
Jiha Lee JihaRheum ( View Tweet)
