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PAH diagnosis and management in the context of CTD ILD
Pulmonary arterial hypertension (PAH) is a serious complication of connective tissue disorders. Approximately 25% of patients with PAH have an underlying CTD, making CTD-PAH the second most common cause of PAH. During the session on Management of Lung Complications in CTD at APLAR 2025, Prof. Dinesh Khanna and Masataka Kuwana provided an excellent overview of PAH diagnosis and management strategies the context of CTD-ILD.
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Antifibrotics - A New Class of Therapies in Rheumatology?
Rheumatologists typically manage systemic autoimmune rheumatic diseases (SARD) and associated interstitial lung disease (ILD) with immunosuppressants. However, evidence increasingly supports also the use of antifibrotic agents in this setting.
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What to give next?
Bone sequencing therapy provides a novel perspective in #osteoporosis treatment.
Several sequential approaches exist.
Better treatment plan = better patient outcomes
#APLAR25 @RheumNow @rheumarhyme https://t.co/XvwnT9ZCU2
Links:
sheila RHEUMarampa ( View Tweet)
This slide reflects the rheumatologist’s goals for treating #lupus
Prof. Mosca also highlights the fact that achieving targets is as important as maintaining these treatment targets.
@RheumNow #APLAR25 https://t.co/u8fw3fThXI
sheila RHEUMarampa ( View Tweet)
Prof. Eric Morand on the SLE T2T approach.
Ultimate goal is remission but we know that not all patients achieve this state.
Thru the T2T approach, low dse activity (LLDAS) is an acceptable target & a protective alternative goal
@RheumNow #APLAR25 #Lupus https://t.co/vz7E5prps0
sheila RHEUMarampa ( View Tweet)
Optimizing outcomes of pregnancy in #lupus:
📌 all patients should undergo preconception counselling
📌 close monitoring by a multidisciplinary team
- a ⬇️ cerebroplacental ratio reflects placental dysfunction
#APLAR25 @RheumNow @rheumarhyme https://t.co/RSyqgpRTG5
Links:
sheila RHEUMarampa ( View Tweet)
@Lupusreference reviews clinical trials in LES, highlights key limitations of current outcome measures and propose a novel a clinical outcome in SLE based on
« How patients feel function and survive »
Very relevant to the human experience of having a chronic illness
@RheumNow https://t.co/vM58C9KfQ3
Aurelie Najm AurelieRheumo ( View Tweet)
Controversies in ILD
Join leading experts as they tackle complex topics: IPAF, MTX, SARD vs. CTD, and anti-fibrotic therapy.
📅 Sep 16, 2025 | ⏰ 7 PM ET
Jeffrey Sparks, MD | Janet Pope, MD | Elena Joerns, MD
Moderator: Jack Cush, MD
👉 Register: https://t.co/O4FQNyGeTr https://t.co/jIfjuWWNvp
Dr. John Cush RheumNow ( View Tweet)
🆕 Intro to ILD (Part I): the essentials
🫁 Definition & basics
🔬 Key pathology patterns
🧑⚕️ Clinical approach
📋 What rheums need to know
⬇️ Download & learn more: https://t.co/Fn76PiGsPl
Created by @MithuRheum | via @RheumNow for our Rheum to Breathe: ILD Campaign https://t.co/MalDKUjonR
Dr. John Cush RheumNow ( View Tweet)
AI can Dx & predict HCQ retinopathy (HR). An International, Multi-center study used retrospective data from 409 pts (171 HR+, 238 HR-) & tested on 8251 SD-OCT scans. AI Dx 100% & predicted 98.7% mean 221 D before Dx. Sensitivity 100%; specificity 98%, PPV 94%; NPV 100% https://t.co/USABVO8Ss5
Dr. John Cush RheumNow ( View Tweet)
Gout: Highlights from APLAR 2025
Dr. Sheila Reyes, The Philippines, reports on highlights and takeaways from lectures on the treatment of gout from the APLAR 2025 Congress in Fukuoka, Japan.
https://t.co/Fxd3MBUYrT https://t.co/gKjHlJXttT
Dr. John Cush RheumNow ( View Tweet)
Dr. Binit Vaidya aptly poses this slide on the gout paradox: evidence-based T2T tx exist yet many still have uncontrolled dse.
How can we close this gap?
- address barriers to tx adherence
- motivation
- px education
- multidisciplinary approach to px care
@rheumnow #APLAR25 https://t.co/IEn9PMAxH5
sheila RHEUMarampa ( View Tweet)
Colchicine for #gout patients with CV risk:
- since it has a purely anti-inflammatory effect, risk of acute CV events in pts w/ high CV risk is reduced.
vs. NSAIDs/steroids, colchicine remains to be a safer option for gout prophylaxis
@rheumnow #APLAR25 https://t.co/WgfTcIleMd
Links:
sheila RHEUMarampa ( View Tweet)
SGLT2 inhibitors exert their anti-inflammatory effects by inhibiting activation of the NLRP3 inflammasome.
Secondary analyses of RCTs show that SGLT2is can reduce the risk of incident #gout
@RheumNow #ACR25 https://t.co/IWgyDYEQoZ
Links:
sheila RHEUMarampa ( View Tweet)
Addressing Disparities and Unequal Burdens in ILD
Interstitial lung diseases (ILDs) represent a complex spectrum of conditions that share one unifying truth: they are almost always serious, progressive, and life-altering. But for many patients, the burden of disease does not https://t.co/Ubh7R7Xb3E
Dr. John Cush RheumNow ( View Tweet)
Study of 111 TAKayasu arteritis pts Rx w/ 74 MMF+MTX vs 37 CYC/AZA. Response rates at 28 & 52 weeks were 58.1% and 55.4% in the MMF+MTX group, respectively, higher than 32.4% at both time points in the CYC/AZA group. https://t.co/wqlOLH0VEA https://t.co/nbLvcyYkbn
Dr. John Cush RheumNow ( View Tweet)
Long-term data from the 48-wk phase 2 SLEek study of upadacitinib +/- a BTK inhibitor elsubrutinib, in SLE pts, showed both arms effective (little added from BTK), @ 1yr, 127 pts maintained efficacy, GC dose and flare rates https://t.co/FbTHCGZ4pQ https://t.co/cATXVHsiXV
Dr. John Cush RheumNow ( View Tweet)
#APLAR2025 Prof Peter Taylor
RA patients have ⬆️ rates of CKD https://t.co/DZl9qpbLhH
Dr Gurdeep S Dulay gurdeep_dulay ( View Tweet)
Systemic Sclerosis–Associated ILD
Watch Alicia Hinze, MD, share personalized strategies for managing Systemic Sclerosis–Associated ILD. Sponsored By: Boehringer Ingelheim
https://t.co/Mxg9P50m7C
#ILD #Scleroderma https://t.co/Cmupl7Dgwl
Dr. John Cush RheumNow ( View Tweet)
Stay sharp in RA, PsA & SpA care. Get the latest breakthroughs + expert insights at RWCS 2026. Don’t miss 'Year in Review: Rheumatology Advances.' Register now: https://t.co/majEsY4tXK https://t.co/fgGniR1OGk
RWCS RWCSmtg ( View Tweet)
