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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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ERS/EULAR guidelines for CTD-related interstitial lung disease
The European Respiratory Society (ERS) and European Alliance of Associations for Rheumatology (EULAR) have published clinical practice guidelines for the evaluation and management of connective tissue diseases (CTD) associated interstitial lung disease (ILD) in two simultaneous publications in the European Respiratory Journal and Annals of Rheumatic Diseases.
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COLCHICORT Trial
The COLCHICORT trial in acute calcium pyrophosphate (CPP) crystal arthritis patients showed that colchicine was inferior to prednisone treatment and that responses were also influenced by other factors.
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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
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Metanalysis of 7 studies (1979-2023) shows RA pts on vegetarian or vegan diets achieved no improvement in disease activity or physical function, but did have a small significant improvement in pain. Insufficient Data on Fatigue. Overall, low certainty https://t.co/jeh6gN5Byg
Dr. John Cush RheumNow ( View Tweet)
SPRING-SIR Italian registry of systemic sclerosis: 1917 SSc pts, 56% had GI Sx, assoc w/ longer Dz duration, more severe Dz, diffuse SSc, ILD, digital ulcers, telangiectasias, & tobacco. In 211 very early SSc, 41% GI Sxs (most esophageal), w/ puffy fingers, & dyspnea. https://t.co/l2hStwavuu
Dr. John Cush RheumNow ( View Tweet)
Obstructive sleep apnea in USA is expected to rise from 34·3% in 2020 to 46·2%, resulting in 76·6 million OSA cases by 2050. By 2050 there will be more males w/ OSA (~46 milliion) than females (30·4 million), but greater growth in females over the next 30 years. https://t.co/6YZvSusTWf
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Multimorbidity predicts flares in rheumatoid arthritis
A study from Olmstead county and the Mayo Clinic shows that multimorbidity and social factors predict higher rheumatoid arthritis (RA) flares and lower remission rates.
https://t.co/yGrvDttcEq https://t.co/45LMtvsFor
Dr. John Cush RheumNow ( View Tweet)
Based on a survey in Japan, resolution of dry mouth was the most important symptom resolution reported by SJD pts.
The JCR CPG for SjD suggests RTX for glandular involvement while BEL for extra-glandular involvements.
#APLAR25 @RheumNow https://t.co/SsUvQIM9Eu
Links:
sheila RHEUMarampa ( View Tweet)
Is it D2T RA or Clinical inertia?
Concept introduced by Dr Kaneko, Japanese Keio RA cohort, followed for 5yrs
5% patients not fitting the D2T RA definition have MDA or HDA
The drivers of persistent DA in RA:
-overestimation of treatment effectiveness
-avoidance of treatment https://t.co/0pkDaUFH4R
Aurelie Najm AurelieRheumo ( View Tweet)
Interesting data shared by Dr. Sandhya Pulukool on Asian pts with SjD vs. Caucasians:
- Younger age of onset except in Japan
- Higher female to male ratio
@RheumNow #APLAR25 https://t.co/RPM9zI4tVQ
sheila RHEUMarampa ( View Tweet)
Peter Taylor on Pre-RA:
If Pre-RA is too late for interception, shall we start screening general population?
We have to remember RA is a RARE disease
Pre-test of RA per year per person would be 0.00025% for primary prevention:
A needle in a haystack?
@RheumNow @APLAR_org https://t.co/LKGtz1P7sl
Aurelie Najm AurelieRheumo ( View Tweet)
Peter Taylor describing the range of potential benefits of Interception strategies in Pre-RA: A) From Ideal: full interception B) To Good outcome: stratified intervention based on high risk population for delay/interception C) To ?Beneficial: attenuate severity of established RA https://t.co/6mqA9tV7ME
Aurelie Najm AurelieRheumo ( View Tweet)
Prof Takeuchi on DMARDs treatment and regional disparities
For similar dose, serum concentration of the polyglutamate (active) form of MTX is much higher in Japanese than US patients
And also high levels achieved much quicker in Japanese than US patients
This is strong https://t.co/ikp63wWifj
Aurelie Najm AurelieRheumo ( View Tweet)
What’s new in RA Pathogenesis in #APLAR25 by Ellen Gravellese
Take home message: there is still hope for synovial biopsies to be a biomarker for prediction of response to treatment
As a synovial biopsy expert, I am not convinced of this one, but time will tell
@APLAR_org https://t.co/EEw5ncKa1r
Aurelie Najm AurelieRheumo ( View Tweet)
Can we prevent #rheumatoidarthritis?
Dr. Gravallese shares this interesting slide that summarizes the different disease prevention trials in RA…..they have managed to delay disease onset but prevention is still in question.
@RheumNow #APLAR25 @rheumarhyme @marklagacmd https://t.co/qhGYnNL5Ek
sheila RHEUMarampa ( View Tweet)
📍Smoking, obesity and low Vit D are significant risk factors for Pre-RA.
📍Subdoligranulum arthritogenic strain is a newly described infectious agent implicated in the pathogenesis of pre-RA
@RheumNow #ACR25 @rheumarhyme https://t.co/ZzZZlfdKmk
sheila RHEUMarampa ( View Tweet)
QD Clinic: Rapidly progressive RA ILD - or not?
Dr. Richard Conway, a rheumatologist in Dublin, Ireland, discusses whether this case shows rapidly progressing RA-ILD, or not, as part of RheumNow's Rheum to Breathe: ILD campaign, presented throughout the month of September 2025. https://t.co/YC8XFiqZmd
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Rheumatoid Arthritis ILD Complications
https://t.co/gAZCGTwHLB https://t.co/qcMmDuxXYx
Links:
Dr. John Cush RheumNow ( View Tweet)
Abatacept and Methotrexate may Lower Risk of Interstitial Lung Disease in RA
A post hoc, pooled analysis of of rheumatoid arthritis (RA) clinical trials shows those received abatacept had a lower rate of Interstitial lung disease (ILD).
https://t.co/3AISriCUeC https://t.co/nN03e4ZBDU
Dr. John Cush RheumNow ( View Tweet)
