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Hmmm Really? (7.11.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week - some obvious, other new thoughts and some - hmmm, reallly?

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ICYMI: Clinical and Therapeutic Challenges in Connective Tissue Disease and ILD

Mrinalini Dey, MD

Connective tissue diseases (CTDs) and interstitial lung disease (ILD) represent a challenging intersection of systemic autoimmunity and progressive respiratory impairment. Research presented at EULAR 2025 continues to highlight the importance of CTD-ILD and the evolving landscape of therapeutic options for patients with autoimmune ILDs.

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Promising role of Fc neonatal receptor blockade in autoimmune rheumatic diseases

Md Yuzaiful Md Yusof, MRCP(UK), PhD

During EULAR 2024, we learned about a novel mechanism of action therapy, nipocalimab in Sjogren’s disease (SjD). This is an anti-neonatal Fc receptor (FcRn) mAb that reduces circulating IgG, including autoantibodies, by selectively blocking the interaction of IgG with FcRn. A year on at EULAR 2025, data from Phase 2 RCT of efgartigimod, an FcRn-inhibitor were presented in autoantibodies positive, moderate to severe active SjD. In addition to SjD, data from Phase 2 RCT of efgartigimod in inflammatory myopathies was presented.

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A new mechanism of action in SARD-ILD

Aurelie Najm, MD, PhD

Nerandomilast, an inhibitor of phosphodiesterase 4B, orally administered, is a new mechanism of action to treat lung fibrotic diseases.

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Predictors and Outcomes in Systemic Sclerosis

EurekAlert!

The VEDOSS project has previously shown that 70% of patients with Raynaud’s phenomenon and at least one red flag – systemic sclerosis (SSc)-specific antibodies, puffy fingers, or an SSc pattern on nailfold capillaroscopy –will fulfil the 2013 ACR/EULAR SSc criteria within 5 years.

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Clinical and Therapeutic Challenges in Connective Tissue Disease and ILD

Mrinalini Dey, MD

Connective tissue diseases (CTDs) and interstitial lung disease (ILD) represent a challenging intersection of systemic autoimmunity and progressive respiratory impairment. Research presented at EULAR 2025 continues to highlight the importance of CTD-ILD and the evolving landscape of therapeutic options for patients with autoimmune ILDs.

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MTX Fails Knee OA (6.6.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com

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JAMA Clinical Challenge - 34-yoF with Forearm Pain and Stiffness. 1 yr of progressive skin tightening over forearms, tibia, LOM of fingers & elbows. Denied DM, Raynauds. Worse after tennis, better w/ steroids. Increased ANA, eosinophils, CRP, aldolase - your Dx? https://t.co/5VrE4OpZ4N
Dr. John Cush RheumNow ( View Tweet)
SCLERODERMA Pt education page from JAMA Dermatology https://t.co/hILqCeUnE2 https://t.co/QPKLqTQfPj

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Dr. John Cush RheumNow ( View Tweet)
#CAR-T in active #scleroderma #diffuse open label @sclerodermaUM presented improvement in #nailfold #capillary patterns Suggesting #vascular recovery Hope is for lungs, skin and survival to improve but These are ▶️ Early days ?risk OP0338 #EULAR2025. @RheumNow @eular_org https://t.co/QhmO6gekXk

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Janet Pope Janetbirdope ( View Tweet)
Management and prognosis of RP by @Lupusreference 1. Pts with mild disease respond to GCs 2. NSAIDs/colchicine good alternatives 3. Most common biologics used: TNFi and IL6i 4. Consider CYP in life threatening dz/ICU pts 5. Dynamic CT assess tracheal collapse. 6. PET-CT can ≠ https://t.co/PNUecMZvkT

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Adela Castro AdelaCastro222 ( View Tweet)
Is #PDE5i protective in development of #SSc #ILD? Maybe 444 w ILD of >4000 #EUSTAR Pts over 1 to 2 yrs f/u #immunesuppressive use maybe or not 🤷‍♀️channeling bias Reduction in new #ILD in #scleroderma PDE5i ✅ Immunesuppression ? @RheumNow #EULAR2025 @eular_org #OP0334 https://t.co/6dtLfybkRV

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Janet Pope Janetbirdope ( View Tweet)
Should we screen for #lung #cancer in #SSc high risk Pts? When >10 yrs? Greek cohort of SSc since 1995 Disease duration 12 yrs, smoking lung ca group ⬆️58% vs 29% ⬆️dcSSc ⬆️immunosuppression OR >4X lung ca if dcSSc, IS Less #DU #PO0940 @RheumNow @eular_org #EULAR2025 https://t.co/L2zEkP8pAc

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Janet Pope Janetbirdope ( View Tweet)
#digital #ulcers in #scleroderma🎯 Retrospective #iloprost vs #selexipag 👇 BIG advantage of oral #prostacyclin receptor #agonist vs iloprost healing faster ⬇️ulcers Selexipag used in iloprost failures; ⬇️IV access WOW! RCT needed #OP035 #EULAR2025 @RheumNow @eular_org https://t.co/6y9LwIlQkd

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Janet Pope Janetbirdope ( View Tweet)
🔬 Proud to present our poster at #EULAR2025! 📌 Serum KL-6 and IL-18 as Diagnostic and Prognostic Biomarkers in Systemic Sclerosis-Associated ILD: A 24-Month Cohort Study KL-6 and IL-18 show promising roles in tracking ILD progression and lung function decline in #SSc 📍F.136 https://t.co/woTMnTkRKY

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Cristiana Sieiro Santos cristianasieiro ( View Tweet)
Delighted to present the @bmsnews data on #scleroderma #eular2025. Breakfree-1 data showing CAR-T is well tolerated with beneficial effects on skin and FVC and composite endpoint, the revised CRISS. https://t.co/E5jlYYHowM

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Dr. Dinesh Khanna sclerodermaUM ( View Tweet)
Nailfold Capillaroscopy correlated w/ cardiac ECHO in Systemic Sclerosis. NFC & ECHOs studied in 30 SSc pts. Systolic & diastolic dysfunction most common in late SSc NFC patterns. Cardiac dysfunction seen w/ low capillary density, avascular areas, cap neoangiogenesis https://t.co/pFBKjXqwfr
Dr. John Cush RheumNow ( View Tweet)
Uncontrolled pilot trial of frequency specific microcurrent treatment given to 17 pts w/ Raynaud’s & systemic sclerosis. Microcurrent Rx given for 45-60 min over 1-2d; w/ average improvement of 40% in hand function & Raynauds improvement ~18% p .016)- RCT needed!! https://t.co/4OUeODuj8Q
Dr. John Cush RheumNow ( View Tweet)
Systematic review of JAK inhibitor use in systemic sclerosis - 18 articles/87 SSc pts (80%F; ages 13–78 yrs). JAKi (83% tofa) mostly used for ILD & Skin Dz (45%) or GI+Skin Dz (39%). 87.5% improved, w/ 6% relapsed. Adverse events in 50% (20% infx). We need RCTs! This could be a https://t.co/VXFuHGpDjB
Dr. John Cush RheumNow ( View Tweet)
🔺CTD-ILD radiological signs to look out for 👀 #CTD #ILD #UIP #NSIP #Fibrosis #scleroderma #systemicsclerosis #Sjogrens #Lupus By @IlliasulK https://t.co/hHupTz0bCy

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Dr Gurdeep S Dulay gurdeep_dulay ( View Tweet)
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