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Tacrolimus in Lupus Nephritis Management
Prof. Sandra Navarra and colleagues compared the efficacy and safety of tacrolimus and glucocorticoids vs. mycophenolate mofetil (MMF) as a continuous induction-maintenance treatment for class III/IV+V lupus nephritis.
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ACR 2025 Rheumatology Round Up
Drs. Jack Cush & Arthur Kavanaugh, two of rheumatology’s most trusted voices, provide a breakdown of the latest breakthroughs and hottest topics in rheumatology from the 2025 ACR Convergence meeting in Chicago.
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ACR25 Best Abstracts - Day 4
Here's the last installment of our "ACR Best" abstracts as chosen by the RheumNow faculty. Most of these were from the final, day 4, but a few were noteworthy holdovers from day 3. Enjoy!
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ACR 2025 – Day 2 Report
Here are 3 abstracts that caught my eye on Day 2 at ACR25. Notably these have takeaway messages that should support your current practices.
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#ACR25 Abstract 1526
“Guidance for #Steroid Tapering in Systemic Lupus Erythematosus”
101 international experts reached Delphi consensus on CS tapering strategies in #SLE.
🔹 Practical guidance for real-world tapering across disease activity levels and organ involvement. https://t.co/GRlUz3Y3EP
Links:
Romatolog Nurullah_Akkoc ( View Tweet)
RA: Inject the Steroids
Dr. Richard Conway reports on abstract 1355, "Use of parenteral compared to oral glucocorticoids in early rheumatoid arthritis is superior for chance of being off steroids and escalation of therapy at 1 year," presented at the #ACR25. https://t.co/xFQMIpi75S
Dr. John Cush RheumNow ( View Tweet)
#SLE #DORIS #remission is RARE and without #prednisone even rarer
#ASIA #Pacific 5K pts over 10 yrs
A call to do better
82% LLDAS, 70% remission, 31% GC-free remission (REM-0) at least once
abst#595 @ACRheum @RheumNow
#ACRBest https://t.co/OK6sYnqs81
Janet Pope Janetbirdope ( View Tweet)
#ACR25 Clinical Preview by Prof Coates to be applied tomorrow!
GC #steroid burden & Mx
Abstr#738 Survey of #GCA patients in US & EU: 3/4 were still on GC; mean 5.3mg/d
Abstr#1526 International consensus of GC taper in #SLE is available & can be applied in clinic
@RheumNow https://t.co/paw7NGjs4p
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
What exercise best for steroid-induced osteoporosis? Does it have to be weight bearing?
Turns out anything helps - get out there and don’t let perfect be the enemy of good!
Laura Coates in the #ACR25 meeting review @RheumNow https://t.co/VGH2rz3dzb
David Liew drdavidliew ( View Tweet)
IgG4 - Rare but Rx
Several studies #ACR25 @ACRheum were presented
Outcome measures
Rx
#steroids
#CD19 mAb #Inebilizumab
👍+RCT reduction of flares
BTKi
#Rilzabrutinib
#Zanubrutinib
#JAKi
+RCT of #tofacitinib +steroids vs pred
@ACRheum @RheumNow #ACR25
1163 LB02 0239 1172 https://t.co/xC3wgaN9bk
Janet Pope Janetbirdope ( View Tweet)
In RA, “strong bones” can give false reassurance.
Pts with higher baseline BMD had faster bone loss, often tied to GC use and less osteoporosis treatment. Undermanagement, not biology, may drive decline.
@RheumNow #ACR25 Abstract#2244 https://t.co/N421ESAUy9
Jiha Lee JihaRheum ( View Tweet)
Infection vs steroid sparing in PMR/GCA/AAV studies with steroid-sparing Rx
GiACTA (1, top right) aside,
- low infection rates
- the more steroid saved, the less the infection risk
Infection risk in vasculitis is driven by steroid, not DMARD
#ACR25 ABST2526 @RheumNow https://t.co/UprbxUQyQC
David Liew drdavidliew ( View Tweet)
#1727
360k+ postmenopausal women w osteoporosis: >1/3 untreated patients were at v high fracture risk, yet few received recommended anabolic or antiresorptive therapy.
Even among treated women at very high risk, >50% were still on oral bisphosphonates
@RheumNow #ACR25 https://t.co/9S66tAU68P
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR25 Please find my video interview with Prof Edward Vital @edvital on their work on International Consensus of Glucocorticoid Tapering Guideline in #SLE #lupus Abstr#1526 @RheumNow
https://t.co/MnQdcdASkG https://t.co/b7GMcnFU2m
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#ACR25 Abstr#1401 Sjogren’s #SjD is definitely not a benign disease! Real world study using US database showed high disease burden within 12 mths of diagnosis (i.e. healthcare resource use). GC use was high (~50%). Better therapy is needed to improve outcomes @RheumNow https://t.co/MI3vQ5LByr
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
~1 in 6 pts with #sarcoidosis May have #cardiac involvemt
1/3 respond to #MTX + #steroids
Followed by repeat #PET
Failures get
👇
#infliximab >#adalimumab
👇
#JAKi
Better survival >yrs ago
R heart involved ⬆️risk of MTX nonresponse
#ACR25 @RheumNow @ACRheum abst#1664 #ACRbest https://t.co/kYt9JRNSVH
Links:
Janet Pope Janetbirdope ( View Tweet)
Like PEXIVAS steroid taper, this is something we need an online resource to check each time. Its complicated, but feels "right". @RheumNow #ACR25 https://t.co/QAgSQB9XMQ
Richard Conway RichardPAConway ( View Tweet)
Pope @Janetbirdope et al. Parenteral (IM and/or IA) superior to oral steroids in early RA. Better discontinuation of steroids with no difference in need for advanced therapies. @RheumNow #ACR25 Abstr#1355 #ACRbest https://t.co/OyvnzEGlLE
Richard Conway RichardPAConway ( View Tweet)
Prednisone remains both lifeline and liability.
New PRED-SAFE SDM tool helps patients and clinicians navigate that tension—visualizing benefits and harms to guide tapering. In pilot testing, 93% had no residual decisional conflict.
@RheumNow #ACR25 Abstract#1052 #ACRbest https://t.co/CgQ75N7A1p
Jiha Lee JihaRheum ( View Tweet)
Post Hoc analysis from SELECT-GCA
Increased rate of herpes zoster for 26wk steroid-UPA 15mg (7.3% vs 4.2% 52wk steroid-plbo) but lower rate of SERIOUS infections (7.9% vs 12.7% 52wk steroid-plbo)
Zoster risk is real; steroids are the bigger problem
@Rheumnow #ACR25 Abstr#0895 https://t.co/IKzO2J4hLH
Links:
Mike Putman EBRheum ( View Tweet)
