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ACR25 - Day 1 Report

Jack Cush, MD

ACR 2025 began today in Chicago with throngs of rheumatologists, fellows, ARP members, APPs and pharma folk taking to the meeting halls and rooms for tons of novel content. 

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steroid prednisone lab

Can Steroids Be Stopped in Lupus Nephritis?

MedPage Today

Patients with lupus nephritis were more likely to get off chronic corticosteroid treatment, and stay off, when certain factors were in place, researchers said.

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REPLENISH - Secukinumab Works in Polymyalgia Rheumatica

Jack Cush, MD

Novartis announced the results of their REPLENISH trial showing the efficacy of secukinumab in adults with polymyalgia rheumatica (PMR).

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Bad Actor Cofactor (10.17.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports, discusses pediatric reports, pregnancy data, diet and nutrition and more.

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CART

CAR-T Product Shows Early Promise in Lupus

Five patients with systemic lupus erythematosus (SLE) in China have been treated with a potentially groundbreaking form of chimeric antigen receptor (CAR) T-cell therapy, researchers reported, with encouraging results after 3 months.

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Methylprednisolone plus Methotrexate in Giant Cell Arteritis

Jack Cush, MD

What is the optimal glucocorticoids (GC) regimen in giant cell arteritis (GCA)? Does methotrexate (MTX) work in GCA?  

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~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

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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

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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

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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

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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

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Mike Putman EBRheum ( View Tweet)
In this MTX+PNL vs TCZ+PNL in GCA study, we saw 5 pts on MTX+PNL get PJP, very surprising. @EBRheum asked what I knew/hoped he’d ask: why did this happen? PJP is v rare in GCA (https://t.co/oPN0dpvG8Q) & with MTX in other diseases. Worth interrogation! #ACR25 ABST0891 @RheumNow https://t.co/rsbScryIFR

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David Liew drdavidliew ( View Tweet)
#ACR25 Abstr#1526 Finally it’s here! Consensus-based guidance on GC #steroid tapering in patients with #SLE. Included considerations before tapering, tapering schedules and monitoring during tapering. Looking forward to the uptake and hearing patients’ views @RheumNow #ACRBest https://t.co/FFl2TFhtTa

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
CMV is a worry with high-dose steroids, especially in certain settings. The risk is far from universal, though: in this Korean cohort treated with high dose pred, almost no-one without risk factors got it. Meds are rarely the only infection risk factor #ACR25 ABST203 @RheumNow https://t.co/zLYhLVKgYL

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David Liew drdavidliew ( View Tweet)
A closer look in skin toxicity of GCs in RMDs GC Toxicity Index, LONG TOX prospective cohort Frequent: -Easy bruising 35% -Atrophy 22% -Hirsutism 17% -Acneiform rash 15% -Erosion/Tear 12% GC-related Neuropsychiatric toxicity highly associated with/ skin, something to look out https://t.co/NfxG8JkxSP

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Aurelie Najm AurelieRheumo ( View Tweet)
Avacopan in the real world: we need to be braver If we want to get steroid-sparing benefit in AAV, we need to trust it claims data shows modest PNL reduction with avacopan some manifestations are harder to taper in, but others we just need to be bolder #ACR25 ABST0726 @RheumNow https://t.co/51nGdpR2db

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David Liew drdavidliew ( View Tweet)
Schmidt et al. 2 year results of SELECT-GCA, upadacitinib in GCA. Remission 69% if upa continued vs 29% if stopped. 90% lower risk of flare, 1G less steroid @RheumNow #ACR25 Abstr#0776 #ACRBest https://t.co/MgRo7kIgIw

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Richard Conway RichardPAConway ( View Tweet)
#ACR25 New ACR Non-Renal #SLE lifecourse Guideline. 3 strong recommendations: - HCQ routinely unless contraindicated - Taper GC to =< 5mg/d - Escalate therapy in any organ system if refractory to initial therapy *Organ-specific: Conditional recommendations only @RheumNow https://t.co/w9rfcvwGHy

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)

Osteonecrosis: suspect with trauma, high-dose steroids, alcoholism, renal failure, transplantation, SLE, thrombotic states (e.g., sickle cell anemia, hemoglobinopathies), radiation injury, pancreatitis, gout, pregnancy, hyperlipidemia, & caisson disease (decompression sickness) https://t.co/y6iYd5fWZ2

Dr. John Cush RheumNow ( View Tweet)
A cohort study of 1 548 538 mother-child pairs with antenatal exposure to steroids (ACS) found a significantly increased risk of res v nonrespiratory infections in preterm & full-term children up to 21 years. (incidence rate, 65 vs 40 & 30 vs 18 per 1000 person-Yrs, https://t.co/Vh4TNYMXgo
Dr. John Cush RheumNow ( View Tweet)
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