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New ideas in gout management

EurekAlert!

Gout flares are associated with cardiovascular events. Treating gout to target serum urate level prevents flares, but whether such treatment can also prevent cardiovascular events is unknown.

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EULAR 2025 – Day 3 Report

Jack Cush, MD

Highlights from today included presentations on imaging in vasculitis, a debate on whether to treat high risk pre-clinical RA, and EULAR Recommendations on a) Treatment of interstitial lung disease (ILD); b) Physical Activity in people with arthritis; and c) EULAR disease activity score for antiphospholipid syndrome and d) the management of SLE nephritis. Below are a few others that caught my eye today.

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Introducing Polyrefractory RA: A New Frontier in Difficult-to-Treat RA

Jiha Lee, MD

At a EULAR 2025 session titled “What makes ‘Difficult-to-treat RA’ so difficult to treat? And what can we do?”, Drs. Paula David and Dennis McGonagle introduced the emerging concept of polyrefractory rheumatoid arthritis (RA), a term now being used to describe a subset of patients who have failed to respond to five or more biologic or targeted synthetic DMARDs. This new classification, derived from recent multinational registry data, represents a significant step in refining our understanding and management of the most treatment-resistant forms of RA.

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The key changes for the new 2025 EULAR recommendations on RA treatment #EULAR2025 @RheumNow https://t.co/dp5LnoFdpW

Links:

David Liew drdavidliew ( View Tweet)
URAT1 inhibitors look like the way to go in Gout! Presented in multiple abstracts at #EULAR2025 Pozdeutinurad Ph2 long term safety data chronic gouty arthritis + tophi OP0300 Ph3 RCT of Ruzinurad in hyperuricemia/primary gout OP0302 Ph 2b RCT of SAP-001 Refractory Gout +/-

Aurelie Najm AurelieRheumo ( View Tweet)

#EULAR2025 @eular_org update #Recommendations #Rheumatoid #Rx prof Smolen subtle diff between former guidelines MTX+GC 👇 D/C GCs rapidly 👇 If inadequate response 👇 Other csDMARDs are OUT ❎ ✅go to bDMARD or tsDMARD* TsDMARD after safety assessed @RheumNow RecommendatnII https://t.co/yUrLdk6Eg1

Links:

Janet Pope Janetbirdope ( View Tweet)
#RA #recommendations #update Some recommendations were merged For sure some regions will consider #Combination #csDMARDs or Switch to another 👇🤔 #sulfasalazine #leflunomide Depends on access, pt preference, disease activity/severity #EULAR2025 @RheumNow @eular_org https://t.co/QDPcHhvQiV

Links:

Janet Pope Janetbirdope ( View Tweet)
Tapering in RA? In SORAIRO (n=149), pts in remission on ozoralizumab+MTX: 🧪 49% became MTX-free ⏱ 80% spaced OZR to q8w CDAI ≤10 maintained in >90% if baseline remission + albumin >3.8 LB0006 @RheumNow #EULAR2025

Jiha Lee JihaRheum ( View Tweet)

#EULAR2025 Abstr#POS1293 Our cohort study support non-medical switch from Rituximab originator to Biosimilar(RTX-B) or btw RTX-Bs in connective tissue disease. No difference in response/B-cell depletion pre- & post-switch.Only 10% stopped RTX at 5-year.Better than in RA @RheumNow https://t.co/ERPgwQ3gZB

Links:

Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
RepurpSS-II RCT (n=46): LEF + HCQ significantly improved systemic disease activity (ESSDAI -4.13) vs PBO in primary #Sjögrens. ⭐️🌱STAR/CRESS response rates also favoured active treatment. Safe, accessible, affordable option for active disease. @RheumNow #EULAR2025 #LB0005

Mrinalini Dey DrMiniDey ( View Tweet)

🦵🏻SAP-001, a novel uricosuric targeting a non-URAT1 renal transporter, lowered sUA <6 mg/dL in up to 79% of patients with refractory #gout on b/g xanthine oxidase inhibitor. >50% on 60 mg/day reached sUA <3 mg/dL. 💊Potential new oral ULT option. @RheumNow #EULAR2025 #LB0008 https://t.co/dfY1V5sHSh

Links:

Mrinalini Dey DrMiniDey ( 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

Links:

Adela Castro AdelaCastro222 ( View Tweet)
#EULAR2025 Abstr#POS0301 Real World Multicentre study in Italy reported higher proportion of CRR at 6-mth & Lower GC in people with #lupus nephritis (~96% Class III, IV or Mixed with V) treated with Belimumab+SOC vs matched cohort on SOC. Predicted by early BEL use @RheumNow https://t.co/D6e2qo9NRL

Links:

Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
NMA of 14RCTs (>2500 pts) eval relative efficacy of bDMARDs and tsDMARDs in mostly biologic naïve nr-axSpA pts. -All therapies studied significantly improved ASAS40 response rates compared to placebo. -Certolizumab and Golimumab were the most effective therapies, followed by https://t.co/BJLRpEDYrv

Links:

Adela Castro AdelaCastro222 ( View Tweet)
In 631 axSpA pts (mean age 33y, 54% female) from DESIR cohort, high-dose NSAID use (ASAS NSAID index ≥50) not associated with incident hypertension (HR 1.01; 95% CI 0.98–1.02) over 72 months. NSAID anti-inflammatory effect may offset BP risk in axSpA. Abstract#POS0256 @RheumNow https://t.co/ELYWoJDyKJ

Links:

Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#Shingrix #vaccination is Impt in #SLE HZ vaccination works in SLE, safe – 1yr still good humeral & cellular immunity -attenuation over 1 yr re #immune #responses No major flares #shingles is ⬆️ in #lupus 👇 abnormal immune response #pred, #MMF #IS POS1005 #EULAR2025 @RheumNow https://t.co/o8lDXgOhE1

Links:

Janet Pope Janetbirdope ( View Tweet)
How does #HCQ work in #SLE Stabilizes lysomal membranes? #Lupus pts on HCQ monoRx & low #SLEDAI were followed Single cell seq HCQ cytokine sigs May vary over time IFN & OXPosph pathways #Hydroxychloroquine in #LN - #IFN I&II #EULAR2025 @RheumNow POS0983 https://t.co/0gMQh9MNlg

Links:

Janet Pope Janetbirdope ( View Tweet)
#TDM for #HCQ warns of #toxic #levels in #CRF v low GFR <30, <60, <90, >90   400mg/d all in low GFR toxic   200mg/d 25% in low GFR toxic   6mg/kg/d – low GFR is too ⬆️ adjust HCQ dose for pts with CRF POS0987 #EULAR2025 @RheumNow @eular_org https://t.co/vg2b87LuiE

Links:

Janet Pope Janetbirdope ( View Tweet)
#EULAR2025 Take Home message from Updated EULAR Recommendations @eular_org for #Lupus Nephritis: -Kidney Biopsy vital -Early use of Combination Therapies (HCQ + GC + Immunosuppressant + CNI/Belimumab/Obinutuzumab) -Severe: High dose Cyclo + GC @RheumNow https://t.co/jHFqdT1TLf

Links:

Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Secukinumab promise in PMR is real GCA is getting steroid-sparing therapy choices, and PMR doesn’t want to miss out. Most PMR patients with current therapy approaches incur multiple grams of cumulative prednisolone exposure, even though they’re often exactly the kind of https://t.co/GuD0l7zSfj
Dr. John Cush RheumNow ( View Tweet)
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