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Dr. Jack Cush reviews the news and journal reports from this week on RheumNow.com. Today we cover GLP-1 agonists, acupuncture, what JAKs won’t do & an FDA Pink Slip.
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Treat-to-target strategies are not a new concept in rheumatology. It has shown to improve patient outcomes and quality of life in RA and PsA, and is now being increasingly adopted not only in SLE research but also in clinical practice. This article reviews key highlights from Dr. Eric Morand’s plenary session lecture on Treat to Target in SLE: Current Evidence and Future Directions, presented during the recent APLAR 2025 Congress.
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In one of the SLE sessions at the APLAR 2025 Congress, Prof. Sandra Navarra discussed the assessment and management of osteoporosis in SLE patients, particularly glucocorticoid-induced osteoporosis (GIOP) and this article reviews the highlights and key takeaways from her talk.
Dr. John Cush
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Study of urinary soluble CD163 levels in 214 SLE pts (129 w/ LN), found urinary CD163 highly correlates w/ UPCR, active vs inactive states, predicts Renal Bx histologic activity (AUC 0.962) & renal dz flares & allows prediction of complete, partial and non-responders https://t.co/HNKAuFDgPG
Dr. John Cush
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This is a pivotal trial. 187 pt w/ incomplete lupus (ANA+ plus 1-2 criteria, but not qualifying as SLE) shows that HCQ does not prevent progression to SLE! Congrats to these researchers lead by Nancy Olsen et al. https://t.co/NnrA8ohiGX
Dr. John Cush
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Hitting the Target: T2T Therapy in SLE
Treat-to-target strategies are not a new concept in rheumatology. It has shown to improve patient outcomes and quality of life in rheumatoid arthritis and psoriatic arthritis and is now being increasingly adopted not only in SLE research https://t.co/PfnG0AeJsH
Dr. John Cush
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There is no criteria for infection-induced Antiphospholipid syndr (APS). aPL & aCL abs have been reported w/ COVID, HCV, HIV, EBV, varicella-zoster, & CMV. infections may induce transient aPL positivity without over APS, but may precipitate APS or catastrophic APS (CAPS).
sheila
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GCs have potent anti-inflammatory effects but it’s long term complications can be catastrophic.
In SLE pts, it shows a 3-fold increased risk of organ damage for each addtl 1mg of Pred/day.
📌Aim for short duration of use with lowest effective dose
@RheumNow #APLAR25 https://t.co/UugrcX073Z
Dr. John Cush
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SLE and Osteoporosis
Systemic Lupus Erythematosus (SLE) is a multisystem autoimmune disease that can present with a variety of signs and symptoms and organ involvement. Comorbidities further complicate the disease course that may lead to poor health-related quality of life and https://t.co/8ZmtLjzbqA
sheila
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In lupus patients presenting with demyelinating symptoms, consider a probable disease overlap between NPSLE and NMOSD.
>>>> serum AQP4 is highly specific for NMOSD.
@RheumNow #APLAR25 @rheumarhyme @marklagacmd https://t.co/2Z8rbJ3a1c
Aurelie Najm
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Juvenile Lupus: some new mechanistic data
Circulating Treg population are expanded in SLE and in particular in Lupus Nephritis compared to HC
Naive Treg display specific molecular features in particular over expression of FCRL3 and TLR5 showing new pathways to explore in https://t.co/RuMtWRkpYB
sheila
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Dr. Alberta Hoi graphically presents the difference bet acute confusional states & chronic cognitive changes in #lupus patients presenting with NP symptoms.
NPSLE continues to pose a diagnostic challenge bec pts may present with more than one syndrome complex
@RheumNow #APLAR25 https://t.co/4nYTo1fzVz
sheila
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‼️More reasons why we should avoid steroids in #lupus patients
@RheumNow #APLAR25 https://t.co/a5IeutJ5mi
sheila
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The overall prevalence of #osteoporosis in SLE is ~33-40% and is due to several factors with GC therapy being one of them.
Monitor DXA every 6-12 months (vs. 2 yrs for standard OP)
☝️Screen for GIOP
☝️Treat accordingly - once on GCs & esp w/long-term use
@RheumNow #APLAR25 https://t.co/E9FJDHrBUo
Dr. John Cush
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Lessons Learned in Neuropsychiatric SLE
Dr. Sheila Reyes, The Philippines, reports highlights from a session on neuropsychiatric systemic lupus erythematosus, presented at the APLAR 2025 Congress in Fukuoka, Japan.
https://t.co/Dh1GQnBhvg https://t.co/wX5FgpIq7C
Dr. John Cush
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9 yr. study of anti-Ro52 & ILD pts -- 1,026 pts 15% Ro52+: interstitial pneumonia w/ autoimmune 48%, CTD-ILD 13%, idiopathic pulm fibrosis 10%, hypersens pneumonitis 6%, idiopathic ILD 24%. Ro52+ were younger w/ more autoimmune dz, +MSA Abs, ILD progression, death, & lung https://t.co/fuFfnaYIRd
sheila
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Is it #lupus?
Interesting study by @escheriKYA et al. showing comparable diagnostic performance of SLERPI (93%) in 🇵🇭 patients vs. SLICC and EULAR/ACR criteria
A practical alternative tool that can be used by clinicians in a resource-limited setting 🤔
@RheumNow #APLAR25 https://t.co/xByBkjEr3r
Dr. John Cush
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3 yr study of FDA Adverse Event Reporting on anifrolumab shows following AEs- URIs, herpes zoster, infusion reactions, and potential new risks like dyspnea and pyrexia, not in the label. https://t.co/vP2YWGT2vR https://t.co/BruGBtXEBu
Aurelie Najm
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A new player in AIRD
ThA age associated T helper cells
Displaying both Cytotoxic & APC functions
Correlation with disease activity in RA and SLE
More research is needed to better characterize function but could be a promising therapeutic target
@RheumNow #APLAR25 https://t.co/4SnY65tXpJ
sheila
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This slide reflects the rheumatologist’s goals for treating #lupus
Prof. Mosca also highlights the fact that achieving targets is as important as maintaining these treatment targets.
@RheumNow #APLAR25 https://t.co/u8fw3fThXI
