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Trends and Innovations from Barcelona (6.20.2025)

Jack Cush, MD

Dr. Jack Cush reviews highlights, trends and novel studies from EULAR 2025 in Barcelona from last week.

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Striking a ‘nerve’ in RA: understanding neuromodulation

Janet Pope, MD, MPH, FRCPC

Over the last 50 years, discoveries of connections between inflammation and the nervous system have been better understood.

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heart in a puzzle

What would it take for JAKs to ROCK the boat?

David Liew, FRACP

JAK inhibitors have taken a beating over the last three years. The excitement and potential has been tempered by mounting cardiovascular safety concerns, but specifically in at-risk patients, compared to TNF inhibitors. So it is an intriguing idea to pair JAK inhibitors with something that might have a cardioprotective effect. It is therefore worth excitement that we have a therapeutic option to follow which does just that. At EULAR 2025, we have seen phase 2 results for CPL’116, and a simultaneous publication in The Lancet Rheumatology.

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Persistent Burden in Early RA Despite Disease Control: insights from CareRA Trials

Mrinalini Dey, MD

Advances in the treatment of rheumatoid arthritis, particularly the treat-to-target strategy and the introduction of effective DMARDs, have improved the management of inflammation in RA. However, improved inflammatory markers do not always translate into a resolution of patients’ symptoms or improvements in functional capacity. A recent pooled analysis from the CareRA and CareRA2020 randomized controlled trials shed new light on this dissociation between biological disease control and patient-reported outcomes.

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Nurse-Led Treat-to-Target Clinics

EurekAlert!

New studies shared at the 2025 annual EULAR congress in Barcelona highlight the benefits that nurse-led care can bring for both patients and healthcare systems.

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How to properly use steroids in early RA

Janet Pope, MD, MPH, FRCPC

Guidelines differ on the early treatment of RA – ACR suggests not to use glucocorticoids (GC) and EULAR updated recommendations for RA treatment presented at #EULAR2025 continued to suggest early treatment with MTX and glucocorticoids. We do know that it is not easy to get a significant minority of RA patients off of prednisone.

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Methotrexate and Leflunomide combination in RA/PsA: Is it safe?

Aurelie Najm, MD, PhD

I asked the EULAR twitter sphere how they feel about combination of methotrexate (MTX) and leflunomide (LEF). The opinions are differing so far, with 50% reporting prescribing this combination often while 50% are worried of side effects. Several abstracts presented this year are providing further data to help us make up our minds in RA and PsA.

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Methotrexate and Leflunomide combination in RA/PsA: Is it safe? Save I asked the EULAR Twitter community about the combination of Methotrexate (MTX) and Leflunomide (LEF). Opinions are split, with 50% prescribing it often and 50% concerned about side effects. In my practice, https://t.co/SZjLaEH1h2
Dr. John Cush RheumNow ( View Tweet)
Rheumatoid arthritis incidence has risen to 17.9 million people globally -13.2% increase from 1990-2021. Fewer people are dying from RA, but disability-adjusted life Yrs have doubled. high sociodemographic index bore the heaviest burden. Smoking control policies is forecasted to https://t.co/YmWcinVdmE
Dr. John Cush RheumNow ( View Tweet)
ALTO: Long-term Outcomes of APIPPRA Dr. Mrinalini Dey interviews Professor Andrew Cope about abstract OP0004, on the long term outcome of APIPPRA patients - the ALTO study, at the EULAR 2025 meeting in Barcelona, Spain. https://t.co/9wVZSXbi6r https://t.co/fm77qDoTwm

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Dr. John Cush RheumNow ( View Tweet)
EULAR 2025 – Day 4 Report Saturday was the final day of EULAR, and included several lectures, but mostly late breaking abstracts and new EULAR guidelines - notably on Rheumatoid Arthritis and another on Interstitial Lung disease in connective tissue disorders. https://t.co/ZJ1pHQJTbK
Dr. John Cush RheumNow ( View Tweet)
Toward Long-Term Prevention of Rheumatoid Arthritis: Are We Closer? As earlier diagnosis and treatment of rheumatoid arthritis (RA) have resulted in greatly improved clinical outcomes, the focus of current research has now shifted to preventing the development of RA altogether. https://t.co/HGbXVLVuSC
Dr. John Cush RheumNow ( View Tweet)
DMARD Combinations in RA Treatment Dr. Jiha Lee discusses abstract OP0195 presented at the EULAR 2025 meeting in Barcelona, Spain. https://t.co/lrZRDvWD0z https://t.co/PS4k2bCqet

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Dr. John Cush RheumNow ( View Tweet)
EULAR 2025 – Day 3 Report Highlights from Day 3 included presentations on imaging in vasculitis, a debate on treating high-risk pre-clinical RA, and EULAR Recommendations on ILD treatment, physical activity for arthritis, the EULAR disease activity score for antiphospholipid https://t.co/FAaj443wPX
Dr. John Cush RheumNow ( View Tweet)
Introducing Polyrefractory RA: A New Frontier in Difficult-to-Treat RA 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 https://t.co/35cWYRehdd
Dr. John Cush RheumNow ( View Tweet)
Several studies have shown predictive value to monocyte counts in RA responses. UK study of 246 #RA pts showed pretreatment absolute monocyte count [ORadj 9.56; 1.61-59.86, p = 0.01) predicted bDMARD nonresponse @ 6 mos. Replicates other reports! https://t.co/GqGj8R0wq1 https://t.co/HJ7wFBoxGE

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Dr. John Cush RheumNow ( View Tweet)
Jokes Aside: The Impact of Laughter in RA Dr. Aurelie Najm reports on POS0685, 'The Impact of Social Frailty and Physical Function on Laughter Frequency in Rheumatoid Arthritis Patients from a Multicenter Observational Study (T-FLAG)', presented at EULAR 2025 in Barcelona, https://t.co/z3tvqQmH96
Dr. John Cush RheumNow ( View Tweet)
Cancer risk in rheumatoid arthritis: anything new? There is still a question I have a hard time answering with certainty when people living with rheumatoid arthritis ask me: Is there a higher risk of cancer that comes with the disease? Or with the treatments? So many https://t.co/6rbZg5Fr2k
Dr. John Cush RheumNow ( View Tweet)
EULAR 2025 – Day 2 Report Day 2 was a full agenda for those attending EULAR 2025 in Barcelona with sessions on the management of RA, Behcets, Lupus and Hand Osteoarthritis. Clinical overviews on MAS, Ehlers-Danlos, Difficult to treat RA and PsA offered a wide variety of options https://t.co/rys0pA6D6j
Dr. John Cush RheumNow ( View Tweet)
Increased Risk of VTE in RA: Lessons Learned from 40 Years of Data Dr. Mrinalini Dey reports on abstract OP0070, "Trends in Incidence and Predictors of Incident Venous Thromboembolism in Patients with Rheumatoid Arthritis: A Population-Based Retrospective Cohort Study", https://t.co/JykR4Mxb9L
Dr. John Cush RheumNow ( View Tweet)
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