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Agrawal et al. Case study of tofacitinib + bDMARDs in refractory IA. 7 SpA, 2 RA, 1 JIA. Effective and safe. @RheumNow #ACR25 Abstr#2338 https://t.co/Y0B3W4csJX
Richard Conway RichardPAConway ( 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)
After melanoma, should RA patients stop DMARDs?
These VA data (n=644) showed no mortality signal, and trending to survival benefit with b/tsDMARDs
Provisos over methotrexate, invasive disease etc, but don’t hold off treating the RA because of melanoma
#ACR25 ABST2237 @RheumNow https://t.co/l9n1V6YVln
David Liew drdavidliew ( View Tweet)
Can a Fitbit track RA?
This Japanese clinic is using Fitbit data and have seen it correlate with CDAI across their RA clinic.
Maybe instead of asking about our patients mobility and sleep, we should be measuring it?
#ACR25 ABST2253 @RheumNow https://t.co/rg2SKgn7K2
David Liew drdavidliew ( View Tweet)
#1751 In early RA, higher disease activity, inflammation & older age linked to more ILD changes on machine-learning chest CT. Even subtle QCT abnormalities correlated with reduced lung function pointing to early inflammatory pathways in RA-ILD. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
Are the clues of RA there in the EMR, before the diagnosis is made?
Jina off-the-shelf AI with subsequent retraining found the digital fingerprint of RA in @MayoClinic medical notes, years before formal diagnosis.
The clues are there
#ACR25 ABST2260 @MyasoedovaElena @RheumNow https://t.co/onGlKUmefd
David Liew drdavidliew ( View Tweet)
In the CLOSE-UP study of UPA in RA
- 61% in remission with responses sustained to 24 mo
- Benefit consistent irrespective of prior DMARD use
- No new safety signals
@RheumNow #ACR25 Abstract#2281
Jiha Lee JihaRheum ( View Tweet)
Serrano-Combarro et al. Abatacept in RA-ILD. 343 patients. Progressive ILD in 23%. Similar to the numbers progressing on baricitinib by same group. Previous MTX treatment appears to REDUCE risk (OR 0.45). Disease activity increases risk (OR 1.29). @RheumNow #ACR25 Abstr#2265 https://t.co/0tl0kGgm5p
Richard Conway RichardPAConway ( View Tweet)
Starting biologic early could save more than joints. In 329 RA pts, first-line anti-TNF reduced testing and hospitalization costs vs csDMARDs across Europe. Earlier targeted therapy pay off in outcomes and economics.
@RheumNow #ACR25 Abstract#2271 https://t.co/zZ32CpT36d
Jiha Lee JihaRheum ( View Tweet)
#1747 Serious infections ~2× more common in RA-LD, esp RA-ILD. Pulmonary, bacterial, viral & fungal infections all increased, underscoring need for tailored prevention and vaccination. @RheumNow #ACR25 https://t.co/soyzqLk7Vj
Mrinalini Dey DrMiniDey ( View Tweet)
#1746 In large US RA cohort, elevated GDF-15 & pentraxin-3 levels linked to prevalent RA-ILD; high GDF-15 predicted future ILD risk.
Other fibrosis-related mediators from IPF or heart failure were not associated, suggesting RA-ILD has distinct pathogenic pathways @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
STOP RA Cellular & Serologic Predictors
Dr. Jack Cush discusses abstract 0774, "Longitudinal peripheral blood multi-omic profiling in at-risk individuals uncovers immune signatures and predictive models for future RA conversion", presented at #ACR25
https://t.co/fS3sFmQJIh https://t.co/V1dVHhUeqF
Links:
Dr. John Cush RheumNow ( View Tweet)
New insights into Pre-RA: It ranges from asymptomatic individuals with ACPA positivity to those with symptomatic pre-clinical synovitis. Predicting who will develop RA is difficult, and there is a need for reliable biologic tools. Focusing on high-risk patients could https://t.co/SPOP7f0t7y
Dr. John Cush RheumNow ( View Tweet)
When every option fails, bold moves remain.
In 5 multi-resistant RA pts, TNFi + JAKi combo brought remission in most without major AEs.
Not standard, not risk-free, but in young, low-infection-risk pts, it may offer a path forward.
@RheumNow #ACR25 Abstract#2272
Jiha Lee JihaRheum ( View Tweet)
Mulcaire-Jones et al. Changes in PFTs over 1 year in early RA. Improved 31%, worsened 25%. No difference based on baseline disease activity, or MTX use. Those with baseline ILD were MORE likely to improve. ?due to effect of treatment @RheumNow #ACR25 Abstr#2235 https://t.co/bJeLYN9oN7
Richard Conway RichardPAConway ( View Tweet)
Punjadath et al. Predictors of progression palindromic rheumatism to RA. 30 patients. 47% progressed to RA. Total number of joints involved, RF, CRP predicted progression univariate. Only total joints significant in mutlivariate but underpowered. @RheumNow #ACR25 Abstr#2261 https://t.co/FtVKdGtEr9
Richard Conway RichardPAConway ( View Tweet)
Can fiber make methotrexate work better? (LB15)
In a placebo-controlled Superfibers RCT, inulin 12 g/day improved EULAR response & Th17/Treg ratio in RA among MTX users.
@RheumNow #ACR25 https://t.co/awMRNloNw5
Jiha Lee JihaRheum ( View Tweet)
Does fiber boost MTX efficacy?
LB15: Fiber + MTX led to
📉 Greater drop in DAS28 (–1.00 vs –0.34 placebo)
🧬 ↓ Th17 cells & Th17/Treg ratio
Some food for thought
@RheumNow #ACR25 https://t.co/VhLVP1nRy2
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Serrano-Combarro et al. Baricitinib in RA-ILD. Observational, 42 patients. Progressive ILD in 26%. More frequent in women. @RheumNow #ACR25 Abstr#2229 https://t.co/ZXfgxKoau7
Richard Conway RichardPAConway ( View Tweet)
How great would it be to have a diagnostic RA-ILD Urine Dipstick?
Small cohort 14 RA-ILD vs. 64 RA no ILD
Urine ILDScore includes 2 proteins
SPOCK1 and PGRMC1
Independently asso with ILD w/ OR 6.19
Urine ILD score alone AUC 0.9
ILD urine score + clinical data AUC = 0.95
Needs https://t.co/7PqX8kdjKJ
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
