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Rheumatoid arthritis and the ‘big bang’ at the ACR!
Is there ‘bang for the buck’ using big data to help predict who will develop RA in at-risk populations and similarly to predict response to csDMARDs, TNFi and JAKi in RA?
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Ogdie et al. Week 24 results of SOLSTICE study. Guselkumab in TNF-IR in PsA. Good efficacy on skin and joint disease. No difference seen in Q4 vs Q8 weekly doses. @RheumNow #ACR25 Abstr#563 https://t.co/ztK0O9iKb8
Richard Conway RichardPAConway ( View Tweet)
Observational study of fibrinogen for diagnosis of GCA
At a cutoff of 4.7, roughly similar diagnostic performance as compared to ESR/CRP
Kind of neat, but does not appear to have additive benefit
#ACR25 @RheumNow Abstr#0750 https://t.co/xy2qn4jHXP
Mike Putman EBRheum ( View Tweet)
ILD found in 30% of Sjögren’s pts w/ HRCT.
A new nomogram-based tool (AUC 0.8) predicts ILD risk using age, ESR, C3, hypergammaglobulinemia & anti-La/SSB.
Goal: guide HRCT referrals & catch ILD earlier.
@RheumNow #ACR25 Abstract #0510 https://t.co/FvAprq8eol
Jiha Lee JihaRheum ( View Tweet)
2-Year data from SELECT-GCA Phase 3 UPA in GCA
Re-randomization & 52 weeks extension UPA 15mg vs. PBO
-Risk of flare 90% lower
-Complete remission 70% vs 20%
-Cumulative GC 1g difference
-No new safety signal
The quick relapse after stopping UPA indicates we are really looking https://t.co/c1khywnPNv
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Immune-Mediated Necrotizing Myopathy @EleniTiniakou #ACR25
*Younger pts tend to have a more aggressive disease
*IVIG and RTX can be considered first-line rx for anti-HMGCR and anti-SRP+, respectively
*CYC and plasmapheresis may be options in cases of aggressive disease https://t.co/zWDX79gqlf
Rheumatology Quarterly RheumQuarterly ( View Tweet)
Abstract 0806
Compared to belimumab, Anifrolumab associated with:
↑ infection risk b (HR 1.40, 95% CI 1.05–1.88)
↑ herpes zoster (HR 3.94) & COVID-19 (HR 1.66)
No diff in mortality or hospital use
📈 3-yr infection: 38.3% vs 21.3%
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Real world effectiveness of voclosporin for SLE
Reduction in UPCR from 2.1 at b/l to 0.9 at 6 months, no improvement in eGFR; as expected based on trials
Wonder about market share of BEL vs voclo vs ANI - anyone seen pubs on this?
#ACR25 @RheumNow Abstr#0661 https://t.co/l7i7IWhLSe
Mike Putman EBRheum ( View Tweet)
#ACR25 Abstr#775 Previous study showed plasma tRNA-derived RNA (tDR-1), produced by bacteria from the phylum Proteobacteria, was assoc. with lower RA activity.
In 60 At-Risk CCP3+ people, Plasma tDR-1 improved prediction of RA. Need validation & adoption in practice @RheumNow https://t.co/XBmtohBEHc
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
From the FOREMOST study factors predicting progression from oligo to polyarticular PsA: Female sex, enthesitis and dactylitis found to increase the risk of progression. Among patients in FOREMOST receiving PBO, prior csDMARD use was protective. Abstract#0576 @RheumNow #ACR25 https://t.co/CFMhAFgFBa
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Accdg to this retro analysis of their prospective cohort study from Toronto, 47 pts (10%) had D2M axSpA of whom 14 had tx-refractory dse.
D2M pts - longer symptom duration; ⬆️ASDAS, BASDAI, BASMI, BASFI & ⬆️CRP
💡Consider non-dse factors in D2M pts
#ACR25 @RheumNow Abs0547 https://t.co/MUUyyELbw8
sheila RHEUMarampa ( View Tweet)
#0191 We found that in a large South London RA cohort, use of advanced therapy in moderate disease (DAS28 3.2-5.1) generally followed NICE guidance. Gaps often reflected telehealth limiting DAS assessment and patient hesitancy. Self-assessment tools may help. @RheumNow #ACR25 https://t.co/UMGtkfABHn
Mrinalini Dey DrMiniDey ( View Tweet)
Real-world T2T strategy from MONITOR-PsA cohort:
🎯 At 48 weeks - 33.6% (49/146) of pts achieved PASDAS 'moderate' response & 37% (54/146) achieved a 'good' response
This was close to the T2T outcomes of the TICOPA trial
Adapt a T2T approach in PsA tx
#ACR25 @RheumNow Abs0572 https://t.co/FPiFIiO8Oe
Links:
sheila RHEUMarampa ( View Tweet)
Albach et al. CAR T-cells in D2T RA. 6 patients. Safety looks ok. ACR20 in 4/6, ACR50 in 2/6. ACPA and RF disappeared. Results maybe not as positive as we might have anticipated? @RheumNow #ACR25 Abstr#471 https://t.co/TaEVWiWsNm
Richard Conway RichardPAConway ( View Tweet)
SELECT-GCA (upadacitinib in GCA for 52w)
we hoped it might have ongoing effect post-cessation
Do we need to continue upa?
Extension data (second year) flare survival curves are clear:
continuing upa far outperforms placebo
It seems >2y toci/upa for GCA
#ACR25 ABST0776 @RheumNow https://t.co/uJA3uQyWxb
David Liew drdavidliew ( View Tweet)
#0776
In the 2-yr SELECT-GCA trial, continued upadacitinib 15mg maintained remission in 69% vs 29% who switched to PBO, cutting flare risk by 90% and reducing steroid exposure by ~1g.
No new safety signals in older adults (mean 71yrs). @RheumNow #ACR25 https://t.co/KC9sm3ic3q
Mrinalini Dey DrMiniDey ( View Tweet)
RheumNow’s expanded coverage of the #ACR2025 annual meeting is sponsored by Bristol Myers Squibb, Novartis, and UCB. All coverage content is independently selected by RheumNow and its faculty.
Dr. John Cush RheumNow ( View Tweet)
Singla et al. In secukinumab phase 3 trials, fungal (inc candida) infections uncommon. 5.51 for sec vs 3.39 for PBO per 100PY. @RheumNow #ACR25 Abstr#585 https://t.co/g78zUsxD5a
Richard Conway RichardPAConway ( 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
Richard Conway RichardPAConway ( View Tweet)
Not all inflammatory nasal lesions are vasculitis! Dr. Zacharek presents from the ENT perspective
@RheumNow #ACR25 https://t.co/TJ4d56oBaJ
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
