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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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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)
Post-hoc PEXIVAS study, estimating risk of relapse from baseline variables
Lotsa fancy stats, mostly corroborated known risk factors, but model predicted relapse reasonably well!
Probably useful for approach to monitoring... mayyybe treatment?
#ACR25 @RheumNow #Abstr0722 https://t.co/XI9y8KgDNR
Links:
Mike Putman EBRheum ( View Tweet)
Statins and SLE: To add or not to add? 💊
Abstract #0599: In an emulated target trial of patients with SLE, statin users vs non-users had significantly⬇️ risk of all-cause death in both ITT & per-protocol analyses.
- No significant differences in MACE or ESKD.
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Mease et al. Sometimes perspective is all important! We worry about apremilast causing GI effects, anorexia, weight loss. Here we see reported benefits for weight loss and HbA1c. @RheumNow #ACR25 Abstr#581 https://t.co/CJjS0VZxWH
Richard Conway RichardPAConway ( View Tweet)
Tracking RA disease activity got a measurable boost in the VA: a 3-month multimodal rollout (feedback, EHR tools, just-in-time lists) raised DAM documentation up to 10%. Small structural changes, big data gains.
@RheumNow #ACR25 Abstract#0221
Jiha Lee JihaRheum ( View Tweet)
Plenary 1: SELECT-GCA (RCT, UPA vs PLBO in GCA)
Pts in remission re-randomized at wk52
Higher maintenance of remission in pts who continued UPA15 (69%) vs switchers from UPA15->PLBO (29%)
Argues strongly for continuing tx in GCA for >1yr!
@RheumNow #ACR25 Ab#0776 #ACRBest https://t.co/exmmIcpgbP
Links:
Mike Putman EBRheum ( View Tweet)
