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Imaging and Early Detection in Psoriatic Arthritis
At EULAR 2025, there have been new developments in imaging in PsA.
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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 rheumatoid arthritis (RA), a term now being used to describe a subset of patients who have failed to respond to five or more biologic or targeted synthetic DMARDs. This new classification, derived from recent multinational registry data, represents a significant step in refining our understanding and management of the most treatment-resistant forms of RA.
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#TDM for #HCQ warns of #toxic #levels in #CRF
v low GFR <30, <60, <90, >90
400mg/d all in low GFR toxic
200mg/d 25% in low GFR toxic
6mg/kg/d – low GFR is too ⬆️
adjust HCQ dose for pts with CRF
POS0987 #EULAR2025 @RheumNow @eular_org https://t.co/vg2b87LuiE
Links:
Janet Pope Janetbirdope ( View Tweet)
1/3 of #ERA pts poor
Outcomes despite controlled disease!
2 #RCT with T2T in early #RA
#CARERA
👇
persistent impact
⬆️TJC, comorbidities
⬇️SJC, CRP, global, HAQ,
F>M
⬆️disease durat’n
▶️
⬆️ b/tsDMARDs despite =diseaese vs others
?overRx
OP0330 #EULAR2025 @RheumNow
@eular_org
Janet Pope Janetbirdope ( View Tweet)
Who/When to Treat Clinically Suspect Arthralgia
Dr. Jack Cush discusses risk stratification in Clinically suspect arthralgia; referencing EULAR2025 abstracts OP0004 (ALTO study) and OP0325 (long term Followup of ARRIA)
https://t.co/FCO80mdHLg https://t.co/sX9u8mUoak
Dr. John Cush RheumNow ( View Tweet)
Procalcitonin can be used in the monitoring of infection, but is also high in Stills disease. 89 AOSD pts showed pts w high PCT had more pleuritis, MAS,^LFTs, & correlated w/ Dz activity, CRP, LDH, hi ferritin & normalized w bDMARD Rx. #EULAR2025 abstr #POS1118 https://t.co/NpRA9optd3
Dr. John Cush RheumNow ( View Tweet)
"H Syndrome" review of 23 French pts. Autoinflammatory dz due to variants of SLC29A3 gene. Multisystem histiocytic lymphoproliferative disorder of young adults- skin 2/3, sensorineural hearing loss, fever w/ endo & autoimmune dz. Best responses w IL6 inhib. #EULAR2025 Abst https://t.co/F7NGI4TkJS
Dr. John Cush RheumNow ( View Tweet)
KORAIL cohort: new RA-ILD progression model (inc. DLCO, ILD pattern/extent, anti-CCP, ± KL-6) stratified risk with high sensitivity & specificity. Adding KL-6 boosted AUC to 0.75.
A step toward personalised care in RA-ILD.
@RheumNow #EULAR2025 #OP0328 https://t.co/AHqNFw40gk
Mrinalini Dey DrMiniDey ( View Tweet)
In real-world PsA, IL-23 inhibitors (guselkumab/risankizumab) showed clinical response in axial/mixed PsA. Best response seen in pts meeting ASAS axial SpA criteria (RR 7.64) & baseline ASDAS-CRP >2.1. Supports role of patient stratification in axial PsA. Abstract#POS0113 https://t.co/qowZZmJOpM
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#EULAR2025 Abstr#OP0281 Not just shredding the weight but now also the pain! Another potential benefit of GLP-1 agonists - reducing symptoms of patients with Fibromyalgia. Propensity matched analysis using TrinetX database showed reduction on opiates, fatigue and pain @RheumNow https://t.co/oh6ecJmM5e
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Efficacy and Safety of Xeligekimab in AS
Dr. Adela Castro reports on abstract OP0102 at the EULAR 2025 meeting in Barcelona, Spain
https://t.co/xpzeV0oZOr https://t.co/wmTnFbFcum
Links:
Dr. John Cush RheumNow ( View Tweet)
Are we missing axial/SIJ lesions in PsA or are we misdiagnosing AxSPA + PSO pts for PsA?
5 register studies including 580+ pts w/ PsA/AxSPA+PSO
1/3 PsA routine care patients had SIJ MRI = SPA
29% Rx SII r-mNY criteria+
of which 38% MRI lesions AxSPA
@RheumNow #EULAR2025 https://t.co/DJljlm7T9m
Aurelie Najm AurelieRheumo ( View Tweet)
Depression and anxiety in PsA is higher and has more consequences than in general population
Swedish and Danish clinical registers 23000+ PsA pts
HR 1.4 specialised psychiatric out/ inpatient care vs. general pop
HR for psychiatric in patient care numerically higher but ns.
No https://t.co/qduMcwGK0S
Aurelie Najm AurelieRheumo ( View Tweet)
Prediction of PsA in PSO pts: does it work?
First predictive model using mainly clinical data and labs extracted from primary care
Performs well in the cohort it was trained w/ but not in validation cohort.
Often an issue with prediction models!
Needs more granularity than https://t.co/5cVgqfd4fX
Aurelie Najm AurelieRheumo ( View Tweet)
‼️Diagnosis of axSpA is clinical
-MRI is a tool but still has a lot of limitations.
-Improve reports by directly communicating with radiology and be specific on pt clinical info.
-Unified algorithms are needed to apply AI in dx of SIJ inflammation on MRI.
#EULAR2025 @RheumNow https://t.co/9GR6FsgIcL
Links:
Adela Castro AdelaCastro222 ( View Tweet)
Is #PDE5i protective in development of
#SSc #ILD?
Maybe
444 w ILD of >4000 #EUSTAR Pts over 1 to 2 yrs f/u
#immunesuppressive use maybe or not
🤷♀️channeling bias
Reduction in new #ILD in #scleroderma
PDE5i ✅
Immunesuppression ?
@RheumNow #EULAR2025 @eular_org #OP0334 https://t.co/6dtLfybkRV
Links:
Janet Pope Janetbirdope ( View Tweet)
#EULAR2025 Take Home message from Updated EULAR Recommendations @eular_org for #Lupus Nephritis:
-Kidney Biopsy vital
-Early use of Combination Therapies (HCQ + GC + Immunosuppressant + CNI/Belimumab/Obinutuzumab)
-Severe: High dose Cyclo + GC
@RheumNow https://t.co/jHFqdT1TLf
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
🔍MRI lesions in early axSpA vs non axSpA with chronic back pain:
-Data from SPACE cohort
-n 318 (214 axSpA vs 108 non-axSpA).
-Baseline imaging (CR and MRI) and at 2y f/u
-Minimal progression on CR in both early axSpA and non-axSpA CBP.
-On MRI, significant increase in the https://t.co/m5YOAiFUz1
Links:
Adela Castro AdelaCastro222 ( View Tweet)
E3N cohort 78000+ women >30yrs follow up
698 incident RA cases)
In non smokers, RA asso w/
-tall at birth HR=1.55
In smokers, RA risk associated w/
-prematurity HR=1.63
-in utero exposure to tobacco HR=1.83 (ns)
#EULAR2025 @RheumNow POS0226 https://t.co/xC3k3kiKsZ
Aurelie Najm AurelieRheumo ( View Tweet)
PsA asso w/ higher risk of preterm births in women
Scandinavian registries
688 PsA pregnancies
8% preterm births vs. 4.5% general population OR 1.8
16.4% if bDMARD combination OR 4
3.1% if bDMARD monotherapy OR 0.7
bDMARDs combo probably a surrogate of high disease activity
Aurelie Najm AurelieRheumo ( View Tweet)
