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Remission in Axial Spondyloarthritis Unrelated to Gut Inflammation

MedPage Today

Most patients with early, active axial spondyloarthritis (axSpA) who quickly received a tumor necrosis factor (TNF) inhibitor experienced remission, and it didn't matter whether or not they had intestinal inflammation at baseline, a small single-arm study found.

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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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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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Lung,AI,Pleura

A new mechanism of action in SARD-ILD

Aurelie Najm, MD, PhD

Nerandomilast, an inhibitor of phosphodiesterase 4B, orally administered, is a new mechanism of action to treat lung fibrotic diseases.

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Promising role of Fc neonatal receptor blockade in autoimmune rheumatic diseases During the Late-Breaking Abstract session at EULAR 2024, we learned about a novel mechanism of action therapy, nipocalimab in Sjogren’s disease (SjD). https://t.co/5bjyaqTqSN https://t.co/i4mGMYfyNK

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Survey shows only 1% of men are concerned about bone density; but 2 million men have osteoporosis, and 16 million men have osteopenia. https://t.co/DA4vSmj0vd? https://t.co/V4OChN022V

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Increasing costs of biologics. X-sectional study of 76 781 psoriasis pts on biologics (TNFi, IL12/23, IL-17i, IL-23i) saw annual treatment cost increase from $21 236 in 2007 to $47 125 in 2021. AVG cost could have been 44% lower if lowest-cost Rx in same class was used https://t.co/IOaK75zsgg
Dr. John Cush RheumNow ( View Tweet)
By March 2025, the FDA has approved 71 biosimilars (15 interchangeable). The US & EU biosimilars markets spent $22.58 billion in 2024 & is projected to increase by 25% to $171.79 billion by 2033 https://t.co/fsqGTzWuhC https://t.co/ZLYSIwRqI4

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UK study of 17472 newly Dx #RA pts (10997 MTX, 4,540 csDMARDs; 13680 steroids-CS) w/ 1307 Serious Infx (SI) (3/100PY) & 311 SI deaths. MTX signif decr. SI (adj HR 0.72) & CS no effect HR 0.99. SI assoc w/ age, smoker, comorbidity, seropositive, high DAS28. 1 DAS unit incr SI https://t.co/Zmsuaf7Rw3
Dr. John Cush RheumNow ( View Tweet)
What would it take for JAKs to ROCK the boat? 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. Once the https://t.co/JgmfxGa6TY
Dr. John Cush RheumNow ( View Tweet)

EMA has published a concept paper about the need for guidance to inform the development of systemic sclerosis (SSc) treatments. They have identified study designs & endpoints; exploratory and confirmatory trials, and assessments of safety and efficacy. See draft here: https://t.co/WADBrw2uXe

Dr. John Cush RheumNow ( View Tweet)
Persistent Burden in Early RA Despite Disease Control: insights from CareRA Trials Advances in the treatment of rheumatoid arthritis (RA), particularly the treat-to-target strategy and the introduction of effective disease-modifying antirheumatic drugs (DMARDs), have improved https://t.co/cMiF6POKGS
Dr. John Cush RheumNow ( View Tweet)
Survey of 154 Saudi established #RA pts on MTX >3mos; 64% claiming #MTX intolerance & 36% w/ MTX Intolerance Severity Score (MISS) >6. But MTX intolerance was NOT related to dose or route of administration, meal or time of day. These were not new MTX starters https://t.co/6KWGcZvx4o
Dr. John Cush RheumNow ( View Tweet)
FDA has approved a SC autoinjector of Benlysta (BEL) for use in pediatric lupus nephritis & pts > 5rs of age for SLE and active LN. BEL SC dosing for Pediatric SLE: 200 mg qwk (>40 kg) or 200 mg EOW (q2wk) if 15-40 kg. https://t.co/xrMJUgdSWv https://t.co/UJ2LZ3dU5p

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Dr. John Cush RheumNow ( View Tweet)
Full read overview of MDA-5 Dermatomyositis (DM) - pathogenesis, findings, & Rx. MDA-5 DM is a rare, aggressive amyopathic form with distinctive skin findings & rapidly progressive interstitial lung dz. Rx includes Hi dose steroids, calcineurin inhib & IV CTX (maybe JAKi, MMF)

Dr. John Cush RheumNow ( View Tweet)

Add-on certolizumab in pregnant women with APS Women with antiphospholipid syndrome and lupus anti-coagulant are at high risk of developing adverse pregnancy outcomes (APO). Usual care includes low molecular weight heparin (LMWH) and low dose aspirin (LDA). https://t.co/qnnkFlhtiS
Dr. John Cush RheumNow ( View Tweet)
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)
Psoriatic Arthritis: Hit hard and Early Two studies found no significant benefit of early biologics over standard methotrexate treatment, but they did not focus on poor prognosis cases. The SPEED trial, funded by the NIHR, aimed to compare disease activity in 192 PsA patients https://t.co/pS9DdOOVCV
Dr. John Cush RheumNow ( View Tweet)
JAK Safety Update Dr. Jonathan Kay offers his perspectives on abstracts POS0150, POS0151, and POS0157 presented at the 2025 EULAR meeting in Barcelona, Spain. https://t.co/F8WzGohCj8 https://t.co/FguBLrmPzZ

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Dr. John Cush RheumNow ( View Tweet)
Steroids, Not JAKi, Are the Real Infection Risk Dr. David Liew reporting at EULAR 2025 in Barcelona, Spain. https://t.co/rLpyo1UNjd https://t.co/bDfdLTEM1N

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Dr. John Cush RheumNow ( View Tweet)
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