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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)
To be continued (or discontinued?):
Abstract 2360: Compared to TNFi, IL-17i & JAKi users had
🔹 Higher odds of med switching <180 days
🔹 Shorter time to discontinuation
@RheumNow #ACR25 #axSpA https://t.co/IOHaFSJqHn
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Interesting study evaluating the "CALLY" index (serum albumin × lymphocyte count / CRP / 10,000) for predicing mortality in AAV
I typically dislike these because (1) they are often cumbersome to calculate & (2) they often perform poorly
This one piqued my interest; pretty https://t.co/ziroQOH5Cq
Mike Putman EBRheum ( View Tweet)
Meta-analysis of 3 RCTs (n=1990) shows IL-17i offers comparable joint response but superior skin clearance vs adalimumab in biologic-naive PsA. IL-17i also had fewer discontinuations due to adverse events. Supports sequencing of biologics through different mechanisms of action in https://t.co/SJgFUMxWVb
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
IgG4-RD continues to present in new and unusual ways
Hasbani et al. report 9 IgG4-RD patients with coronary artery involvement
RCA and LAD most affected
Seen on CTA
Majority received RTX
7/9 pt at least partially improved imaging on f/u
@RheumNow #ACR25 Abst 2531 https://t.co/Na0gdq3dgb
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
A new genetic score for ILD prediction! 🫁
Developed in the Veterans RA cohort and Validation in a Swedish cohort
Model using classic RA-ILD risk factors and a cocktail of genetic risk
A cut off of 0.05 in this cohort would exclude 36% from HRCT or PFTs
Good performance https://t.co/6UsoSQAtyK
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
RESET-RA, RCT of vagus nerve stim (device that zaps pts in neck)
Marginal improvements in ACR20 at wk 12; trend in to improvement in unblinded part of study fwiw
Have never seen result that is more likely to be driven by plbo effect & unblinding 🤪
@RheumNow #ACR25 Abstr#2278 https://t.co/BlR570nv7k
Links:
Mike Putman EBRheum ( View Tweet)
Hindosh et al. Semaglutide associated with reduced synovitis, joint pain and swelling, in RA. @RheumNow #ACR25 Abstr#2286 https://t.co/6Xs4um5l32
Richard Conway RichardPAConway ( View Tweet)
MSK side effects of CAR-T,
based on FAERS pharmacovigilance data
(also see @DrGomezPuerta in @seminarthrheum https://t.co/LnwjU5aebs)
#ACR25 ABST1731 @RheumNow https://t.co/kREEy3HLE9
Links:
David Liew drdavidliew ( View Tweet)
Late Breaker: Observational study of MEPO in EGPA
375 pts receiving MEPO had less ARF/CKD than 727 pts receiving standard of care
Smallish event #'s & lots of p values... also, what about the vasculitis?!?
#ACR25 @RheumNow AbstLB16 https://t.co/XwqNthfwPF
Links:
Mike Putman EBRheum ( View Tweet)
Bremer et al. Earlier initiation of biosimilar adalimumab (vs csDMARDs) may result in cost-savings. Reduced cost of tests, consultations, and hospitalisations. @RheumNow #ACR25 Abstr#2271 https://t.co/lHaSiX3WLd
Richard Conway RichardPAConway ( View Tweet)
Semaglutide isn’t just for weight loss?
In RA, users had 20–40% lower risk of synovitis, stiffness & swelling up to 1 year vs matched controls.
GLP-1 agonists may offer anti-inflammatory benefit beyond metabolism.
@RheumNow #ACR25 Abstract#2286
Jiha Lee JihaRheum ( View Tweet)
PLEX continues to be OUT for DAH in AAV
Retrospective review of ~1.4k AAV-DAH pt
375 who received PLEX compared to those who did not
PLEX tx patients:
- higher odds of death
- higher sepsis
- increased LOS
- increased hospitalization cost
@RheumNow #ACR25 Abst 2517
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Mateo Faxas et al. TriNetX study, propensity score matched. 3000 patients. Arrythmia risk is higher with IL-6i vs TNFi in diabetic RA patients. V Tachy (HR 1.4), PPM need (HR 1.4) significantly higher. AF, SVT, VF all numerically increased. @RheumNow #ACR25 Abstr#2283 https://t.co/U2Tk38Mobg
Richard Conway RichardPAConway ( View Tweet)
Heydari-Kamjani et al. TriNetX study. 28973 PsA patients. IL-17i and IL-23i lower rates stroke, MI, DVT/PE than TNFi. IL-12/23i higher rate of stroke vs TNFi. @RheumNow #ACR25 Abstr#2363 https://t.co/fNHaxyYPCP
Richard Conway RichardPAConway ( View Tweet)
Adding social risk factors to the mix
Abstract 1917: WashU Rheumatology examined SRF screening in the clinic
🔹 50% screened once; 1/3 screened > 1
🔹 Core SRFs (finance, transport, housing, food) relatively stable
🔹 Biggest change over time: stress
@RheumNow #ACR25 https://t.co/oKlwMZ77nB
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Is taking NSAIDs +TNFi better for the joints?
Abstract 2359: In radiographic axSpA, NSAIDS + TNFi associated with
-fewer syndesmophytes 36% vs 58% TNFi
- no significant effect on hip structural changes
- @RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
The CAR T engine doesn’t stop! LB04: Phase 1 bispecific CD19/BCMA CAR T in refractory autoimmune disease 🚗💥 ✅ Low AEs (mostly Gr 1–2 CRS, hematologic) 💪 Robust efficacy in lupus nephritis 🔄 Deep B-cell depletion → naïve B-cell repopulation @RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Effect of air pollution in RA
Prospective cohort 1000+pts w/ 12000+ visits
Higher levels of pollution
& specific size of particles PM25
asso w/
-10% higher odd of flare
-Higher DAS CRP and CDAI
Now the interesting pattern:
PM25 exposure increases 3 weeks before flares https://t.co/MOskJzk05g
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Molina et al. 52 weeks of MANHATTAN study. Guselkumab vs second TNFi after failure 1st TNFi in PsA. MDA 52% vs 33%. Remission/LDA 67% vs 62%. @RheumNow #ACR25 Abstr#2373 https://t.co/qdtOlKLfNU
Richard Conway RichardPAConway ( View Tweet)
