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Should we be using JAKi more in female SpA patients?

Richard Conway, MBBChBAO, PhD

In recent years, data has emerged suggesting that female patients with spondyloarthritis, both psoriatic arthritis and axial spondyloarthritis, may have worse outcomes than male patients. A number of post-hoc analyses of randomised controlled trials of both TNF inhibitors and IL-17 inhibitors suggest that this phenomenon is also manifested in the responses to these agents; female patients do less well than male patients. The mechanisms behind this remain to be fully elucidated.

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Rheumatology’s Blind Spot: The Persistent Exclusion of Older Adults

Jiha Lee, MD

As the population ages globally, rheumatologists are caring for an increasingly older patient population more than ever before. In RA alone, nearly 40 percent of patients are now aged 65 years or older. Yet the evidence guiding our treatment decisions continues to come from studies that rarely include them, giving rise to a fundamental question: do we really know how best to treat older adults with rheumatic diseases?

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New Research Demonstrates Impact of RISE Registry Data on Rheumatology Outcomes

ACR Press Release

New research presented at ACR Convergence 2025 highlights how the Rheumatology Informatics System for Effectiveness (RISE) registry—the nation’s largest collection of electronic health record data from rheumatology practices—is driving transformative improvements in quality, safety, and patient outcomes across rheumatic and musculoskeletal diseases.

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ACR Convergence 2025 Sheds Light on Disparities, Age-Related Trends, and Epidemiology in Autoimmune Rheumatic Diseases

ACR Press Release

At ACR Convergence 2025, new research explored critical disparities and epidemiologic trends shaping outcomes in autoimmune rheumatic diseases across diverse populations and age groups. Studies presented at the meeting highlighted issues ranging from kidney transplant outcomes in lupus to medication disparities in rheumatoid arthritis and demographic patterns in systemic sclerosis and axial spondyloarthritis.

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Classification of sacrioilitis using new york criteria vs a convolutional neural network. Abst#1421 #acr25 @RheumNow Yes no results - accuracy was 70 percent. But the exact grade was right 22 percent times only! https://t.co/9o8OGesH0n

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Bella Mehta bella_mehta ( View Tweet)
Gensler et al. Bimekizumab in male and female axSpA patients. Greater benefit in males at week 16, but similar responses at week 52 @RheumNow #ACR25 Abstr#1449 https://t.co/zDYI2zItqT

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Richard Conway RichardPAConway ( View Tweet)
Mac Gearailt et al. Depression in axSpA. Depression in 10%. Associated higher disease activity, worse functional status, and increased peripheral manifestations. @RheumNow #ACR25 Abstr#1409 https://t.co/8pnoQiaiQr

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Richard Conway RichardPAConway ( View Tweet)
Bimekizumab showed sustained 1-year efficacy in axSpA across age, BMI, CRP, and HLA-B27 subgroups. ASAS40, ASDAS, BASDAI, ASQoL, and MRI scores improved in most groups—especially age ≤35, BMI 25–30, CRP >5, and HLA-B27+. Abstract 1451 @RheumNow #ACR25

Antoni Chan MD (Prof) synovialjoints ( View Tweet)

Abstract 1431: Radiographic sacroiliitis in #PsA: insights from an Indian cohort - Cervical and lumbosacral spine syndesmophytes were common - Levels C5, C6, and L4 vertebrae frequently involved including syndesmophyte damage w/ non-marginal bridging @RheumNow #ACR25

Akhil Sood MD, MS AkhilSoodMD ( View Tweet)

The axSpA Registry of Ireland (ASRI): 10% reported depression, w/ higher prev in older cohorts. Pts w/ depression had ⬆️peripheral involvement, ⬆️dse activity & poor functional status 💡Consider the impact of non-inflamm factors in dse burden #ACR25 @RheumNow Abs1409 https://t.co/yDfHA24M6e

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sheila RHEUMarampa ( View Tweet)
A randomized trial of app-based behavioral (acceptance and commitment) therapy (ACT) showed reduced pain interference and affective distress in axial SpA compared to standard of care. Acceptance was moderate, but impact was meaningful. Abstract 1461 @RheumNow #ACR25 https://t.co/sF5Ldtc61R

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
The CLASSIC study (n=1015, 27 countries) validated revised ASAS-SPARTAN axSpA criteria. Final model achieved 79.5% sensitivity & 90.4% specificity vs global diagnosis. MRI SIJ (active + structural) was strongest predictor. HLA-B27, CRP, IBD, uveitis also included. Abstract#0854 https://t.co/GjSHE2ihVI

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#0854 @Official_ASAS & @SPARTAN_Updates revised #axSpA criteria meet targets: Sn 79.5% / Sp 90.4%. Imaging is central (SIJ MRI + structural lesions) with focused clinical items: HLA-B27, IBP, uveitis, IBD, heel enthesitis, psoriasis, ↑CRP @RheumNow #ACR25 https://t.co/i2d12y9HcD

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Mrinalini Dey DrMiniDey ( View Tweet)
To #cycle within or go to another drug class I #axSpA? #RCT of #TNFi-IR 👇 2nd #TNFi v #IL17i #IJDM it doesn’t matter what choice as #IL17i WAS NOT superior to TNFi cycling from 1st -2nd 👍 stay in #TNFi class = change to #IL17i #ACR25 @RheumNow abst#LB09 #ACRBest @ACRheum https://t.co/VCdL5CUYUa

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Janet Pope Janetbirdope ( View Tweet)
The CLASSIC study validated the performance of the 2009 ASAS classification criteria Model A was chosen for the revised criteria since it achieved prespecified performance targets of SN ≥75% and SP ≥90% 🔸Pso was included 🔸⬆️CRP replaced dactylitis #ACR25 @RheumNow Abs0854 https://t.co/tK52rQyaRa

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sheila RHEUMarampa ( View Tweet)
Real-world Indian cohort of 290 axSpA patients, generic tofacitinib achieved low/inactive disease in 89% after 25 months. Most adverse events were mild (e.g., transaminitis 14.5%) and manageable. No serious infections or MACE reported. A cost-effective alternative to bDMARDs in https://t.co/JBHfNq7kYt

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Urinary proteomics reveals promising biomarkers for ankylosing spondylitis. PIK3IP1 & SDC1 levels were significantly elevated in AS patients, showing strong diagnostic performance (AUCs: 0.852 & 0.875). Combined with AMY1A, the multiplex panel reached an AUC of 0.973. Abstract https://t.co/YUulKFqj8V

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
New biomarkers 14-3-3η multiplex autoantibody assay improves axSpA diagnosis, especially in HLA-B27– patients. Combined with CRP & HLA-B27, detection rose to 99% (training) & 91.4% (evaluation). In HLA-B27– cases, 14-3-3η lifted detection to 70.6% & 55%. Abstract 0531 @RheumNow

Antoni Chan MD (Prof) synovialjoints ( View Tweet)

Using ChatGPT to diagnose axSpA, in 10 low back pain cases, it outperformed clinicians in diagnostic precision (75% vs. 60%) and sensitivity (85% vs. 80%), completing the task 5x faster. Specialty framing (e.g., Rheum vs Neuro) didn’t affect accuracy. Abstract 0530 @RheumNow https://t.co/YMMC4XIX9m

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
A systematic review by Dr. SRamiro et al evaluated efficacy of b/tsDMARDs on peripheral axSpA Majority on bDMARDs (TNFi, n=24; IL-17, n=13) Most of the SMDs were small --> b/tsDMARDs showed small to moderate effects on peripheral arthritis & enthesitis. #ACR25 @RheumNow Abs0588 https://t.co/yGXcqhZ1Uv

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sheila RHEUMarampa ( View Tweet)
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