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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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Pregnancy Management in Inflammatory Bowel Disease: A Global Consensus
Consensus guidance on the management of pregnancy in patients with inflammatory bowel disease (IBD) was simultaneously published in six international journals, including The American Journal of Gastroenterology.
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Not all difficult-to-treat RA will have rapid radiographic progression
A study of radiographic outcomes in difficult-to-treat rheumatoid arthritis (D2T RA) and poly-refractory RA (pr-RA) show a subset in whom damage is rapid and in need of more aggressive therapy.
Associations in Rheumatology (10.3.2025)
Dr. Jack Cush reviews the news, journal reports and important associations in rheumatology from the past week on RheumNow.com.
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Big Fat FDA Pink Slip (9.19.2025)
Dr. Jack Cush reviews the news and journal reports from this week on RheumNow.com. Today we cover GLP-1 agonists, acupuncture, what JAKs won’t do & an FDA Pink Slip.
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Equal Safety of JAK Inhibitors and TNF Inhibitors
JAMA has published a systematic review and meta-analysis of head-to-head studies showing there was no meaningful difference in safety events observed when taking either JAK inhibitor (JAKi) vs TNF antagonist (TNFi) therapies for the treatment of immune-mediated
Novelli et al. Upadacitinib in male vs female PsA. Data from SELECT-PsA studies. Appears equivalent in males and females, contrasting with TNFi/IL17i data. @RheumNow #ACR25 Abstr#557 https://t.co/fMKsbCkju0
Richard Conway RichardPAConway ( View Tweet)
Ogdie et al. Week 24 results of SOLSTICE study. Guselkumab in TNF-IR in PsA. Good efficacy on skin and joint disease. No difference seen in Q4 vs Q8 weekly doses. @RheumNow #ACR25 Abstr#563 https://t.co/ztK0O9iKb8
Richard Conway RichardPAConway ( View Tweet)
Ramiro et al. No significant differences seen between men and women in response to upadacitinib in AxSpA at week 14 or 52. Differs from data on TNFi/IL17i in this regard. Looks to me like men respond a bit quicker and better though... @RheumNow #ACR25 Abstr#589 https://t.co/2m7mrgcG0z
Richard Conway RichardPAConway ( View Tweet)
Phase 3b/4 head-to-head SELECT-SWITCH study tested Humira vs Rinvoq in 492 RA MTX pts failing a TNFi then Rx w/ ADA vs UPA x12 wks. UPA > ADA w/ DAS28-CRP < 3.2 (43% vs 22%; p<0.001) and also for DAS28-CRP < 2.6 (28% vs 14%). No new safety signals seen.https://t.co/EAJ9GglMjv https://t.co/uHTsdTPpWP
Dr. John Cush RheumNow ( View Tweet)
Single center study of pregnancy outcomes in 189 women (131 RA, 29 SpA, 29 PsA). Stats for RA/SpA/PsA -- Live births 76%/90%/69%; Preterm 16%/12%/7%; IUGR 31 RA, none in SpA/PsA.. C-Sections ~1/3. TNFi used in 12% RA, but higher in SpA (48%) & PsA (31%) https://t.co/wVWOlRR0c0 https://t.co/sChkDJMrUs
Dr. John Cush RheumNow ( View Tweet)
Taiwan study of HBV or HCV reactivation w/ bDMARD use in PsO & PsA - among 5527 treatment episodes (3197 ts/bDMARDs) found a 10% risk of reactivation of HBVr (10.6%) & HCV (9.9%), highest w/ TNFi. Reactivation assoc w/ TNFi, HBsAg+, HBeAg+, immunosuppressant use without antiviral https://t.co/AwpmRpfJUT
Dr. John Cush RheumNow ( View Tweet)
Sonelokimab (SLK) is a nanobody that inhibits IL-17 A&F. Phase 2 ARGO trial 207 active PsA pts Rx w/ SLK 120-mg or 60-mg q4wks or PBO or adalimumab. ACR50 at wk 12 was 60-mg WI=46%; 120-mg WI=46%; PBO 20%. PASI90: 60mg 77% vs 120mg 59% vs PBO 15% https://t.co/ra0NqvUEru https://t.co/FXT6kkXUzH
Dr. John Cush RheumNow ( View Tweet)
RA at risk for pneumonia & hospitalisation. Pop/ study (41187 RA vs 205935 matched controls). w/ 4yrs F/U, RA had signif. more pneumonia (adj HR 1.73) & hospitaliz (aHR 2.26); higher w/ seropositives (aHR 1.86 & 2.52) & bDMARDs (1.73), but not tsDMARDs (0.93) https://t.co/XJE1FqVqCn
Dr. John Cush RheumNow ( View Tweet)
Equal Safety of JAK Inhibitors and TNF Inhibitors
JAMA has published a systematic review and meta-analysis of head-to-head studies showing there was no meaningful difference in safety events observed when taking either JAK inhibitor (JAKi) vs TNF antagonist (TNFi) therapies for https://t.co/DTux5QdETS
Dr. John Cush RheumNow ( View Tweet)
Commercial claims analysis of 8855 adults w/ axSpA and/or PsA, 1771 who had joint replacements. JAK inhibitor use did not significantly reduce joint replacement (OR 0.67; 0.41–1.08), BUT TNFi, Non-TNFi biologics & DMARD users had signif fewer surgeries (OR ~0.65) vs NSAID users https://t.co/vnBnFcPxGw
Dr. John Cush RheumNow ( View Tweet)
IL-17is demonstrate efficacy in SpA tx
Comparable with TNFis & JAKis in terms of achieving ASAS40 response rates
IL-17is are generally well-tolerated w/⬇️TB risk (very important tx consideration esp in Asia)
But watch out for candidal infx, IBD exacerbation
@RheumNow #APLAR25 https://t.co/rSUJlZOhKV
Links:
sheila RHEUMarampa ( View Tweet)
Paradigm shift in CTD PAH
-Early triple therapy in patients with intermediate and high risk
-Sotatercept,
a blocker of activin-Smad2/3 signaling
have increased survival importantly
Data presented by Dr Khanna
@RheumNow #APLAR25 https://t.co/Z4yA6DwtOb
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
A case–time-control study of French National Health Insurance database w/ 34 241pts Rx w/ IL-17(R)A inhibitor (2016-2021) (for PsO, PsA, AS, JIA) found no significant association betw IL-17(R)A inhibitors & MACEs over 6 months compared to TNFi Rx pts. https://t.co/fJuPFYKnSr https://t.co/Vscnsq0DTA
Dr. John Cush RheumNow ( View Tweet)
LTBI risk in rheumatic pts is high (22%). Metanalysis 18 studies, 12,167 rheum pts shows LTBI signif. incr w/ current smoking (OR 1.50), golimumab(OR 2.90), Chloroquine (OR 1.27), age >40 (OR 1.84), prior TB OR 3.26). LTBI not increased w/ RF, ADA, ETN, BCG, Pred, smoking, DM https://t.co/0PayHJqwDn
Dr. John Cush RheumNow ( View Tweet)
