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Putting IL17i into ‘focus’ for SpA-associated uveitis
The longest studied drug for uveitis in SpA has been monocolonal TNFi Abs. Reductions of acute anterior uveitis have been found with etanercept but less impressively than adalimumab, infliximab, and in my opinion less than golimumab and certolizumab pegol.
Other data have emerged for JAKi and IL17i, with respect to acute anterior uveitis.
Clinical and Therapeutic Challenges in Connective Tissue Disease and ILD
Connective tissue diseases (CTDs) and interstitial lung disease (ILD) represent a challenging intersection of systemic autoimmunity and progressive respiratory impairment. Research presented at EULAR 2025 continues to highlight the importance of CTD-ILD and the evolving landscape of therapeutic options for patients with autoimmune ILDs.
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#Vagal #nerve #stimulation
Hand held device
#BDMARD failure
Plausible - improved pro inflammatory cytokines
wears off benefit if stopped
Attenuates in ~half over yrs
Open label uncontrolled
@RheumNow @eular_org #EULAR2025
Session D2T-RA https://t.co/98K5gwasHv
Links:
Janet Pope Janetbirdope ( View Tweet)
#RCT of #vagus #nerve #stimulation in #bDMARD-IR #RA Pts
RESSET RCT
+RA #RCT w #VNS
But low response with stat significance
ACR20 1/4 sham vs 1/3 VNS
Would add on to new SoC? 🤔
#EULAR2025 @RheumNow #eular_org
#D2T- RA-session https://t.co/tR1pLPBr74
Links:
Janet Pope Janetbirdope ( View Tweet)
So we used to get taught about bimodal age distribution of RA onset - young people and old people.
Actually, it’s early middle age where RA diagnoses have now grown globally over 30y - right in peak productivity
Global Burden of Disease data
#EULAR2025 OP0240-HPR @RheumNow https://t.co/8yyrex00yy
David Liew drdavidliew ( View Tweet)
Prédiction of PsA from PsO. Stockholm cohort, n=672):
•PsA incidence 21.1/1000 PY.
•AUC 0.80 for both referral and prognostic models.
•Predictors: HLA-B27, uveitis, enthesial pain, TJC, hsCRP, BMI, SAA, GlycA.
•Early identification feasible.
Abstract OP0178 @RheumNow https://t.co/dxdChN6VZy
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Do the sites of clinical onset of PsA (i.e., swelling) correspond to those that, at the time of enrollment in the study, showed evidence of joint tenderness and/or ultrasound-detected alterations compatible with inflammation? Of 28 incident PsA cases, 68% had prior subclinical https://t.co/rAZJU6Va5x
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Even after having things laid out in a great debate, rheumatologists remain unconvinced by medical cannabis #EULAR2025 @RheumNow https://t.co/xMTvngS5N1
David Liew drdavidliew ( View Tweet)
Study on the HLAs associated with the occurrence and course of acute/tender dactylitis in PsA patients.
Acute dactylitis genetics:
•HLA-B27 (OR 1.71), HLA-C12 (OR 1.43), B38/C12 & B27/C02 haplotypes.
•Resolution faster on b/tsDMARDs (HR 1.67); unaffected by HLA.
Abstract
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
cool stuff at #EULAR2025
RESET #RCT - #vagal #nerve #stimulation #VNS vs sham in
#RA w 1or >1 #bDMARD-IR
N=242
D/C bDMARD,
on #csDMARD
#RA 12 yrs, 10SJC 12TJC
2.6 b/tsDMARD failure
Wk12 EULAR good/mod response
61v 42%
Sham▶️goes VNS ✅data=
@RheumNow @eular_org abst#OP190
Janet Pope Janetbirdope ( View Tweet)
Intraarticular IL-1Ra Gene Therapy in Knee Osteoarthritis
In a dose-escalation trial in nine participants, they observed that a single intra-articular injection of the gene product led to an increase in IL-1Ra in the synovial fluid that remained elevated for up to a year. There https://t.co/qi0qHPd06j
Dr. John Cush RheumNow ( View Tweet)
#polyrefractory #RA
=
failed all classes in #rheumatoid #arthritis
+inflammatory #arthritis
Longer disease duration
Late RA Rx
+power Doppler in POCUS
⬆️no refractory
BMI
Fibromyalgia - pain
⬇️SJC, less DAS , rapid X-ray progression
#EULAR2025 @RheumNow #D2T #RA https://t.co/1sPwf3Qa3m
Links:
Janet Pope Janetbirdope ( View Tweet)
RheumNow’s expanded coverage of the #EULAR2025 Annual meeting is sponsored in part by Johnson & Johnson and UCB. All content chosen by RheumNow & its Faculty
Dr. John Cush RheumNow ( View Tweet)
Transcranial Stimulation is Effective in Fibromyalgia
A randomized, controlled clinical trial in fibromyalgia (FM) has shown the efficacy of transcranial direct current stimulation (A-tDCS) (along with exercise and pain neuroscience education [PNE]), in alleviating the pain. https://t.co/P8SKs3JNEx
Dr. John Cush RheumNow ( View Tweet)
🦵🏼💉LOSEIT study: liraglutide led to slight↑ in medial joint space width in knee OA vs placebo (0.22 vs 0.07 mm), but difference not statistically significant (p=0.17). More potent GLP-1RAs may be needed for greater improvement in structural knee OA
@RheumNow #EULAR2025 #OP0223
Mrinalini Dey DrMiniDey ( View Tweet)
GRAPPA defines :
- D2T-PsA (failed ≥3 therapies incl. ≥2 b/tsDMARDs)
- CM(complex to manage)-PsA (adds pain, comorbidity, complexity).
A needed framework to improve trial design & real-world care.
Do these definitions fit your clinic?
#OP0175 @RheumNow #EULAR2025 https://t.co/ot1bVLIYLA
Jiha Lee JihaRheum ( View Tweet)
#RITAZAREM: infection risk during RTX induction in AAV was ↑ w/ lung disease & nodules/cavities; ↓ w/ TMP-SMX prophylaxis. Early infections predicted later ones, but risk didn’t differ by RTX vs AZA. Pulmonary damage is a key red flag for infection
@RheumNow #EULAR2025 #OP0167
Mrinalini Dey DrMiniDey ( View Tweet)
29% of new-onset psoriasis pts in Stockholm cohort developed PsA over 9,255 person-years.
Two prediction models (AUC 0.804) identify:
➡ who to refer
➡ who will progress
Key predictors: HLA-B27, CRP, enthesitis, arthralgia.
@RheumNow #EULAR2025 #OP0178:
Jiha Lee JihaRheum ( View Tweet)
The definition of MAS. MAS is secondary HLH. Other causes of secondary HLH are infections, malignancy and iatrogenic.
Georgin-Lavialle S @RheumNow #EULAR2025 https://t.co/CpB78JBlVJ
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Clinical Pearl's for #MAS
Infections are still the most common cause.
Next is malignancy...
Then other causes like autoimmunity..
Ask a detailed history ! Sometimes check with the family when the pt can't give history..
#EULAR2025 @RheumNow https://t.co/fepercz5Af
Bella Mehta bella_mehta ( View Tweet)
