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New Gout Therapies Show Promise in Phase III Trials

ACR Press Release Oct 26, 2025

At ACR Convergence 2025, the American College of Rheumatology’s annual meeting, researchers presented pivotal Phase III studies highlighting novel therapeutic options for patients with gout, particularly those with limited treatment choices or uncontrolled disease.

#ACR25 Abstr#0773 Anti-MDA5 ab is assoc. with progressive DM-ILD. But MDA5 expression is also upregulated in IPF. Any new biomarker which can link these ILD? Measuring reactivity to MDA5 (aa 201-300) epitope peptide may help identify poor ILD prognostics (with/out DM) @RheumNow https://t.co/rziwihKfIr

Is tocilizumab equally effective in ischemic vs. non-ischemic GCA? Ischemic = vision, jaw claudication, or CVA Remission at 6 mo higher in non-ischemic group then with equalization at month 12 No major difference in GCs at month 12 @RheumNow #ACR25 #Abst0739 https://t.co/OeYggSQYx8

https://x.com/Dr_Brian_MD/status/1982559595559342309/photo/1

We need more biomarkers in GCA - what about fibrinogen? Miller et al retrospectively compared CRP, ESR, and fibrinogen at different points in GCA dx Fibrinogen (and ESR/CRP) only helpful prior to initiation GC with comparable performance @RheumNow #ACR25 Abst #0750 https://t.co/q5gFxDMnTy

https://x.com/Dr_Brian_MD/status/1982557897369530485/photo/1

Abstract 0842 💡 Urinary biomarkers as the next frontier for monitoring lupus nephritis activity 🔹 Proteinuria didn’t track w/ histologic activity 🔹 IL-16 & sCD163 correlated at baseline only 🔹 Urinary Tenascin C & BAFF correlated w/ activity at 1 yr @RheumNow #ACR25

2 year extension data from SELECT-GCA: Patients in remission who remained on upadacitinib 15mg daily after 1 year had 90% reduced risk of flare compared to those who switched to placebo Higher rates zoster, CK elevation in UPA group #ACR25 @RheumNow #ACRBest https://t.co/jf8Dh2wCBj

https://x.com/Dr_Brian_MD/status/1982552487518413161/photo/1

Could a sputum test predict risk for RA conversion in at-risk patients? 98 at risk pts, Converters had higher -BL sputum CCP levels -BL Sputum nucleosome and cit-nucleosome levels !although not asso after adjusting for sputum anti-CCP-IgA level In converters, correlation of https://t.co/bqmQqS1Jz5

More biomarkers predictive of conversion to clinical RA in at-risk pts Serum PAD4 & PAD 4 levels measured in CCP+ at-risk individuals -PAD4 (not PAD2) increased in RA Converters vs. non converters and HC -PAD4 levels Pre-RA = RA Within high CCP+ at risk individuals, higher https://t.co/LU5zUzui1G

CMV is a worry with high-dose steroids, especially in certain settings. The risk is far from universal, though: in this Korean cohort treated with high dose pred, almost no-one without risk factors got it. Meds are rarely the only infection risk factor #ACR25 ABST203 @RheumNow https://t.co/zLYhLVKgYL

#ACR25 Abstr#803 We need more data to justify biologics before conventional immunosuppressant in #SLE. Post-hoc analysis of 5 Phase 3 RCTs = improved efficacy & GC reduction in BEL+No IS vs PBO+IS. Potential selection bias as control group might be doomed to fail @RheumNow https://t.co/kXmrOUbJzj

Upadacitinib in GCA doesn't just affect IL-6, it alters IFNg, known to be important in vascular change in GCA. If UPA in GCA has some cardiovascular concerns extrapolated from RA, it also has some plausible cardiovascular benefits too that TCZ may not #ACR25 ABST0751 @RheumNow https://t.co/rMetLPP9z6

https://x.com/drdavidliew/status/1982525324610228517/photo/1

A closer look in skin toxicity of GCs in RMDs GC Toxicity Index, LONG TOX prospective cohort Frequent: -Easy bruising 35% -Atrophy 22% -Hirsutism 17% -Acneiform rash 15% -Erosion/Tear 12% GC-related Neuropsychiatric toxicity highly associated with/ skin, something to look out https://t.co/NfxG8JkxSP

Nice SRMA evaluating HCQ dosing >5mg/kg associated w/3.8x risk of retinopathy... ...but <5mg/kg associated w/1.8x risk of SLE flares Morbidity from one of those is easily avoided by regular screening; morbidity from the other can be devastating @RheumNow #ACR25 Abstr#805 https://t.co/1vJXxXqiRC

https://x.com/EBRheum/status/1982522869562364407/photo/1

CE study BEL vs csDMARDs in TriNetX Mortality ~3-4% for MTX/AZA/MMF vs ~1.5% for BEL, ~50% reduction in adjusted analysis Pretty surprising given mediocre results from BLISS RCTs, but strong research group & lotsa fancy stats Do you believe it? #ACR25 @RheumNow Abstr#0804 https://t.co/Yex98EYDjP

#ACR25 Abstr#802 In #SLE pts with CLASI-A ≥8, pooled post-hoc analysis of Phase 2 RCT showed enpatoran, oral small molecule toll-like receptor 7/8-i impoved cutaneous response vs PBO as early as WK4. First-in-class promising therapy & warrant investigation in Phase 3 @RheumNow https://t.co/rn6NXdiGjD

Effect of BioDMARDs on Diabetes risk in 6400+ Psoriasis pts IL-23i and IL-17Ai associated w/ -lower risks of diabetes -Diabetic nephropathy -Stage 3–5 CKD and reduced risk compared to TNFi treated and bionaive pts Adjustment on several variables, but not disease severity https://t.co/TDIHXJOC2T

#ACR25 Abstr#801 Post-hoc analysis of Phase 2 RCT showed longer duration on Ianalumab (IAN) is beneficial. More #SLE pts achieved LLDAS or DORIS remission and GC taper in IAN in blinded 28-wk phase + open label IAN for the next 24-week group vs PBO-Open Label IAN @RheumNow https://t.co/I1Ugfj3BBl

https://x.com/Yuz6Yusof/status/1982512157893050797/photo/1

A retrospective study from Spain assessed the relationship bet HPV infxn & biologic tx in SLE pts 🔅 Prevalence of HPV 9.9% 🔅 No significant assocs bet HPV infxn, biologic tx, SLE-related dse variables & HPV RF progression Still, emphasize HPV screening #ACR25 @RheumNow Abs0659 https://t.co/1YusM1nYPr

https://x.com/RHEUMarampa/status/1982511293178491235/photo/1

FDA Approves Obinutuzumab for Active Lupus Nephritis The FDA has approved obinutuzumab (Gazyva) for the treatment of lupus nephritis. This is good news for the more than 1.7 million people worldwide with lupus nephritis. https://t.co/Wr3tG5izCi https://t.co/P8A5PUCIX0

FDA Approves Obinutuzumab for Active Lupus Nephritis | RheumNow

#ACR25 Beyond blinatumomab, A-319, CD3xCD19 BiTE in 12 patients with #SLE in China reported dose-dependent depth of B-Cell depletion but not efficacy or safety. One withdrew due to AE. No CRS/ICANS. Be interested to see results in larger trials & longer follow-up @RheumNow https://t.co/e5RuZlFI6i

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New Gout Therapies Show Promise in Phase III Trials

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