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Late-Onset Disease: Different Age, Different Rules?

Jiha Lee, MD

We’re seeing more patients develop rheumatic diseases for the first time in their 60s, 70s, or beyond. But are these truly the same diseases we see in younger adults, or do they behave differently, shaped by age-related biology, comorbidity, and the biases that influence medical decision-making? Several abstracts presented at EULAR 2025 challenge us to reconsider how we diagnose and treat rheumatic disease in older adults.

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SLE Preview: advances to achieve deep B-cell depletion

Md Yuzaiful Md Yusof, MRCP(UK), PhD

The race is on for the first chimeric antigen receptor (CAR)-based therapy to be approved for the treatment of systemic lupus erythematosus. Its main principle is to induce deep B-cell depletion, with the hope to reset the B-cell aberrant immunity for a sustained clinical remission. At EULAR 2025 in Barcelona, several advances of CAR-based therapies will be presented.

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MTX Fails Knee OA (6.6.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com

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Type 2 SLE: Insights from a Biopsychosocial Framework

Jennifer L. Rogers, MD

Many of the common symptoms of lupus - fatigue, nociplastic pain, brain fog - can be invisible and difficult to measure, and can often co-occur with impaired sleep, depression and anxiety. These symptoms have led to a well described discordance between physician and patient perception of lupus activity and flares, and this discordance can impact communication, trust, medication adherence, and ultimately outcomes. We developed the Type 1 and Type 2 model many years ago as a means to bridge this gap.

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Moneyball Rheumatology (5.30.2025)

Jack Cush, MD

Dr. Jack Cush reviews the book/movie, "Moneyball" and a suggests moneyball strategy is needed to find next level responses for our patients.

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#EULAR2025 Abstr#POS0677 I will be at Poster Area today (1530). Single centre (N=23): Rituximab vs Cyclophosphamide for #Sjogren-Neuropathy. No superiority but clinical response was more complete & longer retention numerically favouring RTX. Support trial of BCDT in SjD @RheumNow https://t.co/87e6yFMRkk

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Rheums! Have a rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/f3nm9awojS https://t.co/dOaVZpDAWH

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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)

Systematic review of fibromyalgia & sleep quality - 47 RCTs, 11094 pts showed CBT for insomnia had a significant improvement in sleep quality; but CBT for pain had no impact. Only moderate improvement w/ pregabalin, sodium oxybate; but no effect w/ amitriptyline, milnacipran, https://t.co/bArizMLGR8
Dr. John Cush RheumNow ( View Tweet)
Let the young know they will never find a more interesting, more instructive book than the patient himself." – Giorgio Baglivi

Dr. John Cush RheumNow ( View Tweet)

PETRI-isms: "The patient is always right (even when they are wrong)." - Dr. Michelle Petri

Dr. John Cush RheumNow ( View Tweet)

Review of ARF & Post-streptococcal reactive arthritis (PSRA) following Group A strept infxn. Early Dx & Rx of Strept can prevent ARF & PSRA. PSRA is a sterile arthritis, bimodal age onset, lower extrem arthritis, usually resolves without lasting sequelae https://t.co/ld208yf0Zk

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Save the date! RheumNow will be at EULAR '25 June 11-14. https://t.co/J0dq4PWf6q
Dr. John Cush RheumNow ( View Tweet)
Moneyball Rheumatology (5.30.2025) Dr. Jack Cush reviews the book/movie, "Moneyball" and a suggests moneyball strategy is needed to find next level responses for our patients. https://t.co/c79y9UNTcQ https://t.co/at7mDderOP

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Dr. John Cush RheumNow ( View Tweet)
2025 ACR Guideline for the Treatment of SLE The ACR has released its 2025 Systemic Lupus Erythematosus (SLE) treatment guidelines and consensus-based good practice statements, applicable to children and adults with SLE. https://t.co/2NFwTllLZa https://t.co/Q6smp1ZVH2

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Dr. John Cush RheumNow ( View Tweet)
QUOTES TO LIVE BY: "it took me a long time be a good listener and be comfortable with silence. Its important to not just throwing facts back to patients who are suffering. Sometimes pausing is powerful. Its all about establishing relationships " - Dr. Len Calabrese https://t.co/wcKX8nTa2o
Dr. John Cush RheumNow ( View Tweet)
JAMA -- Full read review "Uveitis in Adults:" - affects adults 20 to 50 years - noninfectious anterior uveitis: corticosteroids 1st line Rx - posterior noninfectious uveitis: DMARDs 1st line Rx; Biologics 2nd line https://t.co/BJQkPtK2z2 https://t.co/9zAntZK66Q

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Dr. John Cush RheumNow ( View Tweet)
2025 ACR Guideline for the Treatment of SLE The ACR has released its 2025 Systemic Lupus Erythematosus (SLE) treatment guidelines and consensus-based good practice statements, applicable to children and adults with SLE. https://t.co/2NFwTllLZa https://t.co/i5Q5UfE9v3

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Dr. John Cush RheumNow ( View Tweet)
Emulation Trials in SLE: Real or Fake Dr. Janet Pope, Ontario, Canada, discusses emulation trials in systemic lupus erythematosus. https://t.co/wVmMfLVAuQ https://t.co/V4VGVncSE9

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Dr. John Cush RheumNow ( View Tweet)
2024 ACR Lupus Nephritis Guidelines: The Controversies Drs. Maria Dall’Era & Michelle Petri discuss the sticking points in the latest lupus nephritis recommendations. 🗣️ Insightful, honest, and essential for your practice. 📍Full update on RheumNow: https://t.co/KPjyCrMTBr https://t.co/VoOslSqs99

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Dr. John Cush RheumNow ( View Tweet)
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