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Drs. Jack Cush & Arthur Kavanaugh, two of rheumatology’s most trusted voices, provide a breakdown of the latest breakthroughs and hottest topics in rheumatology from the 2025 ACR Convergence meeting in Chicago.
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Here's the last installment of our "ACR Best" abstracts as chosen by the RheumNow faculty. Most of these were from the final, day 4, but a few were noteworthy holdovers from day 3. Enjoy!
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Promising novel mechanisms of action always create excitement, but the immune checkpoint PD-1 has cemented itself in the news far more than most. This fame is primarily from therapeutic inhibition in cancer and rheumatological inflammatory sequelae that emerge, but invoking the inverse and using PD-1 agonism to treat classical autoimmunity has subsequently been making its own mark. Given the evident plausibility, how do we feel about invoking the opposite and agonising PD-1 in classical autoimmunity?
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At ACR Convergence 2025, abstract 1039 entitled, “Global Cost-Effectiveness and Equity in CAR-T Cell Therapy for Rheumatoid Arthritis” adds a critical dimension to the growing enthusiasm around cellular therapies in autoimmune disease.
Dr. John Cush
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This and other reports on palindromic rheumatism show that PR is a pre-clinical RA state, both having same predictive factors for progression to RA! https://t.co/jfpraGfe72
Dr. John Cush
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Rheumatology’s Blind Spot: The Persistent Exclusion of Older Adults
In RA alone, nearly 40% 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 https://t.co/2pqXGURQtL
David Liew
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Not only lovely work @TheLancetRheum from @jeffsparks and friends, but they have some AI imaging work up tomorrow from the same SAIL-RA cohort, showing the spectrum of impact in all RA patients, using radiomics.
Check it out #ACR25 ABST1751 @RheumNow
https://t.co/TlmHOOpNNp https://t.co/P62RXI8ePQ
Dr. John Cush
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Is Low Disease Activity Low Enough?
Drs. Jonathan Kay and Joel Kremer discuss abstract 0449, "Consistency of CDAI Low-Disease Activity (LDA) Outcomes with Time in a Large US Registry: Association With Patient-Reported Clinical Outcomes and Measures of Quality of Life". #ACR25 https://t.co/kI8qOYjVL4
Dr. John Cush
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💬 #ACR25 Topic Panels — LIVE!
Nov. 3 join RheumNow at 7 PM ET for a deep dives into the hottest topics in rheumatology:
👉 RA
Join Us Live on:
X • Facebook • YouTube • LinkedIn • https://t.co/V10S4oVFsv
Top experts. Real clinical insight. Don't miss these discussions https://t.co/i5UM0OBu86
Dr. John Cush
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RA: Inject the Steroids
Dr. Richard Conway reports on abstract 1355, "Use of parenteral compared to oral glucocorticoids in early rheumatoid arthritis is superior for chance of being off steroids and escalation of therapy at 1 year," presented at the #ACR25. https://t.co/xFQMIpi75S
Dr. John Cush
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Rheumatoid arthritis and the ‘big bang’ at #ACR25!
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?
https://t.co/QDvdiP3q9R https://t.co/cz4j4vZkSd
Dr. John Cush
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From Fitbit to first diagnosis: AI is rewriting the RA playbook
Two studies presented at this year’s #ACR25 meeting highlight just how close we may be to a future where algorithms flag disease before we can and monitor activity with minimal patient burden. https://t.co/8AwBZkyZIW
Dr. John Cush
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New Insights into Pregnancy Outcomes and Maternal-Fetal Health in Rheumatic Diseases
At #ACR25, the ACR presented new research illuminating critical challenges and advances in pregnancy outcomes for women living with rheumatic diseases, including axial spondyloarthritis, https://t.co/nJjtTMHnD3
David Liew
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Toxicity is the big question about CAR-T in RA - what did the CRS/ICANS profile look like in this German ph1 in RA?
Pretty good so far - but obviously will be under enormous scrutiny when we are looking at diseases with good existing therapies
#ACR25 ABST0471 @RheumNow https://t.co/xXyzOwLvx8
Akhil Sood MD, MS
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LB23: Regulate-RA- ongoing Phase 1 trial of autologous CAR-Tregs in refractory RA (no lymphodepletion)
🔹 4/6 pts had ↓ DAS28-CRP by wk 4 with rapid onset & ↓ joint counts at dose level 2
🔹 Synovial biopsies to date showed ↓ inflammatory score post-tx
@RheumNow #ACR25 https://t.co/JMBbLIEmJG
Janet Pope
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Will #PAD4 levels predict pts w #CCP positive #arthralgia who will develop #RA?
Leeds study - 79 at risk pts
PAD4 levels may predicting #rheumatoid #arthritis development
#ACR25 @RheumNow @ACRheum abst#832 https://t.co/dnAA6z3NJQ
Mike Putman
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Meta analysis evaluating age specific incidence across multiple registries (n=882)
Incidence 9.3 for women & 1.4 for men per 100k person-years
1. Wider distribution than I would have guessed
2. Much less age-dependency for men
@RheumNow #ACR25 Abstr#29W06 https://t.co/46dNGBZ45V
Mike Putman
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Phase 1 study of CAR-Treg in difficult to treat RA
4/6 pts had 50% reduction in TJC/SJC, no CYC/fludrabine required & good prelim safety data
CAR-T remains exciting, but less of the "totally magical everyone cured" stuff we saw w/initial CAR-T reports
@RheumNow #ACR25 https://t.co/kjBIkLCYpF
Mike Putman
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"Achieving good control of joint disease activity is probably the key objective of treatment of patients with RA-ILD"
- Gregory McDermott (Epi Abstracts, #2662)
Totally agree with this! SARD guidelines recommendingn drugs with mediocre activity in RA was surprising
@RheumNow
Mike Putman
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Excited about this target trial emulation in RA-ILD
Compared to RTX, NO significant difference in hospitalization/transplant/death for JAK, ABA, IL6 or TNF
Trends toward ABA and JAK looking better than RTX
Need trials for sure, but I like this project a lot
@RheumNow #ACR25 https://t.co/FQcphRvyHK
