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Psoriatic Arthritis: Hit hard and Early
EurekAlert!
Two recent studies suggest there is no significant benefit of early biologics over standard step-up care with methotrexate2,3, but these did not select for poor prognosis.
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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)
#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)
#infections in #JAKi
@drdavidliew
#JAKi sl ⬆️ infection risk vs #TNFi
⬆️HZ w JAKi
JAKi same risk w #latent #TB #LTBI and new TB ⬇️in JAKi v bDMARDs
He didn’t discuss TYK2i
Reassuring - risk⬇️ over time for infection
@RheumNow #EULAR2025 @eular_org
JAKi & infection https://t.co/KVsY2gXVkQ
Links:
Janet Pope Janetbirdope ( View Tweet)
JAKi: expanding RMD indications—but important safety concerns to consider
⚠️ Cancer: Neutral vs MTX/placebo, ↑ risk vs TNF
⚠️ Infection: ↑ with age, disease activity & GC use—not uniformly higher with JAKi
🗣️ Patients rank infection risk as top concern
@rheumnow #EULAR2025 https://t.co/RJRDWQjqNC
Links:
Jiha Lee JihaRheum ( View Tweet)
Age & dose ⬆️ infections in JAKi
Not all JAKi are created w equal risk
@RheumNow @eular_org #EULAR2015 @drdavidliew
#JAKi & #infection https://t.co/F7zLUBuzJR
Janet Pope Janetbirdope ( View Tweet)
Rheumatology #AI to optimize rheumatology triage. Only 53 percent correlation between the AIs diagnosis with rheumatologists final diagnosis. Not sure if we want 47 percent pts to drop off...without a chance for diagnosis?
#POS0883 #EULAR2025 @RheumNow https://t.co/UWsCHG00t1
Bella Mehta bella_mehta ( View Tweet)
#D2T #RA ~20%
#Polyrefractory 3%
Many reasons for d/c ing #Rx - D2T
AEs
Intolerance
Chronic pain
Etc
My approach is different depending on reasons why drugs were d/c
Ie ?obj inflammation vs pain or intolerance
@RheumNow @eular_org #EULAR2025
#whatmakes D2T RA difficult https://t.co/AL6TMVJIk9
Janet Pope Janetbirdope ( View Tweet)
POS0150: From 12 RA registries, JAKi starts fell by ~13% after FDA safety alerts.
Tofa & bari took biggest hits; upa growth slowed but offset losses.
Real-world prescribing adapts—but doesn’t abandon.
@RheumNow #EULAR2025 https://t.co/QZ5haW2vhX
Jiha Lee JihaRheum ( View Tweet)
Fascinating to see JAKi uptake in European JAK-pot centres
- tofa was already on the decline pre-ORAL Surveillance
- JAKi use (driven by upadacitinib) continues to grow, although maybe it’s slowed
Hopefully rational JAKi has its place #EULAR2025 POS0150 @RheumNow https://t.co/XRyHJVw821
David Liew drdavidliew ( View Tweet)
In #SLE, #HCQ levels >1150 ng/ml ↑toxicity risk w/o added benefit. Levels 750-1150 ng/ml linked to ↓disease activity.
CKD stage ≥3 doubled HCQ levels at same dose.
Supports monitoring & dose adjustment in CKD to balance safety & efficacy.
@RheumNow #EULAR2025 #OP0199
Mrinalini Dey DrMiniDey ( View Tweet)
PHOENYCS GO🏃: Dapirolizumab pegol (DZP) led to higher rates of LLDAS (41% vs 20%) & DORIS remission (19% vs 8%) at wk48 vs PBO+SOC. DZP showed earlier & more sustained disease control, advancing T2T in SLE.
@RheumNow #EULAR2025 #OP0201 https://t.co/zuxBELxTDd
Mrinalini Dey DrMiniDey ( View Tweet)
Ph 2 RCT CPL'116 dual inhibition JAK/ROCK
106 MTX IR pts
wk12 primary endpoint met (DAS28-CRP decrease) in 240mg arm vs. PBO
75% >= AEs, SAE 2: 1 MI, 1 bladder cancer
Authors suggest absence of lipids/LFTs disruption compared to other JAKs
Ph3 is awaited!!
#OP0193 #EULAR2025 https://t.co/TnnM410LfM
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
OP0195: MTX+LEF isn’t commonly used—but could it be a viable option after all?
In >1,100 RA pts, no link to liver fibrosis (FIB-4/APRI), modest ALT ↑, and fewer hospitalizations.
real-world safety data worth a second look.
@RheumNow #EULAR2025
Jiha Lee JihaRheum ( View Tweet)
ACQUIVAS: RTX-treated AAV patients had poor response to #pneumococcal vaccine PCV-13 (8% vs 45% in non-RTX). Boosting w/ PPV-23 helped a few but 48% failed to mount robust response. Time to rethink vaccine strategies in RTX-treated patients?
@RheumNow #EULAR2025 #OP0173 https://t.co/soU5qfwRib
Mrinalini Dey DrMiniDey ( View Tweet)
#MITIGATE subgroup analysis: Inebilizumab reduced flares & boosted remission across all #IgG4-RD subgroups. HR for flare vs PBO: 0.12-0.16 across sex/race. Similar results for all subgroups in achieving flare-free, treatment-free complete remission.
@RheumNow #EULAR2025 #OP0189
Mrinalini Dey DrMiniDey ( View Tweet)
There is still hope for vagal nerve stimulation in RA!
RCT RESET-RA 240+pts multibioIR
Implantable cervical device
Meets Primary endpoint ACR 20 wk12
Subgroup 1 prior bioDMARD ACR 20 wk12 46% vs 19% sham
EULAR Good response 61% vs 42% sham Wk 12
SAE rate 1.7%
#OP0190 #EULAR2025 https://t.co/DCON01XXgd
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
2-year #MANDARA data: Benralizumab shows durable remission, eosinophil suppression & OGC-sparing in EGPA. ~62-68% in remission at wk104. Low relapse rate, no loss of asthma control or decline of lung function. No new safety signals.
@RheumNow #EULAR2025 #OP0166 https://t.co/kXh2q2ilJF
Mrinalini Dey DrMiniDey ( View Tweet)
In SLEek LTE, ABBV-599 HD (BTKi+JAKi) & UPA 30mg sustained or improved disease control through 104wks: SRI-4 ≥82%, ↓flares, near steroid-free, no new safety signals. PBO-switchers improved too. Targeted oral combos look promising.
@RheumNow #EULAR2025 #OP0198 https://t.co/IHXC2iD0h6
Mrinalini Dey DrMiniDey ( View Tweet)
#EULAR2025 Abstr#OP0006. There is no standardised definition for complete renal response in #lupus nephritis. Post-hoc analysis of REGENCY showed Obinutuzumab + SOC was superior to PBO + SOC if endpoints for voclosporin and belimumab RCTs were used. Effect size ~13-16% @RheumNow https://t.co/q8MNAV8XF3
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
