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Trends and Innovations from Barcelona (6.20.2025)

Jack Cush, MD

Dr. Jack Cush reviews highlights, trends and novel studies from EULAR 2025 in Barcelona from last week.

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heart in a puzzle

What would it take for JAKs to ROCK the boat?

David Liew, FRACP

JAK inhibitors have taken a beating over the last three years. The excitement and potential has been tempered by mounting cardiovascular safety concerns, but specifically in at-risk patients, compared to TNF inhibitors. So it is an intriguing idea to pair JAK inhibitors with something that might have a cardioprotective effect. It is therefore worth excitement that we have a therapeutic option to follow which does just that. At EULAR 2025, we have seen phase 2 results for CPL’116, and a simultaneous publication in The Lancet Rheumatology.

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Lung,AI,Pleura

A new mechanism of action in SARD-ILD

Aurelie Najm, MD, PhD

Nerandomilast, an inhibitor of phosphodiesterase 4B, orally administered, is a new mechanism of action to treat lung fibrotic diseases.

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pregnant woman

Add-on certolizumab in pregnant women with APS

Md Yuzaiful Md Yusof, MRCP(UK), PhD

Women with antiphospholipid syndrome and lupus anti-coagulant are at high risk of developing adverse pregnancy outcomes (APO). Usual care includes low molecular weight heparin (LMWH) and low dose aspirin (LDA). Despite these therapies, APO have been reported up to 40%.

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nurse,appointment,vitals

Nurse-Led Treat-to-Target Clinics

EurekAlert!

New studies shared at the 2025 annual EULAR congress in Barcelona highlight the benefits that nurse-led care can bring for both patients and healthcare systems.

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steroids.prednisone.pills_.jpg

How to properly use steroids in early RA

Janet Pope, MD, MPH, FRCPC

Guidelines differ on the early treatment of RA – ACR suggests not to use glucocorticoids (GC) and EULAR updated recommendations for RA treatment presented at #EULAR2025 continued to suggest early treatment with MTX and glucocorticoids. We do know that it is not easy to get a significant minority of RA patients off of prednisone.

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question mark

Methotrexate and Leflunomide combination in RA/PsA: Is it safe?

Aurelie Najm, MD, PhD

I asked the EULAR twitter sphere how they feel about combination of methotrexate (MTX) and leflunomide (LEF). The opinions are differing so far, with 50% reporting prescribing this combination often while 50% are worried of side effects. Several abstracts presented this year are providing further data to help us make up our minds in RA and PsA.

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Persistent Burden in Early RA Despite Disease Control: insights from CareRA Trials Advances in the treatment of rheumatoid arthritis (RA), particularly the treat-to-target strategy and the introduction of effective disease-modifying antirheumatic drugs (DMARDs), have improved https://t.co/cMiF6POKGS
Dr. John Cush RheumNow ( View Tweet)
Survey of 154 Saudi established #RA pts on MTX >3mos; 64% claiming #MTX intolerance & 36% w/ MTX Intolerance Severity Score (MISS) >6. But MTX intolerance was NOT related to dose or route of administration, meal or time of day. These were not new MTX starters https://t.co/6KWGcZvx4o
Dr. John Cush RheumNow ( View Tweet)
FDA has approved a SC autoinjector of Benlysta (BEL) for use in pediatric lupus nephritis & pts > 5rs of age for SLE and active LN. BEL SC dosing for Pediatric SLE: 200 mg qwk (>40 kg) or 200 mg EOW (q2wk) if 15-40 kg. https://t.co/xrMJUgdSWv https://t.co/UJ2LZ3dU5p

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Dr. John Cush RheumNow ( View Tweet)
Full read overview of MDA-5 Dermatomyositis (DM) - pathogenesis, findings, & Rx. MDA-5 DM is a rare, aggressive amyopathic form with distinctive skin findings & rapidly progressive interstitial lung dz. Rx includes Hi dose steroids, calcineurin inhib & IV CTX (maybe JAKi, MMF)

Dr. John Cush RheumNow ( View Tweet)

Add-on certolizumab in pregnant women with APS Women with antiphospholipid syndrome and lupus anti-coagulant are at high risk of developing adverse pregnancy outcomes (APO). Usual care includes low molecular weight heparin (LMWH) and low dose aspirin (LDA). https://t.co/qnnkFlhtiS
Dr. John Cush RheumNow ( View Tweet)
Methotrexate and Leflunomide combination in RA/PsA: Is it safe? Save I asked the EULAR Twitter community about the combination of Methotrexate (MTX) and Leflunomide (LEF). Opinions are split, with 50% prescribing it often and 50% concerned about side effects. In my practice, https://t.co/SZjLaEH1h2
Dr. John Cush RheumNow ( View Tweet)
Psoriatic Arthritis: Hit hard and Early Two studies found no significant benefit of early biologics over standard methotrexate treatment, but they did not focus on poor prognosis cases. The SPEED trial, funded by the NIHR, aimed to compare disease activity in 192 PsA patients https://t.co/pS9DdOOVCV
Dr. John Cush RheumNow ( View Tweet)
JAK Safety Update Dr. Jonathan Kay offers his perspectives on abstracts POS0150, POS0151, and POS0157 presented at the 2025 EULAR meeting in Barcelona, Spain. https://t.co/F8WzGohCj8 https://t.co/FguBLrmPzZ

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Dr. John Cush RheumNow ( View Tweet)
Steroids, Not JAKi, Are the Real Infection Risk Dr. David Liew reporting at EULAR 2025 in Barcelona, Spain. https://t.co/rLpyo1UNjd https://t.co/bDfdLTEM1N

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Dr. John Cush RheumNow ( View Tweet)
Safety of Recombinant Zoster Vaccine in Rheumatic Patients New work presented at EULAR focuses on the RZV, which contains recombinant glycoprotein E – the major target of CD4+T-cells. The abstract describes the tolerability and safety of RZV in patients with inflammatory https://t.co/NS3h9CdGIU
Dr. John Cush RheumNow ( View Tweet)
Cancer risk in rheumatoid arthritis: anything new? There is still a question I have a hard time answering with certainty when people living with rheumatoid arthritis ask me: Is there a higher risk of cancer that comes with the disease? Or with the treatments? So many https://t.co/6rbZg5Fr2k
Dr. John Cush RheumNow ( View Tweet)
Increased Risk of VTE in RA: Lessons Learned from 40 Years of Data Dr. Mrinalini Dey reports on abstract OP0070, "Trends in Incidence and Predictors of Incident Venous Thromboembolism in Patients with Rheumatoid Arthritis: A Population-Based Retrospective Cohort Study", https://t.co/JykR4Mxb9L
Dr. John Cush RheumNow ( View Tweet)
The Impact of Biologics on Methotrexate Adherence Dr. Aurelie Najm reports on abstract POS0563, 'Methotrexate biochemical adherence significantly reduces in new starters of biologic/targeted DMARDs: Results from the Biologics in Rheumatoid Arthritis Genetics and Genomics Study https://t.co/t7DEsJW35v
Dr. John Cush RheumNow ( View Tweet)
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