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Clinical and Therapeutic Challenges in Connective Tissue Disease and ILD
Connective tissue diseases (CTDs) and interstitial lung disease (ILD) represent a challenging intersection of systemic autoimmunity and progressive respiratory impairment. Research presented at EULAR 2025 continues to highlight the importance of CTD-ILD and the evolving landscape of therapeutic options for patients with autoimmune ILDs.
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The great debate: are cannabis and cannabinoids a valid treatment option in patients with rheumatic diseases?
A thread 🧵👇🏼
@RheumNow #EULAR2025 https://t.co/KLZN9MvcFy
Aurelie Najm AurelieRheumo ( View Tweet)
Interesting debate today #EULAR2025 about medical cannabis - where relative harms have come up.
Would you rather be addicted to prescription opioids or recreational cannabis?
(not going to argue about cannabis addiction - let’s say social impact is equal)
@RheumNow
David Liew drdavidliew ( View Tweet)
#RCT of #vagus #nerve #stimulation in #bDMARD-IR #RA Pts
RESSET RCT
+RA #RCT w #VNS
But low response with stat significance
ACR20 1/4 sham vs 1/3 VNS
Would add on to new SoC? 🤔
#EULAR2025 @RheumNow #eular_org
#D2T- RA-session https://t.co/tR1pLPBr74
Links:
Janet Pope Janetbirdope ( View Tweet)
So we used to get taught about bimodal age distribution of RA onset - young people and old people.
Actually, it’s early middle age where RA diagnoses have now grown globally over 30y - right in peak productivity
Global Burden of Disease data
#EULAR2025 OP0240-HPR @RheumNow https://t.co/8yyrex00yy
David Liew drdavidliew ( View Tweet)
Even after having things laid out in a great debate, rheumatologists remain unconvinced by medical cannabis #EULAR2025 @RheumNow https://t.co/xMTvngS5N1
David Liew drdavidliew ( View Tweet)
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)
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)
GRAPPA defines :
- D2T-PsA (failed ≥3 therapies incl. ≥2 b/tsDMARDs)
- CM(complex to manage)-PsA (adds pain, comorbidity, complexity).
A needed framework to improve trial design & real-world care.
Do these definitions fit your clinic?
#OP0175 @RheumNow #EULAR2025 https://t.co/ot1bVLIYLA
Jiha Lee JihaRheum ( 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)
Are we all going to be replaced by robots?
Not just yet
ARTHUR trial: the robotic ultrasonographer
vs. human
While the concept is promising, and ICC with humans were low to moderate, the robot is overestimating grey scale scores in MCPs of both HC and RA pts
#EULAR2025 https://t.co/mTtbknu0lO
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
?fishing for + results #EULAR2025
⚠️opinion
be aware that results do not live or die on P values
Impt findings beyond primary endpoints may be Impt beyond P<0.05
Conversely
Unexpected P values in a database
❎interpret w caution
Consider as hypothesis only
@RheumNow
Janet Pope Janetbirdope ( View Tweet)
Software enhances treat to target outcomes for #RA GoTreatIT
P0S0750 ##EULAR2025 @RheumNow https://t.co/GpihWr5KLA
Links:
Bella Mehta bella_mehta ( 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)
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)
✨️ New Definition Alert
The GRAPPA definition of
C2M (Complex to Manage)
&
D2T (Difficult to Treat)
#Psoriatic_arthritis
A hope for having a homogeneous and widely accepted definition for future clinical research
Presented at #EULAR2025
Proft et al.
OP#0175
@RheumNow https://t.co/et9cuMROkb
Nelly ZIADE 🍀 Nellziade ( View Tweet)
Combination of LEF and MTX in RA: Yay or Nay?
#EULAR2025 @RheumNow
Aurelie Najm AurelieRheumo ( View Tweet)
Difficult-to-treat & early PsA at #EULAR2025
GRAPPA definitions: D2T-PsA (≥3 therapies incl ≥2 b/tsDMARDs with persistent inflammation); C2M-PsA (broader: comorbidities, pain, intolerance). 95% GRAPPA consensus.
Abstact OP0175 @RheumNow #EULAR2025 https://t.co/eqKmMPh80x
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
▶️Erosive hand OA
🔺Gull-wing erosion @ DIPJs ✅
🔺Saw-tooth erosions @ PIPJs ✅
#OA #Osteoarthritis #EULAR2025 https://t.co/5Hh4Ki9P8V
Dr Gurdeep S Dulay gurdeep_dulay ( 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)
