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EULAR 2025 – Day 3 Report
Highlights from today included presentations on imaging in vasculitis, a debate on whether to treat high risk pre-clinical RA, and EULAR Recommendations on a) Treatment of interstitial lung disease (ILD); b) Physical Activity in people with arthritis; and c) EULAR disease activity score for antiphospholipid syndrome and d) the management of SLE nephritis. Below are a few others that caught my eye today.
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FIBRONEER-ILD Ph3 PD4B inhibitor Nerandomilast
1100+ pts, 320+ w/ SARD-ILD wk52
FVC relative reduction of decline 9 mg bid 43% 18 mg bid 39% vs. PBO
HR 0.56 time to first acute exacerbation of ILD, hospitalisation for resp cause or death in higher dose group
11% https://t.co/CeXWB2GlOe
Aurelie Najm AurelieRheumo ( View Tweet)
#EULAR2025 Abstr#LB0003 Post-hoc analyses of Phase 3 RCT: Nerandomilast (with or without Nintadenib combo) in sub-group patients with autoimmune #ILD reported similar lung efficacy and safety over PBO, in line with overall trial population. Diarrhoea was common AE @RheumNow https://t.co/fxRdflCi9W
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Guselkumab in APEX study (PsA, n=1020, biologic-naïve):
🦴 Less joint damage: 0.55 vs 1.35 (placebo)
💪 More responders: 67–68% hit ACR20 on GUS
🛡 Safety: similar to placebo
GUS - selective IL-23i - delivers joint protection and symptom relief
LB0010 @RheumNow #EULAR2025
Jiha Lee JihaRheum ( View Tweet)
In RCT of RA pts in remission/low disease activity, spacing ozoralizumab (next gen TNFi) or reducing MTX led to more flares vs continued tx; but most pts in remission at baseline maintained LDAS.
Remission matters for subsequent Tx reduction.
@RheumNow #EULAR2025 #LB0006
Mrinalini Dey DrMiniDey ( View Tweet)
#EULAR2025 Abstr#LB0004 Phase 2 RCT of first-in-class, Enpatoran, TLR7/8-i in active #SLE despite SOC (Cohort B) reported nominal improvement in BICLA but no dose-dependent response. Greater effects seen on active CLE, high IFN-GS or high dose GC. No major safety signal @RheumNow https://t.co/aX4ier0rAy
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Enpatoran (TLR7/8 inhibitor) in SLE & CLE
- helps skin, others?
- suppresses interferon
lowest dose was highest response though (upsetting primary endpoint)
Promising, watch for the ph3
No photos allowed, but official slides:
https://t.co/1yX6XrYvKH
#EULAR2025 LB0004 @RheumNow
David Liew drdavidliew ( View Tweet)
💉Early results from a dose-escalation trial of novel CD19xCD3xCD28 trispecific antibody (CC312) in refractory #SLE show no ICANS or ≥G2 CRS, rapid B cell depletion & 100% SRI-4 response (n=5).
@RheumNow #EULAR2025 #LB0007 #CART
Mrinalini Dey DrMiniDey ( View Tweet)
#EULAR2025 Abstr#POS1155 Fatigue remains a management challenge in #SLE. Consistent with other endpoints achieved, Dapirolizumab+SOC improved fatigue (FACIT-Fatigue & FATIGUE-PRO) over PBO+SOC in a Phase 3 RCT @RheumNow https://t.co/rYujy2YjBl
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
APEX Phase 3b trial: #guselkumab (Q4W or Q8W) reduces joint damage in #PsA
✅ ACR20: 67–68% vs 47% (PBO)
✅ ↓radiographic progression (vdH-S: 0.55/0.54 vs 1.35)
No new safety signals identified.
@RheumNow #EULAR2025 #LB0010 https://t.co/LLN1TXvOC3
Mrinalini Dey DrMiniDey ( View Tweet)
#GameChanger
Subset analysis of #CTD Pts with
Progressive pulmonary fibrosis
#PPF
Ok background #nintedanib 1/3
❎lung IS
2 doses #PDE4Bi #nerandomilast vs #PBO
each dose ⬇️worsening #FVC vs PBO
⬇️lung events - hospital
⬇️death
GI A/E
#EULAR2025 Latebreakers I @RheumNow https://t.co/PWKEnpyyMN
Links:
Janet Pope Janetbirdope ( View Tweet)
Management and prognosis of RP by @Lupusreference
1. Pts with mild disease respond to GCs
2. NSAIDs/colchicine good alternatives
3. Most common biologics used: TNFi and IL6i
4. Consider CYP in life threatening dz/ICU pts
5. Dynamic CT assess tracheal collapse.
6. PET-CT can ≠ https://t.co/PNUecMZvkT
Links:
Adela Castro AdelaCastro222 ( View Tweet)
Results from open label
extension of BE-OPTIMAL:
-Bimekizumab in bDMARD naïve pts showed sustained efficacy after 1y until 3y.
-No significant major tolerability issues or major SE.
abstract #POS1294
#EULAR2025
@RheumNow https://t.co/VAEiciCR1z
Adela Castro AdelaCastro222 ( View Tweet)
ICI-PMR irAEs are sometimes underestimated compared to inflamm arthritis, but why?
ICI-IA and ICI-PMR look different, but at @HSpecialSurgery, steroid needs and disease impact for both are basically the same. Let’s not devalue either
@lovetolearn27 #EULAR2025 POS1200 @RheumNow https://t.co/NVq2tpjvdu
Links:
David Liew drdavidliew ( View Tweet)
#EULAR2025 Abstr#LB0007 Two’s Company, Three’s a Crowd! In 5 #SLE pts treated with CC312, a novel CD19/CD3/CD28 tri-specific ab in dose escalation showed rapid & B-cell depletion & all achieved SRI-4. No =>G2 CRS or ICANS. USP: off-the-shelf & overcome T-cell exhaustion @RheumNow https://t.co/6DZRj09JEQ
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
LEVI-04 (neutrophin-3 inhibitor presented as #ACR24 late-breaker in knee OA)
more good efficacy data, no rapidly progressive OA safety signal.
For us clinicians: impressive impact size, esp relative to alternatives.
Finally, something that works??
#EULAR2025 OP0374 @RheumNow https://t.co/iVdlwyaqrv
David Liew drdavidliew ( View Tweet)
In 631 axSpA pts (mean age 33y, 54% female) from DESIR cohort, high-dose NSAID use (ASAS NSAID index ≥50) not associated with incident hypertension (HR 1.01; 95% CI 0.98–1.02) over 72 months. NSAID anti-inflammatory effect may offset BP risk in axSpA. Abstract#POS0256 @RheumNow https://t.co/ELYWoJDyKJ
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#Shingrix #vaccination is Impt in #SLE
HZ vaccination works in SLE, safe – 1yr still good humeral & cellular immunity
-attenuation over 1 yr re #immune #responses
No major flares
#shingles is ⬆️ in #lupus
👇
abnormal immune response
#pred, #MMF #IS
POS1005 #EULAR2025 @RheumNow https://t.co/o8lDXgOhE1
Janet Pope Janetbirdope ( View Tweet)
How does #HCQ work in #SLE
Stabilizes lysomal membranes?
#Lupus pts on HCQ monoRx & low #SLEDAI were followed
Single cell seq
HCQ cytokine sigs May vary over time
IFN & OXPosph pathways
#Hydroxychloroquine in #LN - #IFN I&II
#EULAR2025 @RheumNow POS0983 https://t.co/0gMQh9MNlg
Janet Pope Janetbirdope ( View Tweet)
#TDM for #HCQ warns of #toxic #levels in #CRF
v low GFR <30, <60, <90, >90
400mg/d all in low GFR toxic
200mg/d 25% in low GFR toxic
6mg/kg/d – low GFR is too ⬆️
adjust HCQ dose for pts with CRF
POS0987 #EULAR2025 @RheumNow @eular_org https://t.co/vg2b87LuiE
Links:
Janet Pope Janetbirdope ( View Tweet)
