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The Long View of Diagnostic Delay in Axial Spondyloarthritis
Axial spondyloarthritis (axSpA) remains a diagnostic challenge, particularly in its early stages before structural sacroiliitis is visible on imaging.
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RESET-RA, RCT of vagus nerve stim (device that zaps pts in neck)
Marginal improvements in ACR20 at wk 12; trend in to improvement in unblinded part of study fwiw
Have never seen result that is more likely to be driven by plbo effect & unblinding 🤪
@RheumNow #ACR25 Abstr#2278 https://t.co/BlR570nv7k
Links:
Mike Putman EBRheum ( View Tweet)
Late Breaker: Observational study of MEPO in EGPA
375 pts receiving MEPO had less ARF/CKD than 727 pts receiving standard of care
Smallish event #'s & lots of p values... also, what about the vasculitis?!?
#ACR25 @RheumNow AbstLB16 https://t.co/XwqNthfwPF
Links:
Mike Putman EBRheum ( View Tweet)
Semaglutide isn’t just for weight loss?
In RA, users had 20–40% lower risk of synovitis, stiffness & swelling up to 1 year vs matched controls.
GLP-1 agonists may offer anti-inflammatory benefit beyond metabolism.
@RheumNow #ACR25 Abstract#2286
Jiha Lee JihaRheum ( View Tweet)
Adding social risk factors to the mix
Abstract 1917: WashU Rheumatology examined SRF screening in the clinic
🔹 50% screened once; 1/3 screened > 1
🔹 Core SRFs (finance, transport, housing, food) relatively stable
🔹 Biggest change over time: stress
@RheumNow #ACR25 https://t.co/oKlwMZ77nB
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
The CAR T engine doesn’t stop! LB04: Phase 1 bispecific CD19/BCMA CAR T in refractory autoimmune disease 🚗💥 ✅ Low AEs (mostly Gr 1–2 CRS, hematologic) 💪 Robust efficacy in lupus nephritis 🔄 Deep B-cell depletion → naïve B-cell repopulation @RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Effect of air pollution in RA
Prospective cohort 1000+pts w/ 12000+ visits
Higher levels of pollution
& specific size of particles PM25
asso w/
-10% higher odd of flare
-Higher DAS CRP and CDAI
Now the interesting pattern:
PM25 exposure increases 3 weeks before flares https://t.co/MOskJzk05g
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
CD19 counts during RTX maintenance therapy do NOT perform well in assessing the risk of relapse
Interestingly, only younger age was associated with relapse in this retrospective study
@RheumNow #ACR25 Abst 1766 https://t.co/crsFKJ0LnP
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Can AI predict who stops their RA meds?
In older adults on b/tsDMARDs, interpretable ML found frailty, comorbidity & age top the list for nonadherence risk.
@RheumNow #ACR25 Abstract#2287
Jiha Lee JihaRheum ( View Tweet)
Hojiej et al. Prevalence and Impact of lifestyle factors in PsA. Lifestyle factors impacted disease activity. Cumulative effect of increasing number of factors @RheumNow #ACR25 Abstr#2309 https://t.co/oDGQyLBRDO
Richard Conway RichardPAConway ( View Tweet)
In DISCOVER-2, male PsA patients had greater radiographic progression than females despite similar baseline scores. Early joint response (W8 cDAPSA LDA) was linked to less progression more strongly in men. Highlights the sex differences in PsA outcomes. Abstract#2345 @RheumNow https://t.co/zIo59FYPVg
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Macedo et al. Increasing exercise improved QoL in axSpA. Mobility limitation and obesity worsened it. At least to some degree these effects appear independent. @RheumNow #ACR25 Abstr#2326 https://t.co/Ei4cKTNHyn
Richard Conway RichardPAConway ( View Tweet)
A prediction model for RA-ILD in RA pts: is it possible?
Not quite yet!
Veterans Affairs RA registry 2700+ pts
5% of prevalent ILD
Associated w/
-GDF-15
-Pentraxin 3
No prediction for Incident disease
Needs more work to understand implications for practice
@RheumNow #ACR25 https://t.co/CmW72nybcQ
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Simulation modeling by Patel et al helps generate probability of remission, relapse, and adverse events in newly dx AAV
Projected risk by model were similar to observed rates in RCTs
@RheumNow #ACR25 Abst 1764 https://t.co/xevkJ2Ih0M
Links:
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
This cohort study from Ontario of 🚺w/axSpA
✳️GDM, antepartum hem, SMM (severe maternal morbidity) -⬆️ in axSpA
✳️Neonat complications-preterm birth
Factors assoc w/SMM- age, comorbidity, gestational age at delivery
Better strategies for maternal care
#ACR25 @RheumNow Abs2200 https://t.co/LrVzJLnvWe
Links:
sheila RHEUMarampa ( View Tweet)
#1727
360k+ postmenopausal women w osteoporosis: >1/3 untreated patients were at v high fracture risk, yet few received recommended anabolic or antiresorptive therapy.
Even among treated women at very high risk, >50% were still on oral bisphosphonates
@RheumNow #ACR25 https://t.co/9S66tAU68P
Mrinalini Dey DrMiniDey ( View Tweet)
Excited (and a little nervous!) to be presenting on a topic I’m very passionate about- social determinants of health & shared decision making, alongside some fantastic speakers & chairs.
Join us in room W184D, 10:00-11:30
Looking forward to a lively discussion!
#ACR25 @RheumNow https://t.co/FsDDrjisR3
Mrinalini Dey DrMiniDey ( View Tweet)
SLGT-2 and GLP-1 in RA: More than Weight Loss https://t.co/SRKMHNlHZo
Future of rheumatology is bright , Shreya Sakthivel discussed her work on TriNetX database , looking specifically for effect of SLGT-2. GLP-1 on RA flare incidence.
@RheumKay
@RheumNow
#acr25
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
In a retrospective study of TAK patients, ~about 1/3 developed new lesions on imaging over time
Most lesions:
- stenotic
- L carotid
- Abdominal aorta
- SMA
50% of the 1/3 = 2 or more lesions
Serial imaging is crucial!
@RheumNow #ACR25 Abst 1631
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Delay in PsA diagnosis
Meta Analysis of 32000+ pts
Median diagnostic delay 2.5 years
Median delay in referral 1 year
Increase odds of Rx damage from 50%
Geographic variation
We need to do better
#ACR25 @RheumNow #ABSTRACT1713 https://t.co/CWwqosa5NT
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
