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What can we use to better predict MACE in RA patients?
ESPOIR cohort showed value of two cardiac biomarkers:
- hs-cTnT
- soluble ST2
Combined, predicted MACE even after adjusting for disease activity/traditional CV RF. We need something like this!
#ACR25 ABST1334 @RheumNow https://t.co/EUNDuuMaYD
David Liew drdavidliew ( View Tweet)
Loarce et al. Poor performance of CXR and PFT in diagnosing RA-ILD (compared to HRCT). Message is, if you think they have RA-ILD, you need to do CT. @RheumNow #ACR25 Abstr#1335 https://t.co/eeSTf72mvM
Richard Conway RichardPAConway ( View Tweet)
Who with #SSc-ILD will progress?
progression is non linear - can stabilize and worsen
Search for Predictive biomarker
For clinical care & enriching RCTs
Maybe #KL6 🤷♀️
Maybe IP-10, MIG
No strong #biomarker
Depends on what is used
#ACR25 @RheumNow @ACRheum
Abst#0882 #0883 https://t.co/lyTRUEY9SI
Links:
Janet Pope Janetbirdope ( View Tweet)
Don’t forget
👇
#lcSSc Pts can get and progress #ILD
1/3 of #limited #cutaneous #systemic #sclerosis #scleroderma GET ILD
From #EUSTAR
>14% progress
Esp +Scl70
Remember to screen #CREST Pts
& allow these Pts into lung disease trials
#ACR25 @RheumNow @ACRheum abst#0879 https://t.co/X15tUgClzN
Links:
Janet Pope Janetbirdope ( View Tweet)
TriNetX database 4000+ pts PsA + GLP-1 RA & 86000+ PsA non GLP-1 ctrls
Without much surprise GLP-1 treated pts had lower risk of MACE and death
Observational, retrospective study.
Now awaiting the prospective evidence.
RCT on the way but capturing MACE and death are always https://t.co/GWbAMC1mJK
Aurelie Najm AurelieRheumo ( View Tweet)
Summary take home points by Dr Highland
1. PAH and PH-ILD are associated with high mortality in patients with SARDs
2. Multimodal and early screening is recommended
3. “It takes a village” work with Pulm and Cardiology colleagues
@RheumNow #ACR2025 https://t.co/Xa7TecMOIe
Gabriela Martinez Zayas, MD MartinezZayasMd ( View Tweet)
Summary of (some) drugs in the pipeline for management of PAH. Slide credits: Dr Benjamin Freed @RheumNow #ACR2025 https://t.co/qazQNk4ovR
Gabriela Martinez Zayas, MD MartinezZayasMd ( View Tweet)
In a global retrospective study of 90,536 PsA patients, those on GLP-1 receptor agonists (n=4,104) had significantly lower risk of major cardiovascular events and reduced mortality vs non-users. Most common GLP-1 RA: semaglutide. Supports future research on cardiometabolic https://t.co/ccOL10gD5b
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Time for the 2nd plenary session! 🎤
#0849 GLP-1 receptor agonists in #PsA linked with lower mortality & fewer major cardiac events in >90K patients.
Promising data for inflammation, weight & heart health in PsA care. @RheumNow #ACR25 https://t.co/8zyrSrumOP
Mrinalini Dey DrMiniDey ( View Tweet)
This morning in the plenary, same theme, but in PsA:
Similar metabolic/CV concerns
Similarly benefit from GLP-1 RA
looking at TriNetX data again, reduced MACE
Now prospective trials in rheum disease, for both metabolic benefits & disease activity?
#ACR25 ABST0849 @RheumNow https://t.co/DHZN1hwbIG
David Liew drdavidliew ( View Tweet)
GLP-1 RA meds: we are just starting to see their impact in rheumatoid arthritis. We know metabolic, CV risk in RA, but what to do?
RA pts in TriNetX, obese non-diabetic
GLP-1 RA reduced 1y CV events & also all-cause mortality
Soon will be near-standard
#ACR25 ABST0445 @RheumNow https://t.co/4ptAHdmf9q
David Liew drdavidliew ( View Tweet)
#ACR25 Abstr#0773 Anti-MDA5 ab is assoc. with progressive DM-ILD. But MDA5 expression is also upregulated in IPF. Any new biomarker which can link these ILD?
Measuring reactivity to MDA5 (aa 201-300) epitope peptide may help identify poor ILD prognostics (with/out DM) @RheumNow https://t.co/rziwihKfIr
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
What is the #frequency of #CTD #ILD in #USA?
Data from #Marketscan >9K & #Optum ~20k CTD-ILD Pts
56-65 yrs, 3/4 F
?under ascertained #RA-ILD - low % but #SSc-ILD approx 16% clinically relevant
Same as Ont, Canada #SSc-ILD %
Not rare
#ACR25 @RheumNow @ACRheum
Abst#0154 https://t.co/imfSyOtYpC
Links:
Janet Pope Janetbirdope ( View Tweet)
SGLT-2 inhibitors and the prevention of autoimmune rheumatic disease
SGLT-2 inhibitors offer benefits beyond glycemic control, such as cardioprotective and nephroprotective effects, and modest weight loss. A recent study also suggests they may have immunomodulatory effects and https://t.co/grsgHFQic5
Dr. John Cush RheumNow ( View Tweet)
💊 SGLT2i vs GLP-1 in Lupus Nephritis
TriNetX evaluating the impact of GLP-1 agonists vs SGLT-2 inhibitors on outcomes of lupus nephritis
📊 GLP-1 use linked to better renal & CV outcomes in LN including:
⬇️ CKD progression
⬇️ Mortality
⬇️ Acute MI
@RheumNow #ACR25 https://t.co/v4LgKFDt68
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Upadacitinib in GCA doesn't just affect IL-6, it alters IFNg, known to be important in vascular change in GCA.
If UPA in GCA has some cardiovascular concerns extrapolated from RA, it also has some plausible cardiovascular benefits too that TCZ may not
#ACR25 ABST0751 @RheumNow https://t.co/rMetLPP9z6
David Liew drdavidliew ( View Tweet)
A closer look in skin toxicity of GCs in RMDs
GC Toxicity Index, LONG TOX prospective cohort
Frequent:
-Easy bruising 35%
-Atrophy 22%
-Hirsutism 17%
-Acneiform rash 15%
-Erosion/Tear 12%
GC-related Neuropsychiatric toxicity highly associated with/ skin, something to look out https://t.co/NfxG8JkxSP
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Retrospective study by Dr. Goudot et al. - pts w/D2T PsA had dactylitis, fibromylagia & ischemic cardiomyopathy
In multivariate analysis, FM & ischemic CM found to be RFs for D2T PsA
☝️Consider other dx if D2T PsA
#ACR25 @RheumNow ABS0566 https://t.co/FOXv6LbysZ
sheila RHEUMarampa ( View Tweet)
ILD found in 30% of Sjögren’s pts w/ HRCT.
A new nomogram-based tool (AUC 0.8) predicts ILD risk using age, ESR, C3, hypergammaglobulinemia & anti-La/SSB.
Goal: guide HRCT referrals & catch ILD earlier.
@RheumNow #ACR25 Abstract #0510 https://t.co/FvAprq8eol
Jiha Lee JihaRheum ( View Tweet)
Statins and SLE: To add or not to add? 💊
Abstract #0599: In an emulated target trial of patients with SLE, statin users vs non-users had significantly⬇️ risk of all-cause death in both ITT & per-protocol analyses.
- No significant differences in MACE or ESKD.
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
