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The 2025 Rheumatology Year in Review
The year 2025 presented numerous advances in rheumatology and related inflammatory and autoimmune disorders ranging from several new groundbreaking FDA approvals/indications, drug developments, game-changing guidelines and practices that will impact patient care for rheumatic diseases.
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Advanced Practitioner Biologic Prescriptions for Psoriasis
Advanced practice clinicians (APCs; nurse practitioners and physician assistants) deliver a large share of US dermatologic care, accounting for 37% of clinicians and 27% of dermatology visits by 2020. A current JAMA Dermatology reports APC drug spending trends in dermatology, with a focus on specialty medications (eg, biologics).
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Antirheumatic drug use with rheumatoid arthritis pregnancies
A nationwide Norwegian registry study of rheumatoid arthritis (RA) pregnancies showed that while medication use increased during pregnancy, many discontinued treatment during pregnancy, only to resumed it after childbirth.
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Subcutaneous Anifrolumab in SLE
Manzi et al. have published the results of the TULIP-SC trial that showed that weekly subcutaneous (SC) anifrolumab, when given to severe SLE patients, had comparable efficacy and safety to the approved intravenous (IV) anifrolumab. https://t.co/ruZM3Qftxb
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Rheum Survey> 40 yoF RA pt on Prednisone 5 mg/d is at increased risk for ?
Dr. John Cush RheumNow ( View Tweet)
FDA & Administration are deregulating artificial intelligence & promote widespread use, includes use of wearables & other AI-enabled devices. Commissioner Marty Makary updated two guidance docs defining use general wellness devices, clinical decision support software https://t.co/KnkYqCiroa
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Retrospective study of recombinant zoster vaccine Rheumatic (RMD) pts on DMARDs (32% JAKi) (114) vs 65 normals. HZoster reactivation: no controls vs 1in RMD. 1 Dz flare requiried steroids. Minor AE (ISR, HA, myalgia) seen in 17.5% & 21.5% w/ 1st & 2nd dose. RZV is safe in RMD https://t.co/Mu3OyA4EOD
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Metanalysis of 21 clinical trials, 2,100 adults, shows cannabis-based medicines (vs placebo) over 2-26 weeks are not effective in treating chronic neuropathy nerve pain, regardless if given as THC of CBD. https://t.co/ZOJrcMGZkr https://t.co/nqCWoFmaWp
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In Dec 2025, the FDA qualified total hip bone mineral density (BMD) assessed by DXA as a validated surrogate endpoint for osteoporosis clinical trials. Previously OP trials required fracture endpoints as primary efficacy measures, necessitating large 2-5 yr studies https://t.co/5t9rftwX4A
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ADJUST trial (248 JIA pts w/ Uveitis & inactive >6mos, either continued or weaned off adalimumab. ADA weaning resulted in more flares (68% vs 14%, mostly uveitis) w/ no protection from background DMARD Rx. Restarting ADA was mostly effective. https://t.co/ZWHfPl2UNl https://t.co/Fk1HES2UIc
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FIBROSCANS in 60 RA pts on #MTX for 5 yrs w/ liver studies. Mean age = 39.5yrs, w/ Dz Dur 8.2 yrs, mean BMI 24.4 & MTX 12.5–25 mg for ~8 yrs (cum dose 6728mg). All had normal AST, ALT, APRI, Abd US; fibroscan score = 170 ((steatosis grade 0). Only 4(6.7 %) had mild, fibrosis https://t.co/7SACsEYi37
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Diffuse Alveolar Hemorrhage in Rheumatic Disease
A retrospective, cross-sectional, single-center study of adult rheumatic disease patients with diffuse alveolar hemorrhage (DAH), demonstrates a high proportion have coexistent pulmonary infection and significant mortality risk. https://t.co/vpzF8Dnspr
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Subcutaneous Anifrolumab in SLE
Manzi et al. have published the results of the TULIP-SC trial that showed that weekly subcutaneous (SC) anifrolumab, when given to severe SLE patients, had comparable efficacy and safety to the approved intravenous (IV) anifrolumab. https://t.co/3DWNEXaO2x
Dr. John Cush RheumNow ( View Tweet)
Systematic review of cardiovascular death in systemic immune-mediated Dz (SIDs): 39 studies, 171,748 pts - SIDs assoc w/ signif. higher CV mortality (HR 1.26; 1.09-1.47; p = 0.002), especially for RA, SLE, GPA & females. 92% of CV deaths from acute coronary syndrome (ACS) https://t.co/ogLhqKMwON
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Metanalysis of Tramadol included 19 PBO-RCTs, 6506 pts, showing a very modest benefit on chronic pain (low certainty of evidence), but a doubling of risk for serious adverse events (OR 2.13); including nausea (NNH 7), dizziness (NNH 8), constipation (NNH 9), somnolence (NNH 13) https://t.co/0ZEIoy1gqC
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US Overdose Deaths have dropped in 2024 & 2025!. Overdose (opioids, heroin, fentanyl) deaths peaked at ~110,000 in 2022, fell a little in 2023, but plummeted (27%) to 80,000 in 2024. Reported deaths highes in the N. East & Atlantic states. https://t.co/P3mgrOzGhr https://t.co/eGOBhIx7ZB
Dr. John Cush RheumNow ( View Tweet)
Retrospective study of recombinant zoster vaccine Rheumatic (RMD) pts on DMARDs (32% JAKi) (114) vs 65 normals. HZoster reactivation: no controls vs 1in RMD. 1 Dz flare requiried steroids. Minor AE (ISR, HA, myalgia) seen in 17.5% & 21.5% w/ 1st & 2nd dose. RZV is safe in RMD https://t.co/Hf7HaGOLXd
Dr. John Cush RheumNow ( View Tweet)
101 Meditteranean pregnant RA compared to 236 non-RA controls. HCQ & SSZ (45-73%) most used; biologics less (25%). RA had signif more adverse preg outcomes - LBW (OR 3), C-section (OR 2.55), fewer neonatal deaths (OR 0.38). RA had more miscarriages (20 v 1%) & fewer live births https://t.co/3nTdXEbBHI
Dr. John Cush RheumNow ( View Tweet)
In Dec 2025, the FDA qualified total hip bone mineral density (BMD) assessed by DXA as a validated surrogate endpoint for osteoporosis clinical trials. Previously OP trials required fracture endpoints as primary efficacy measures, necessitating large 2-5 yr studies https://t.co/q8a7QmoIXs
Dr. John Cush RheumNow ( View Tweet)
Subcutaneous Anifrolumab in SLE
Manzi et al. have published the results of the TULIP-SC trial that showed that weekly subcutaneous (SC) anifrolumab, when given to severe SLE patients, had comparable efficacy and safety to the approved intravenous (IV) anifrolumab. https://t.co/yrAirr2R2Y
Dr. John Cush RheumNow ( View Tweet)
