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If We Can’t Prevent RA, Can We at Least Prevent Difficult-to-Treat RA?
Two new studies presented this year tackle a key question: can our initial treatment choices influence who ends up in the difficult-to-treat category?
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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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Pooled data fr diff SLE cohorts by Dr SGarg et al were evaluated to determine an upper threshold tx range of HCQ
750-1150 ng/mL: safe & effective HCQ levels
>1150ng/mL-supratx, no added tx benefit
CKD st >/=3: 2x ⬆️odds of toxic hcq levels
#ACR25 @RheumNow Abs1722 #ACRBest https://t.co/RFx1VO0bov
Links:
sheila RHEUMarampa ( View Tweet)
#1723 Why is systemic autoimmunity more common in females?
Loss of X-chromosome inactivation maintenance in B cells (not T cells) amplifies interferon-driven disease, with increased autoantibodies, inflammation and renal injury. Key mechanistic advance. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
3rd plenary session!
#1722 Defining safe HCQ levels in SLE: whole-blood 750-1150ng/mL= therapeutic range; >1150ng/mL ➡️ ~2× toxicity risk; <750ng/mL ➡️ higher flare risk
CKD ≥3 increases odds of supratherapeutic levels
New era of precision monitoring in SLE?
@RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
Plenary 3, HCQ blood levels in SLE
HCQ level > 1150: 1.9x risk of HCQ toxicity
HCQ level < 750: 1.4x risk of active SLE
HCQ dose < 5mg/kg: 1.9x risk active SLE
My take home? Blindly reducing dose to <5mg/kg is BAD; use levels instead!
@RheumNow #ACRBest #ACR25 Abstr1722 https://t.co/UCBPAKAyon
Links:
Mike Putman EBRheum ( View Tweet)
Late-Breaking Trials in axSpA and PsA https://t.co/Fw8wiAPLoN
The amazing @Janetbirdope discussing head to head trials in Axial SpA and PsA with primary failure to TNF.
To switch to another TNF or IL17?
IL17 for my PsA patient for sure.
@RheumNow
#ACR25
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
#ACR25 Please find my video interview with Dr Kate Rochlin on a novel Bi-specific T-cell engager (BiTE) in development which binds to pan-gamma delta T-cell instead of CD3 to minimise risk of cytokine release syndrome side effect. Abstr#1535 @RheumNow
https://t.co/MOmUm41cyA https://t.co/TgIUGgWGw5
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
🎥 LIVE from #ACR25
Join us daily at 5 PM CST for RheumNow’s ACR Recap Live -
Your must-watch debrief of the day’s biggest breakthroughs, hot abstracts, and real-time clinical takeaways.
Streaming on YouTube Live, Facebook Live, X-Live & LinkedIn Live.
Save the time. Be part of https://t.co/ZgZM14L6ta
Dr. John Cush RheumNow ( View Tweet)
#ACR25 Please find my video interview with Prof Edward Vital @edvital on their work on International Consensus of Glucocorticoid Tapering Guideline in #SLE #lupus Abstr#1526 @RheumNow
https://t.co/MnQdcdASkG https://t.co/b7GMcnFU2m
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Management of cardiac and joint sarcoidosis. Use of TNFi in treatment refractory cases. Alana Nevares-Berrios @RheumNow #ACR25 https://t.co/hXOfkgQHP9
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#ACR25 Please find my video and take on Abstr#0646. Promising new Bi-specific T-cell engager (BiTE) other than Blinatumomab in #SLE @RheumNow
https://t.co/5JrLG41nsD https://t.co/KeY6AkHUNK
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#ACR25 Please find my video and take on Abstr#0803. Should we use Belimumab before- or after a trial of concentional immunosuppressant in #SLE? @RheumNow
https://t.co/ExIvrdJXw5 https://t.co/AVb5ohWwXZ
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( 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)
GLP-1 in Knee Osteoarthritis https://t.co/SxyVEAK1CZ
@bella_mehta Discusses role of GLP1 in OA and possible mechanisms of effectiveness ? weight reduction ? or doses it have anti-inflammatory -anti-fibrotic role ?
@RheumNow
#ACR25
Links:
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
Progressive BiTE in SLE 2 https://t.co/ykMQmSAdlb
More on BiTES in SLE by the one and only @Yuz6Yusof
Bi specific Tcell engager ( CD3-CD19).
@RheumNow
#ACR25
Links:
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
New Paradigms in RA Treatment https://t.co/CqpI2znglE
@jeffsparks Highlights new trials in RA
1-Neuro immune modulation ( Vagal nerve stimulation).
2-Targeting pathogenic T cells
3-T reg CAR-T ( Peace maker).
@RheumNow
#ACR25
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
Day 2 Recap: ACR Convergence 2025 Highlights https://t.co/b8XvrEsoLW
Such a great time to be a rheumatologist.
Fake rheumatology sounds like a great topic! Daily challenges and unusual presentations.
@DrMiniDey
@synovialjoints
@drdavidliew
@RheumNow
#ACR25
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
#ACR25 Abstr#0855 Five extra patients were added to complete IMPACT Open Label Phase 2 trial of add-on Certolizumab in APS women + LAC+ve. Results stood: primary endpoint was met (adverse pregnancy outcome=19.6%; lower than 20% expected). Significant enough to adopt @RheumNow https://t.co/zhFVGYXiaU
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
RheumNow’s expanded coverage of the #ACR25 annual meeting is sponsored by Bristol Myers Squibb, Novartis, and UCB. All coverage content is independently selected by RheumNow and its faculty.
Dr. John Cush RheumNow ( View Tweet)
