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Systematic review of 10 studies showed TNFi exposure in utero not assoc w/ incr risk of infant severe infxn (4 RCTs); same for breast milk exposure (2 RCTs). Infant vaccination outcomes unaffected by TNFi use, but rec delaying BCG vaccination if TNFi exposed https://t.co/02Nn6TuzR3

In 2024, 77 pts referred to Rheum for possible PMR were ultimately Dx w/ B19 viral infx. 96% had arthralgia & 7% had PMR-like features (5/5 w/ BL shoulder/neck. prolonged AM stiff, fever & Hi CRP/ESR - none had hip pain. 4/5 were male, w/ mean age of 55 yrs. None were RF/CCP+ https://t.co/AiK2K9whBH

Hospitalization in Stills: Is it "Still" an infection? Dr. Janet Pope discusses abstract 0163, "Trends in hospitalization and outcomes among patients admitted with Adult-onset Still’s disease in the United States: INSIGHTS FROM THE NATIONAL INPATIENT SAMPLE (2016-2022)," https://t.co/3Z0U9XN3nx

Why are vaccine Abs maintained after CAR-T -depletion of pathogenic #Abs are dampened/eliminated Clonal repetoire expansion Remission=naive B cell pop'n Reset immune system sparing memory cells vs ?not all pathogenic cells eliminated in tissue #ACR25 @RheumNow @ACRheum #26S21 https://t.co/jb3dD5Ssip

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Another toxicity signal to watch in the CAR T space: LICATs Abstract 1537 reports a new immune-related toxicity distinct from CRS or ICANS: 🔹Affects organs prev involved in autoimmune dx: skin (35%) and kidneys (22%) 🔹Mostly mild (Grade 1–2); 3 cases Grade 3 @RheumNow #ACR25 https://t.co/mtZh47nWtv

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CAR-T toxicity in hematology (the things we have to look out for in rheumatology, as application of CAR-T potentially broadens) @andrew02114 @MGHCancerCenter with the heme-onc point of view in the #ACR25 BCRC @RheumNow https://t.co/1YjadL7LCF

Post-CAR-T myelopathy has been an issue in heme onc, and is still an unpredictable quantity without a clear cause. Will this be a problem for autoimmune CAR-T as we gain more experience? @CarolineDiorio @ChildrensPhila in the #ACR25 BCRC pre-meeting @RheumNow https://t.co/RhhdOiyEAX

#2682 In a randomised trial of 320 RA patients, the recombinant zoster vaccine (RZV) was safe and did not trigger disease flares. But methotrexate use and older age significantly blunted antibody responses ➡️key factors to consider for vaccine strategies in RA. @RheumNow #ACR25

Observational study from VCRC AAV patinet, >70% had pulm involvement at some point As expected, nodules favor GPA (63% vs 12% MPA) & DAH favors MPA (61% vs 31%) More ILD in MPA (11% vs 1%) & more endobronchial in GPA (12% vs 2%) Helpful pearls! @RheumNow #ACR25 Abstr#0721 https://t.co/Iu5MdiTABR

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Cohort study comparing 3yr safety outcomes of JAKi vs. TNFi in AS pts JAKi use: ⬆️incidence of HZ infxn but not significant; ⬆️all-cause mortality (HR 4.94) and GI bleed (p=0.04) Individualize tx. consider potential complications #ACR25 @RheumNow Abs2633 https://t.co/pjKAazQFwW

Lung Disease in ANCA-associated Vasculitis Dr. Mike Putman discusses abstract 0721, "Pulmonary Manifestations of Granulomatosis with Polyangiitis and Microscopic Polyangiitis", presented at #ACR25. https://t.co/A5uKT4jG1I https://t.co/7E4k7QdiNK

https://buff.ly/sOoeyqA

In a retrospective TrinetX analysis of 3 year safety outcome in AS, JAKi use was linked to higher mortality and GI bleeding vs TNFi, but lower malignancy risk. Infection rates were similar, with a trend toward more herpes zoster in JAKi users. Abstract#2633 @RheumNow #ACR25 https://t.co/pPY0wpAKA3

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Adverse events from avacopan the WHO pharmacovigilence database (VigiBase) Not a lot new - infections happen, hepatic events happen but seem to be somewhat rare Pharmacovigilence is hard; most events go unreported & we often have the classic "denominator problem" (ie we saw https://t.co/28tYkXv0Lz

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Infection vs steroid sparing in PMR/GCA/AAV studies with steroid-sparing Rx GiACTA (1, top right) aside, - low infection rates - the more steroid saved, the less the infection risk Infection risk in vasculitis is driven by steroid, not DMARD #ACR25 ABST2526 @RheumNow https://t.co/UprbxUQyQC

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#ACR25 How hard will you go & at what cost? A study in China using CD20/BCMA Bispecific autologous CAR-T showed profound depletion, normalisation of abs and good response in #SLE (10/11 had LN). But 2 had G3 infections & cytopenia. Presenters said some had IVIG @RheumNow #ACRBest https://t.co/TF0wpib5rr

#1747 Serious infections ~2× more common in RA-LD, esp RA-ILD. Pulmonary, bacterial, viral & fungal infections all increased, underscoring need for tailored prevention and vaccination. @RheumNow #ACR25 https://t.co/soyzqLk7Vj

https://x.com/DrMiniDey/status/1983215181129031750/photo/1

#ACR25 Abstr#LB02 Is there a role for JAK-i for the treatment of IgG4-RD? Opel label RCT in China (N=58) showed NO relapse in Tofacitinib + GC taper vs GC Taper alone (54%). No serious infection. Interesting and a PBO-controlled is warranted @RheumNow https://t.co/dFvAmcGfCT

https://x.com/Yuz6Yusof/status/1983213337606291939/photo/1

EGPA relapse in MANDARA including OLE Majority of relapses are asthma / sinonasal in nature Of non-airway: - arthralgia/myalgia - sensory peripheral neuropathy @RheumNow #ACR25 Abst1769 https://t.co/cPjjzl4RWS

MSK side effects of CAR-T, based on FAERS pharmacovigilance data (also see @DrGomezPuerta in @seminarthrheum https://t.co/LnwjU5aebs) #ACR25 ABST1731 @RheumNow https://t.co/kREEy3HLE9

Is RA-ILD associated with/ higher risk of infection? Retrospective US cohort study 151 RA-ILD 980 matched controls 79% higher risk of any and pulmonary infections in RA-ILD Pathogen type: bacterial, viral and fungi Some of these infections are preventable! Take Home: https://t.co/fPmRjLL7Po

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