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From Domains to Decisions: Personalizing PsA Care with Data
At EULAR 2025, Dr. Laura Coates (Oxford) took the plenary stage to reframe how we think about treating psoriatic arthritis. The message was clear: in 2025, PsA treatment is no longer about following a linear algorithm; it’s about understanding the unique constellation of domains, comorbidities, and patient factors that shape each clinical decision.
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Imaging and Early Detection in Psoriatic Arthritis
At EULAR 2025, there have been new developments in imaging in PsA.
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Cancer risk in rheumatoid arthritis: anything new?
Is there a higher risk of cancer that comes with the disease? Or with the treatments? So many confounding parameters, such as disease duration, disease state, and disease activity come into play. A promising session explored comorbidities in Rheumatoid Arthritis, in particular cancer and cardiovascular events. Here are my takeaways.
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EULAR 2025 – Day 2 Report
Day 2 was a full agenda for those attending EULAR 2025 in Barcelona with sessions on the management of RA, Behcets, Lupus and Hand Osteoarthritis. Clinical overviews on MAS, Ehlers-Danlos, Difficult to treat RA and PsA offered a wide variety of options to rheumatologists. Here are a few interesting presentations from today.
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Impact of TNFi on efficacy of Vunakizumab in AS.
-Post hoc analysis of Vunakizumab
(humanized monoclonal IgG1/k antibody targeting IL-17A) trial on AS pts.
-440 total pts, 163 had prior TNFi exposure
- At week 16, no significant differences in ASAS20 b/w TNFi exposed pts https://t.co/O9PFOuLa5l
Adela Castro AdelaCastro222 ( View Tweet)
In BIODOPT study (RA, PsA, axSpA), disease activity-guided tapering of biologics (incl. biosimilars) maintained QALY (Δ0.008, NS) while lowering biologic costs (Δ€–1,979 [95%CI –3,798;–161]) & total hospital costs (Δ€–1,936 [95%CI –3,753;–119]) over 18mo. Supports https://t.co/CJUpfU2oRA
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Biologic switching in PsA:
-Retrospective study on 3,851 PsA pts initiating bDMARDs, 1,848 (48%) switched therapy at least once.
-TNFis were the initial therapy.
-IL17i were the first switch in both single-switch and multi-switch scenarios.
-Subsequent switches: back to TNFi https://t.co/tJDJvPeu9T
Adela Castro AdelaCastro222 ( View Tweet)
Data from COAST-V study (post hoc)
🔹️Ixekizumab in #axSpA
🔹️Efficacy stratified by CRP level
🔹️Better treatment response in the elevated compared to the normal CRP group
OP0699
#EULAR2025
@RheumNow https://t.co/1mVoly3Gws
Nelly ZIADE 🍀 Nellziade ( View Tweet)
In RCT of RA pts in remission/low disease activity, spacing ozoralizumab (next gen TNFi) or reducing MTX led to more flares vs continued tx; but most pts in remission at baseline maintained LDAS.
Remission matters for subsequent Tx reduction.
@RheumNow #EULAR2025 #LB0006
Mrinalini Dey DrMiniDey ( View Tweet)
APEX study Ph3 RCT Guselkumab
In BioNaive active PsA w/ erosions>=2
wk 24
ACR20 GUS Q4W 67% Q8W 68% vs PBO 47%
Less Rx progression in both Q4W & Q8W vs. PBO
#EULAR2025 @RheumNow LB0010 https://t.co/OVDWWECtOZ
Aurelie Najm AurelieRheumo ( View Tweet)
APEX Phase 3b trial: #guselkumab (Q4W or Q8W) reduces joint damage in #PsA
✅ ACR20: 67–68% vs 47% (PBO)
✅ ↓radiographic progression (vdH-S: 0.55/0.54 vs 1.35)
No new safety signals identified.
@RheumNow #EULAR2025 #LB0010 https://t.co/LLN1TXvOC3
Mrinalini Dey DrMiniDey ( View Tweet)
Management and prognosis of RP by @Lupusreference
1. Pts with mild disease respond to GCs
2. NSAIDs/colchicine good alternatives
3. Most common biologics used: TNFi and IL6i
4. Consider CYP in life threatening dz/ICU pts
5. Dynamic CT assess tracheal collapse.
6. PET-CT can ≠ https://t.co/PNUecMZvkT
Links:
Adela Castro AdelaCastro222 ( View Tweet)
In the APEX Phase 3b RCT (N=1020), guselkumab (IL-23p19 inhibitor) significantly reduced radiographic progression (ΔvdH-S 0.55 & 0.54 vs 1.35 PBO; p≤0.002) and improved ACR20 (67–68% vs 47%) at W24 in biologic-naïve PsA. Safety consistent with prior data. Abstract LB0010 https://t.co/mFDsBsCg6m
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
NMA of 14RCTs (>2500 pts) eval relative efficacy of bDMARDs and tsDMARDs in mostly biologic naïve nr-axSpA pts.
-All therapies studied significantly improved ASAS40 response rates compared to placebo.
-Certolizumab and Golimumab were the most effective therapies, followed by https://t.co/BJLRpEDYrv
Links:
Adela Castro AdelaCastro222 ( View Tweet)
👁️Uveitis in axSpA:
-Up to 40% can present before SpA dx
-NMA of 44 RCTs showed tx with TNFi, JAKi and IL-17i protective effects against uveitis
-Low rates of uveitis in axSpA pts on BIME trials suggests its possible beneficial effects.
#EULAR2025
@RheumNow https://t.co/mPuSMnD1Zs
Links:
Adela Castro AdelaCastro222 ( View Tweet)
Tofacitinib vs biologics in PsA:
📍MI/stroke ✅ similar
📍Serious infection ✅ similar
📍Malignancy ✅ similar
📍VTE ❌ higher vs TNFi (aHR 0.26)
Large US claims study (n=48k)
Abstract POS0296 @RheumNow #EULAR2025
Jiha Lee JihaRheum ( View Tweet)
Should we still be worried about lymphoma developing in RA patients?
Incidence has plummeted with modern therapy, although still a small risk. TNFi and other bDMARDs don’t seem to confer any real risk.
So what should our approach be?
Karin Hellgren #EULAR2025 @RheumNow https://t.co/9ZodpojSaz
David Liew drdavidliew ( View Tweet)
In PsA, can we better pick IL-17A inhibitor responders (after TNFi failure)?
Transcriptomic profiling is going to get better at telling us which pathways are truly important for response to specific treatments
POS0232 #EULAR2025 @RheumNow https://t.co/uycuXB0TFK
David Liew drdavidliew ( View Tweet)
#RITAZAREM: infection risk during RTX induction in AAV was ↑ w/ lung disease & nodules/cavities; ↓ w/ TMP-SMX prophylaxis. Early infections predicted later ones, but risk didn’t differ by RTX vs AZA. Pulmonary damage is a key red flag for infection
@RheumNow #EULAR2025 #OP0167
Mrinalini Dey DrMiniDey ( View Tweet)
#infections in #JAKi
@drdavidliew
#JAKi sl ⬆️ infection risk vs #TNFi
⬆️HZ w JAKi
JAKi same risk w #latent #TB #LTBI and new TB ⬇️in JAKi v bDMARDs
He didn’t discuss TYK2i
Reassuring - risk⬇️ over time for infection
@RheumNow #EULAR2025 @eular_org
JAKi & infection https://t.co/KVsY2gXVkQ
Links:
Janet Pope Janetbirdope ( View Tweet)
