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SLE Conference Preview: progress in biologics
The pharmacology treatment including biologics, cellular-based therapies, and Bi-specific T-cell Engager (BiTE) in systemic lupus erythematosus (SLE) is a rapidly expanding field of research that provides excitement and optimism to both the patients and the physicians.
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New Insights into Pregnancy Outcomes and Maternal-Fetal Health in Rheumatic Diseases
ACR Press Release
At ACR Convergence 2025, the American College of Rheumatology presents new research illuminating critical challenges and advances in pregnancy outcomes for women living with rheumatic diseases, including axial spondyloarthritis, antiphospholipid syndrome, and lupus.
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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)
SLE & arthritis: Is there a difference?
Abstract #0629:
- Non-deforming (ND): 73% | Jaccoud’s: 19% | Rhupus: 8%
- Vs ND, Rhupus had lower odds of type I IFN signature
- Time to deformities: Jaccoud's ~2 yrs vs Rhupus ~5 yrs
- RNP+ predictive of Jaccoud’s
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Managing lupus is complex. How do we ensure quality care?
Abstract #0218 convened 8 focus groups:
✅ Support for patient navigators
⚠️ Barriers: low resources, staff turnover
💻 Solution: EHR outreach workflow to flag missed visits & labs
@RheumNow #ACR25 https://t.co/BWaIMMEPit
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Abstract #0607: The age at diagnosis of SLE is rising in US based cohort📈
Those diagnosed ≥30 yrs were:
⬆️ More likely to have oral ulcers, hematologic features, +ANA
⬇️ Less likely to have malar rash or proteinuria
@RheumNow #ACR25 https://t.co/pMPVLg1xTZ
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Abstract 0196: Too many referrals, too few slots? A hybrid RN + MD referral cut wait times for patients with SLE by 26%
Median time to appointment 69 days --> 51 days
Next steps: streamline high-risk triage, reduce manual chart review
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Dr. Werth on the #SLE guidelines on tx of cutaneous LE:
🔅All patients should be on hydroxychloroquine unless with CI.
☝️Important! For SLE pts presenting with new-onset rashes, review/ask about medications; consider drug-induced SCLE.
#ACR25 @RheumNow https://t.co/ok5jAi7uO0
Links:
sheila RHEUMarampa ( View Tweet)
#ACR25 In a rush and wondering which abstract to look out for pertaining to new update on Biologics in #SLE #lupus? Please find my article on conference preview @RheumNow
https://t.co/usIXPsj5bm https://t.co/4wmWvDyv83
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#ACR25 Abstr#0772. Should we be worried of #SLE patients with low uPCR 0.25-0.49? Kidney biopsy in N=28 + poor prognostic (Non-White, active serology or active sediment)
- 71% had LN (No class IV or Mixed)
- 46% actionable LN
Cost-effectiveness data needed.
#ACRBest @RheumNow https://t.co/Bt3fuA3aJh
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Organ Specific Recommendations-ACR guidelines for Management of SLE by Dr Lisa Sammaritano. @RheumNow #ACR2025 https://t.co/ilKWG8CQbe
Dr M Nazibur Rahman, MD (Rheumatology) NaziburM ( View Tweet)
Plenary session at #ACR25!
#0772 When should we biopsy in SLE?
In pts with uPCR 0.25-0.49 g/g + LN predictors, 69% already had LN (many Class III/V). Low C3/C4 were most important factors.
0.5 g/g cutoff may delay diagnosis and treatment. Time to rethink thresholds? @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
Early, low level proteinuria is a harbinger in SLE. ~50% with elevated UPCR but <0.5 had actionable LN on early bx.
Risk factor = low c3/c4
Urine biomarkers promising
#ACRBest #ACR25 @RheumNow https://t.co/WuNPKeqeid
Links:
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
From Dr. Petri at Plenary - even small amounts of proteinuria are a PROBLEM. Reduction of microalbuminuria by even 10% improves mortality! #ACR25 @RheumNow https://t.co/hjmH26vXIb
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Topical therapies in cutaneous lupus - find the right level
Victoria Werth #ACR25 SLE guideline session @RheumNow https://t.co/o3gBuFkr4n
Links:
David Liew drdavidliew ( View Tweet)
For #SLE pleuropericarditis: recommendation intentionally tries to leverage use of colchicine/NSAIDs vs. GCs
But there are special situations where GCs are req’d:
> Concomitant active SLE
> CI to NSAIDs/Col
> Recurrent pericarditis
> Late pregnancy
> 💊interxns
#ACR25 @RheumNow https://t.co/sLL72t3Qhf
Links:
sheila RHEUMarampa ( View Tweet)
HIGH YIELD🚨Summary of Organ Specific Recommendations-ACR guidelines for Management of SLE by Dr Lisa Sammaritano. @RheumNow #ACR2025 https://t.co/ysSTKOz1ym
Gabriela Martinez Zayas, MD MartinezZayasMd ( View Tweet)
Year in Review: Regency Trial showed that LN pts given obinutuzumab achieved CRR at 76 wks (46.4%) vs. PBO.
Take note: the Regency trial did not evaluate the extrarenal effects of Obinutuzumab in #SLE, thats for a diff study.
#ACR25 @RheumNow https://t.co/WJssU1DbzZ
sheila RHEUMarampa ( View Tweet)
#ACR25 New ACR Non-Renal #SLE lifecourse Guideline. 3 strong recommendations:
- HCQ routinely unless contraindicated
- Taper GC to =< 5mg/d
- Escalate therapy in any organ system if refractory to initial therapy
*Organ-specific: Conditional recommendations only
@RheumNow https://t.co/w9rfcvwGHy
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
@ACRheum SLE Treatment Guidelines 2025
Key points:
- HCQ is standard
- steroids with precision
- immunosuppressive therapies early
- shared decision making
#ACR25 @RheumNow https://t.co/AYIXE6dLlW
David Liew drdavidliew ( View Tweet)
