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ACR25 Best Abstracts - Day 3
Tweeting about an ACR presentation or poster is a skill and sometimes art -- one that is mastered by the RheumNow faculty roving the halls and floors for the best new insights at ACR Convergence 2025.
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The Decade Ahead: Predicting Long-Term Proteinuria Risk in SLE
The ACR Convergence 2025 in Chicago opens with engaging topics curated for the global rheumatologist. As a clinician, I always look forward to sessions that provide updates and practical key points that I can bring home and apply to my practice.
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Turns out you can directly degrade NETs. Holy smokes
NETs critical in pathology of SLE & other dx
They’ve found you can target it
Enzymatic degrader fused to albumin
Proof-of-concept: degraded a patient’s SLE manifestations in hours
Definitely one to watch
#ACR25 LB22 @RheumNow https://t.co/HVEt8wFYmI
Links:
David Liew drdavidliew ( View Tweet)
#ACR25 Abstr#2411 How good is performance of 2019 ACR-EULAR #SLE criteria at the point of diagnosis in At-Risk ANA+ people? Our group compared this with Clinician dx -> high specificity(93.8%); low sensitivity(79.3%). Might be a cause why SMILE HCQ RCT failed in At-Risk @RheumNow https://t.co/6GNU2B2wvj
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
A deep dive into Lupus 🔬
Abstract 2601: Single-cell insights in SLE & pre-clinical autoimmunity
🔹 Plasmablast expansion → high disease activity & SLE risk
🔹 Metabolic activity varies by cell type
🔹 Established disease: ↑ glycolysis & OxPHOS changes
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Abstract 2360: Single-center lupus pregnancy cohort found that:
🔹 Absence of DORIS remission associated w/ adverse pregnancy outcomes (Pre-term, Pre-eclampsia)
🔹 This is along with known risk factors: antihypertensive use, prior nephritis, active disease
@RheumNow #ACR25 https://t.co/STg1NBeFPo
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Reaadmissions in sle pregnancies from 66k patients
Insurance and economics seem to be very important in predictions using machine learning.
Abst#2629 #ACR25 @RheumNow https://t.co/x2oo9TOxoh
Bella Mehta bella_mehta ( View Tweet)
#ACR25 Abstr#2601 At single cell level using CyTOF, metabolic activity varied btw HC & autoimmune groups but clusters in At-Risk ANA+ve appeared closer to #SLE. ANA+ve who progressed to AI-CTD showed Plasmablast expansion & enhanced glycolysis. Could be used as target @RheumNow https://t.co/jtrM1wvQLk
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
@RheumNow Obinutuzumab for lupus nephritis was a very recent FDA addition two weeks ago, and we’ll play catch-up with the hematologists to get familiar with it, including its safety profile
#ACR25 FDA Update @RheumNow https://t.co/h6bf4roGzB
Links:
David Liew drdavidliew ( View Tweet)
#IL2 #Rx in active #SLE?
Maybe 🤔
IL2 is tricky - low dose May help #SLE but too much of a good thing may have a neg impact.
RCT of IL2i in #SLE gave a good dose response and improved TRegs.
#ACRBest #ACR25 @RheumNow @ACRheum #LB01 https://t.co/F61qz5x5We
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Janet Pope Janetbirdope ( View Tweet)
#ACR25 Abstr#LB10 Promising 4-Year data of Deucravacitinib in blinded phase 2 RCT +LTE study showed efficacy inc. LLDAS and CLASI-50 response were maintained/improved over time in #SLE No concerning safety signal. Looking forward to Phase 3 results next year @RheumNow https://t.co/fZv82zJ6Q4
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#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
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Data from this retrospective cohort study by Alomari et al show that SLE pts on SGLT2is
⬇️rates of PulHPN (OR 0.79)
⬇️all-cause mortality (0.49)
⬇️hospitalizations (OR 0.56)
⬇️LN (OR 0.4)
vs non-SGLT2i users(p<0.001)
Impt role of SGLT2i as adjunct tx
#ACR25 @RheumNow Abs2438 https://t.co/NQJTzQwRCt
sheila RHEUMarampa ( View Tweet)
#ACR25 Abstr#LB01 After several smaller studies, a Multicentre, Phase 2b RCT of 152 #SLE pts in China. SRI-4 was met in IL-2 as s/c every other day for 12 wks, followed by weekly for another 12 wks vs PBO. Efficacy & T-regs expansion were dose dependent. On to Phase 3 @RheumNow https://t.co/L0rYr5D1R1
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Late Breaker: Phase 2 RCT of low dose IL2 in SLE
Dose dependent response in SRI4 over 12 weeks
& surprisingly high rates of LLDAS
Too early to know if useful, but worth evaluating in a phase 3
#ACR25 @RheumNow Abstr#LB01 https://t.co/oPOLG82nwi
Mike Putman EBRheum ( View Tweet)
The CAR T engine doesn’t stop! LB04: Phase 1 bispecific CD19/BCMA CAR T in refractory autoimmune disease 🚗💥 ✅ Low AEs (mostly Gr 1–2 CRS, hematologic) 💪 Robust efficacy in lupus nephritis 🔄 Deep B-cell depletion → naïve B-cell repopulation @RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
HCQ weight-based dosing: out
HCQ whole blood monitoring: in
Whole blood levels more precisely balance risks of SLE flare (under-dosing) vs. toxicitiy (over-dosing)
Many pt on <5 mg/kg had supra-therapeutic blood levels with risk for toxicity
@RheumNow #ACR25 #ACRBest Abst 1722 https://t.co/qIbACxAW39
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
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)
