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Stopping therapy in GCA
They say the easiest bit about GCA, like PMR, is the first week after you start steroids. Those fond memories belie the challenge of ongoing treatment in GCA. In a steroid-only world, there is only misery. Steroid-sparing therapies have changed this completely.
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Sooner May Still Be Too Late: Kidney Biopsies in SLE
#ACR25 kicked off with Plenary Session by Michelle Petri (Abstract 0772: Redefining When to Biopsy the Kidney in Patients with SLE. As part of a collaboration with the Accelerating Medicines Partnership, Petri and colleagues https://t.co/bU09vpcDew
Dr. John Cush RheumNow ( View Tweet)
In a 5-year EHR-based cohort, PsO patients initiating IL-17i had significantly lower incidence of PsA/IA vs IL-23i, IL-12/23i, or TNFi. IL-17i reduced time with PsA/IA by 45% vs IL-23i, 61% vs IL-12/23i, and 74% vs TNFi. Further research need investigate if IL-17i may delay https://t.co/0PTbXZpLbu
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#ACR25 Abstr#2695 Inguinal lymph node biopsies pre- and post-OBI, RTX, BLIN & CD19 CAR-T showed complete tissue depletion with CAR-T. B-cells reduced but often incomplete with protein-based depleters; OBI being the best. Still don’t agree with “immune reset” @RheumNow #ACRBest https://t.co/Sq7m9sXlLP
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#2660 In >8000 women, serum urate rose sharply during the menopausal transition, then plateaued after menopause.
Hyperuricemia reached 4-5% post-menopause, up to 18% in obesity or low eGFR.
Healthy body weight & kidney function pre-menopause may decrease HU later @RheumNow #ACR25 https://t.co/v6ai3lgAd2
Mrinalini Dey DrMiniDey ( View Tweet)
#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
Mrinalini Dey DrMiniDey ( View Tweet)
kids w
👇
Undifferentiated #systemic #autoinflammatory #disease
Rx #IL1i
N=33
=boys &girls 3.5 yrs Sx
Abst#2151
#ACR25 @ACRheum @RheumNow
There are many periodic fever syndromes
🤔some mutations are not yet discovered
Access to &use of
Anakinra
canukinumab
Rilonacept https://t.co/IyTx0nFxKC
Janet Pope Janetbirdope ( View Tweet)
#2659 In a large real-world target trial (>1.3M with T2D), SGLT2 inhibitors, esp dapagliflozin & empagliflozin, were assoc with lower risks of RA, lupus, vasculitis & other autoimmune rheumatic diseases vs DPP-4 inhibitors. Possible immune benefits of SGLT2i? @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR25 Please find my video summary on the Phase 3 RCTs results of Ianalumab in moderate to severe disease activity in #Sjogren Disease presented during Late Breaking Abstract session Abstr#LB24 #SjD @RheumNow
https://t.co/ngCAglwAO0 https://t.co/PaUYsxhBKS
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Abstract 2697: Compared to MMF, tacrolimus showed
- similar SRR by week 96 (58.5% vs. 69.2%, OR 0.62; 95% CI 0.29-1.29)
- similar time to renal AE/deaths (HR 0.70; 95% CI 0.37-1.35)
- serious AEs less frequent (12.3% vs. 30.8%)
@RheumNow #ACR25 https://t.co/o3LtgOp7St
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
In PsA patients, GLP-1 RA therapy led to significant weight loss and improvements in CRP, pain, lipids, and blood pressure. PsA outcomes improved proportionally with weight loss. Regression analyses revealed that each 1% reduction in body weight was associated with significant https://t.co/Pph1PjfOve
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Abstract 2696: Phase 1/2 study of rapidly engineered CD19 CAR T showed:
- rapid depletion of CD19 B cells w/ recovery by Day 90
- Days 180 and 360: returning B cells largely naive (CD27-IgD+)
- Interferon expression ↓ after CAR T treatment
@RheumNow #ACR25 https://t.co/FzdFbqWwtE
Links:
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
#ACR25 Abstr#2697 H2H RCT of Tacrolimus + GC vs MMF + GC in #lupus Nephritis in Asia for Induction-Maintenance showed similar efficacy. Different side effects: AKI more in TAC, low WCC & infections in MMF. Informative for services with no access to biologics/Voclosporin @RheumNow https://t.co/V4uWhuqjjW
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#2658 In >870k adults with T2DM or obesity, GLP-1 receptor agonists showed no increase in autoimmune or inflammatory disease risk, and were instead linked to lower mortality, heart failure, stroke and dementia. Excellent real-world safety signals. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
Abstract 2695: Deep dive into B-cell depletion (BCD)
Lymph node biopsy pre/post tx:
🔹 CAR T: complete BCD + disrupted follicular architecture
🔹 RTX, OBI, BLIN: reduced BCD + preserved follicular architecture
✅ Complete LN depletion → drug-free remission
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Inflammation skews lipid levels in RA: the “lipid paradox”
Using data from CERTAIN and VARA, inflammation (hsCRP)-adjusted TC & LDL better predicted ASCVD events than standard lipids.
Are we missing RA pts who need statins?
@RheumNow #ACR25 A#2681
Jiha Lee JihaRheum ( View Tweet)
#2681 Tackling the “lipid paradox” in RA: inflammation-adjusted TC & LDL (using hsCRP correction) improved ASCVD risk prediction and flagged more high-risk patients than standard lipids. A smarter way to guide statin use in RA. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
Abst 2694:
Post-hoc analysis of Phase 2 PAISLEY SLE trial examined impact of deucravacitinib on renal dysfunction
🔹 Plasma proteins a/w ↑ BILAG renal score and ↓ UPCR --> reduced by WK 32
🔹 Biomarkers inversely related to eGFR were reduced with deucra vs PBO
@RheumNow #ACR25 https://t.co/6CvmQ9lCfS
Links:
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
In the epidemiology session on the final day of #ACR25, a large cohort study (>430k pts) showed that GLP-1 receptor agonists were linked to lower incidence of RA, gout & OA vs DPP-4 inhibitors. Adds to the growing case for GLP-1 benefits beyond glucose control. @RheumNow #2657
Mrinalini Dey DrMiniDey ( View Tweet)
Lots of interest in MRI for GCA diagnosis... but what about monitoring?
Case series of 14 pts: MRI identified relapse prior to symptoms or inflammatory markers in 2 cases, including those on TCZ, which hides them
More available in US context, noninvasive, & more structures https://t.co/pnrI9SEpll
Mike Putman EBRheum ( View Tweet)
