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#Shingrix #vaccination is Impt in #SLE
HZ vaccination works in SLE, safe – 1yr still good humeral & cellular immunity
-attenuation over 1 yr re #immune #responses
No major flares
#shingles is ⬆️ in #lupus
👇
abnormal immune response
#pred, #MMF #IS
POS1005 #EULAR2025 @RheumNow https://t.co/o8lDXgOhE1
Janet Pope Janetbirdope ( View Tweet)
Procalcitonin can be used in the monitoring of infection, but is also high in Stills disease. 89 AOSD pts showed pts w high PCT had more pleuritis, MAS,^LFTs, & correlated w/ Dz activity, CRP, LDH, hi ferritin & normalized w bDMARD Rx. #EULAR2025 abstr #POS1118 https://t.co/NpRA9optd3
Dr. John Cush RheumNow ( View Tweet)
#EULAR2025 Abstr#POS0991 RCT showed Adjuvanted Herpes Zoster vaccination appeared safe in #SLE upto 1 year. However, humoral and cellular responses declined over time. Longer follow up needed to ascertain frequency of vaccine to be repeated @RheumNow https://t.co/FcUi1OfBLu
Md Yuzaiful Md Yusof Yuz6Yusof ( 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)
The definition of MAS. MAS is secondary HLH. Other causes of secondary HLH are infections, malignancy and iatrogenic.
Georgin-Lavialle S @RheumNow #EULAR2025 https://t.co/CpB78JBlVJ
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Clinical Pearl's for #MAS
Infections are still the most common cause.
Next is malignancy...
Then other causes like autoimmunity..
Ask a detailed history ! Sometimes check with the family when the pt can't give history..
#EULAR2025 @RheumNow https://t.co/fepercz5Af
Bella Mehta bella_mehta ( View Tweet)
MAS can be triggered by infections in VEXAS syndrome. The threshold is reached leading to a hyperinflammatory state
Georgin-Lavialle S @rheumnow #EULAR2025 https://t.co/NKLL75rOgP
Links:
Antoni Chan MD (Prof) synovialjoints ( 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)
JAKi: expanding RMD indications—but important safety concerns to consider
⚠️ Cancer: Neutral vs MTX/placebo, ↑ risk vs TNF
⚠️ Infection: ↑ with age, disease activity & GC use—not uniformly higher with JAKi
🗣️ Patients rank infection risk as top concern
@rheumnow #EULAR2025 https://t.co/RJRDWQjqNC
Links:
Jiha Lee JihaRheum ( View Tweet)
Age & dose ⬆️ infections in JAKi
Not all JAKi are created w equal risk
@RheumNow @eular_org #EULAR2015 @drdavidliew
#JAKi & #infection https://t.co/F7zLUBuzJR
Janet Pope Janetbirdope ( View Tweet)
Stabilize the pts with HLH with steroids when still trying to figure out the diagnosis of #HLH/ #MAS
Many drugs can be used...but important to balance infection risk with immunosuppression
These are critical pts. Be vigilant..
#EULAR2025 @RheumNow https://t.co/id4ae3SWtj
Links:
Bella Mehta bella_mehta ( View Tweet)
3 Fs of diagnosis of #HLH
-Fever
-Ferritin
-Falling blood count
Raising awareness is the key! Especially in rare diseases like this where the morbidity and mortality is super high!
Collaboration between specialists help
HLH networks will be helpful like this
@RheumNow #EULAR2025 https://t.co/HWbvIma3yx
Bella Mehta bella_mehta ( View Tweet)
ACQUIVAS: RTX-treated AAV patients had poor response to #pneumococcal vaccine PCV-13 (8% vs 45% in non-RTX). Boosting w/ PPV-23 helped a few but 48% failed to mount robust response. Time to rethink vaccine strategies in RTX-treated patients?
@RheumNow #EULAR2025 #OP0173 https://t.co/soU5qfwRib
Mrinalini Dey DrMiniDey ( View Tweet)
POS0627: RA patients aged ≥90 yrs can benefit from biologics/JAKi! In 3,600 pts, 84% of those ≥90 achieved low disease activity, 71% were on JAKi. But serious infections occurred in 21%—mostly pneumonia. Use w/caution in the oldest-old. #EULAR2025 @rheumnow
Jiha Lee JihaRheum ( View Tweet)
What’s worse for infection in GCA: tail end steroid taper, or a JAK inhibitor?
This is exactly SELECT-GCA in the second 6mo. What happened?
upa skews better on serious infection, worse on HZ
JAKi might have infection risk, but not like steroids. OP0057 #EULAR2025 @RheumNow https://t.co/FigxviOW3e
David Liew drdavidliew ( View Tweet)
Case series of 22 PsA pts treats w/ combination bioDMARDs & JAKi,TYK2i or APR
IL17i + JAKi 10.5 PY = 1 mild infectious stomatitis
IL23i + JAKi 3.7 PY = no AE
IL-17i + TYK2i 8.5 PY = 2 mild upper respiratory infections
IL-23i + TYK2i 8.3 PY = 2 mild URIs, 1 folliculitis
TNFi + https://t.co/Qg9HIwuslJ
Aurelie Najm AurelieRheumo ( View Tweet)
Rheumatologists can’t ignore hypereosinopilic syndrome anymore, not when it borders on our diseases and therapies. Great takeaways on subtypes and therapies from Giacomo Emmi in an elegant talk #EULAR2025 @RheumNow https://t.co/vqZajY0nUp
David Liew drdavidliew ( View Tweet)
135 pts w/ neurologic autoimmune dz (MS, GBS, myasthenia gravis) who had cancer & Rx w/ checkpoint inhibitors (ICI) showed exacerbations in SOME - 18% of MS pts, but 67%of MG, latter often w/ hospitalization (50%) or death (17%). GBS faired well w/ ICI Rx. https://t.co/RksC6QXce0 https://t.co/mYjzgxbcdQ
Dr. John Cush RheumNow ( View Tweet)
In 2019 there was an estimated 273,000 coccidioidomycosis cases in the USA; 23,000 hospitalizations and 900 coccidioidomycosis-associated deaths. Mostly from endemic states California & Arizona. https://t.co/JXPs8B4Dwb https://t.co/ddXIcub0pG
Dr. John Cush RheumNow ( View Tweet)
CMAJ reminds us that w/ parvovirus B19 infection, Arthropathy seen in ~60% of adolescents & adults, but the classic “slapped cheek rash” is uncommon. Symmetric, polyarticular inflamm arthralgias/itis affects PIPs, MCPS mostly. Sxs resolve w/in 3 wks. ~20% can last mos-yrs https://t.co/WXnuViSLbe
Dr. John Cush RheumNow ( View Tweet)
