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EULAR 2025 - Day 1 Report

Jack Cush, MD

Wednesday was Day One at EULAR 2025 in Barcelona. Thousands from around the world gathered, eager to reunite at this international educational forum. Below are a few of my favorites from Day 1.

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Belimumab in SLE with Mucocutaneous or Vasculitis Findings

Jack Cush, MD

A post hoc analysis of a belimumab (BEL) inn systemic lupus erythematosus (SLE) study showed lupus mucocutaneous and vasculitic manifestations improve with BEL and standard care.

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2025 ACR Guideline for the Treatment of SLE

Jack Cush, MD

The ACR has released its 2025 Systemic Lupus Erythematosus (SLE) treatment guidelines and consensus-based good practice statements, applicable to children and adults with SLE. 

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Shifting the Management Paradigm for SLE and Lupus Nephritis

Karen Costenbader, MD, MPH

The paradigm for treating patients with systemic lupus erythematosus (SLE) is rapidly shifting and our patients will surely benefit with improved outcomes.

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Steroids in Lupus Nephritis: No Free Lunch

Michael Putman, MD, MSCI

Today I'm here to talk with you about steroids in lupus nephritis. The impetus for this is the 2024 ACR guideline for the management of lupus nephritis.

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Panacea of Prednisone & Cannabis (5.16.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal and regulatory reports from this week on RheumNow.com.  Interesting trends and results with prednisone in lupus, cannabis in RA and opioid deaths too!

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Lupus in an empty house

Eric Dein, MD

The full house immunofluorescence pattern is the classic histopathologic finding of lupus and lupus nephritis. Glomerular deposits staining for IgG, IgA, IgM, C3 and C1q can help confirm a suspected diagnosis of SLE. But what about patients with negative immunofluorescence and no proliferative or membranous features?

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#MTX in new #PMR?! RCT of #MTX was negative in early #PMR - no effect on #steroid #tapering ACR24 #1697 At #EULAR2025 👇 +RCT of #methotrexate in PMR <8wks #steroids #Rx MTX 25 mg/wk v #placebo N=64 ⬆️GC remission ✅80% v 46% ⬇️relapse w MTX 🤔 Abst0064 @RheumNow #EULAR2025

Janet Pope Janetbirdope ( View Tweet)

Single center study of 1538 #SLE pts found 2.2% w/ lupus mesenteric vasculitis (LMV) - 39 LMV episodes in 31 pts - 2/3 had Nausea, vomiting, diarrhea & abdominal pain (~15% peritoneal irritation) & had active Dz (renal, Skin, Heme). LMV responded to steroids & https://t.co/vXCpbiC60P
Dr. John Cush RheumNow ( View Tweet)
Early RA or undiff. arthritis (UA) shows initial hi-dose steroids have significantly better earlier outcomes, but lower doses have fewer early side effects. IMPROVED used high dose GC (60 mg/d tapered to 7.5 mg in 7wks). tREACH used lower dose GC (15 mg/d tapered in 10 wks to https://t.co/TkrGPb6EBZ
Dr. John Cush RheumNow ( View Tweet)
Steroids in Lupus Nephritis: No Free Lunch https://t.co/yPQuZcnRLH https://t.co/V8GZoslSqV

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Dr. John Cush RheumNow ( View Tweet)
Treat to target 🎯 #SLE #recommendations Considerations are nuanced and Impt Lowest clinical disease activity is goal Try for remission 🎯 Get patients off #glucocorticoids If not ⬇️low dose #prednisone @RheumNow #LUPUS2025 https://t.co/HlBeh2FLxP

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Janet Pope Janetbirdope ( View Tweet)
controversy re 👇 Monitoring for +Ro pregnant re #congenital #heart #block 87% Y echo is possibly too late No ideas if flourinated #steroids work But many thing we should do something Guidelines differ on recommendations Would fetal home HR be better #LUPUS2025 @RheumNow https://t.co/MY0oPjLnGs

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Janet Pope Janetbirdope ( View Tweet)
‘It’s #Lupus, it’s all in your head!’ ➡️ Some patients with #SLE have heard this from others At #LUPUS2025 in a packed session on #CNS lupus #Dx is tricky 40% of #neuropsychiatric lupus have NEGATIVE #brain #MRI 👇r/o infarct/bleed Infection Rx #steroids @RheumNow https://t.co/yU1olg0uZU

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Janet Pope Janetbirdope ( View Tweet)
‘To screen or not’? For #CHB #congenital #heart #block Great debate #LUPUS2025 In #pregnant women with #SLE In + #Ro #SSA &/or #La #SSB mothers CHB Rx - #flourinated #steroids To ⬇️#fetal #mortality ❎no benefit ⬇️#cardiomyopathy ❎ ⬇️#pacemaker ❎ ⁦@RheumNow⁩ ??🤷‍♀️ https://t.co/xauDzfNBsC

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Janet Pope Janetbirdope ( View Tweet)
Vitiligo affects up to 2% of people globally; more in blacks & hispanics than whites & more common in women > men. The prevalence has increased over time. Oral corticosteroids are most frequently prescribed, followed by other immunosuppressive drugs https://t.co/wNh6z3lKg1 https://t.co/hQo9sNn4kg

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Dr. John Cush RheumNow ( View Tweet)
MTX works in pulmonary Sarcoid! NEJM reports Open label RCT of 138 un-Rx pulm. Sarcoid pts w/ either MTX or placebo. After 24 wks MTX was noninferior to PBO w/ mean change in FVC (-6.7 vs -6.1). AE: more Wt gain, insomnia w/ pred & more Nausea fatigue LFTs w/ MTX https://t.co/8XMCM2DitR
Dr. John Cush RheumNow ( View Tweet)
New Steroid Rules in Lupus? Let’s Talk. Dr. Michelle Petri breaks down the latest strategies to minimize steroid exposure while managing disease activity in lupus patients. 💡 Smarter steroid use = better outcomes. 👉 Watch now on RheumNow: https://t.co/vbjrXAlixz #Lupus https://t.co/TN5EkZhbef

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Dr. John Cush RheumNow ( View Tweet)
SLE trends: pulse methylprednisolone followed by low dose steroids is rec by various guidelines. Risk factors for SLE flare after GC withdrawal: high Dz activity, active serology, younger age, shorter remission duration, faster tapering strategy, shorter duration/cessation of https://t.co/g6LaTijOpA
Dr. John Cush RheumNow ( View Tweet)
#2 most downloaded paper in 2024 on Journal of Clinical Medicine was “IgA Vasculitis (Henoch–Schönlein Purpura): An Update on Treatment” - Steroids are 1st line Rx, esp in adults w/ severe IgAV; other Rx include calcineurin inhibitors, MMF, RTX , https://t.co/F5jogxkoGr

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Dr. John Cush RheumNow ( View Tweet)

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