Serrano-Combarro et al. Abatacept in RA-ILD. 343 patients. Progressive ILD in 23%. Similar to the numbers progressing on baricitinib by same group. Previous MTX treatment appears to REDUCE risk (OR 0.45). Disease activity increases risk (OR 1.29). @RheumNow #ACR25 Abstr#2265 https://t.co/0tl0kGgm5p

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#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

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Starting biologic early could save more than joints. In 329 RA pts, first-line anti-TNF reduced testing and hospitalization costs vs csDMARDs across Europe. Earlier targeted therapy pay off in outcomes and economics. @RheumNow #ACR25 Abstract#2271 https://t.co/zZ32CpT36d

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#1747 Serious infections ~2× more common in RA-LD, esp RA-ILD. Pulmonary, bacterial, viral & fungal infections all increased, underscoring need for tailored prevention and vaccination. @RheumNow #ACR25 https://t.co/soyzqLk7Vj

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#1746 In large US RA cohort, elevated GDF-15 & pentraxin-3 levels linked to prevalent RA-ILD; high GDF-15 predicted future ILD risk. Other fibrosis-related mediators from IPF or heart failure were not associated, suggesting RA-ILD has distinct pathogenic pathways @RheumNow #ACR25

New insights into Pre-RA: It ranges from asymptomatic individuals with ACPA positivity to those with symptomatic pre-clinical synovitis. Predicting who will develop RA is difficult, and there is a need for reliable biologic tools. Focusing on high-risk patients could https://t.co/SPOP7f0t7y

When every option fails, bold moves remain. In 5 multi-resistant RA pts, TNFi + JAKi combo brought remission in most without major AEs. Not standard, not risk-free, but in young, low-infection-risk pts, it may offer a path forward. @RheumNow #ACR25 Abstract#2272

Post hoc eval of relapses from MANDARA, MEPO vs BEN in EGPA 30% of pts had relapse, 81% of which were asthma +/- sinonasal disease Remainder were mostly muscle involved, only a few mononeuritis Mostly as expected; useful epi data for clinic #ACR25 @RheumNow Abstr#1769 https://t.co/IKKolMZJlF

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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

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Late breaking: secukinumab out-performs ustekinumab in PsA pt who have failed TNF therapy RCT of 119 pt 57.1% response at wk 28 in SEC 27% response at wk 28 in UST Numerically lower adverse events leading to d/c in SEC @RheumNow #ACR25 #ACRBest Abst LB06 https://t.co/wDxtscP2ku

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Serrano-Combarro et al. Baricitinib in RA-ILD. Observational, 42 patients. Progressive ILD in 26%. More frequent in women. @RheumNow #ACR25 Abstr#2229 https://t.co/ZXfgxKoau7

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Cutaneous vasculitis: who is most likely to have systemic disease? 430 pt w skin vasculitis examined in case-control Associated with risk for systemic vasculitis/CTD: - GI sx - ulcerating/necrotic lesions - constitutional sx - hematuria @RheumNow #ACR25 Abst 2525 https://t.co/lRjLKRYxDW

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To be continued (or discontinued?): Abstract 2360: Compared to TNFi, IL-17i & JAKi users had 🔹 Higher odds of med switching <180 days 🔹 Shorter time to discontinuation @RheumNow #ACR25 #axSpA https://t.co/IOHaFSJqHn

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Interesting study evaluating the "CALLY" index (serum albumin × lymphocyte count / CRP / 10,000) for predicing mortality in AAV I typically dislike these because (1) they are often cumbersome to calculate & (2) they often perform poorly This one piqued my interest; pretty https://t.co/ziroQOH5Cq

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Meta-analysis of 3 RCTs (n=1990) shows IL-17i offers comparable joint response but superior skin clearance vs adalimumab in biologic-naive PsA. IL-17i also had fewer discontinuations due to adverse events. Supports sequencing of biologics through different mechanisms of action in https://t.co/SJgFUMxWVb

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