IgG4 is a rare autoimmune disease with excessive IgG4 immunoglobulins that can affect multiple organs yielding plasma cell deposition (inflammation) and fibrosis.There has been great progress in treatment. Traditionally, glucocorticoids were used and if ineffective, then an oral immunesuppressive (ex: Azathioprine, MMF) and, if needed, rituximab. Many patients can improve sufficiently on this regimen.

My favorite session at ACR Convergence is often the “Great Debate.” The debate this year also evaluated one of my favorite topics – ultrasound in giant cell arteritis (GCA). More specifically, it asked the question of whether biopsy or ultrasound should be the preferred modality for diagnosing GCA.

Methotrexate (MTX) remains the cornerstone of rheumatoid arthritis (RA) treatment, yet it remains unclear as to how to predict who will respond to it. Two studies presented at ACR (Abstracts 2639 and 2643) suggest the answer may be hiding in the gut.

At ACR 2025, the session “27M02: Nutrition for Rheumatic Disease: Where Aging Biology, Sarcopenia, and Diet Intersect” invited the audience to view rheumatic disease through the lens of biological aging and to consider how nutrition and exercise can serve as integrative lifestyle interventions.