Rheumatoid Arthritis
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.
Jiha Lee JihaRheum
3 months ago
CDAI appropriately guided therapy escalation in RA, but not for everyone. Treatment adjustments were less likely in pts with public or no insurance. Even data-driven care can fall short when access barriers persist.
@RheumNow #ACR25 Abstract#2616
Bella Mehta bella_mehta
3 months ago
Large Canada ICES dataset- DMARD use is not associated with adverse pregnancy outcomes. In pts with RA, SlE and other rheumatic diseases.
Abst#2627 #ACR25 @RheumNow https://t.co/T9Ll1FNjT7
Mrinalini Dey DrMiniDey
3 months ago
#1748 Higher air pollution, esp PM2.5, linked to ⬆️RA disease activity and more flares in >1000 Korean patients. Each rise in PM2.5 significantly boosted DAS28, CDAI & joint counts.
Does cleaner air mean calmer joints?
@RheumNow #ACR25
Aurelie Najm AurelieRheumo
3 months ago
US Electronic Health Record cohort 2000+pts
Incidence Heart Failure over 10 yrs 6.8%
HF asso w/
Older
Male
Lower eGFR
Hypertensive medication
Diabetes
TTMTS MTX, TNFi
Higher CRP
Probably surrogates for High Disease Activity...
How do we detect it?
Maybe not by using the https://t.co/s9SjEyk3WF
Richard Conway RichardPAConway
3 months ago
Agrawal et al. Case study of tofacitinib + bDMARDs in refractory IA. 7 SpA, 2 RA, 1 JIA. Effective and safe. @RheumNow #ACR25 Abstr#2338 https://t.co/Y0B3W4csJX
Jiha Lee JihaRheum
3 months ago
In RA, “strong bones” can give false reassurance.
Pts with higher baseline BMD had faster bone loss, often tied to GC use and less osteoporosis treatment. Undermanagement, not biology, may drive decline.
@RheumNow #ACR25 Abstract#2244 https://t.co/N421ESAUy9
David Liew drdavidliew
3 months ago
After melanoma, should RA patients stop DMARDs?
These VA data (n=644) showed no mortality signal, and trending to survival benefit with b/tsDMARDs
Provisos over methotrexate, invasive disease etc, but don’t hold off treating the RA because of melanoma
#ACR25 ABST2237 @RheumNow https://t.co/l9n1V6YVln
David Liew drdavidliew
3 months ago
Can a Fitbit track RA?
This Japanese clinic is using Fitbit data and have seen it correlate with CDAI across their RA clinic.
Maybe instead of asking about our patients mobility and sleep, we should be measuring it?
#ACR25 ABST2253 @RheumNow https://t.co/rg2SKgn7K2
Mrinalini Dey DrMiniDey
3 months ago
#1751 In early RA, higher disease activity, inflammation & older age linked to more ILD changes on machine-learning chest CT. Even subtle QCT abnormalities correlated with reduced lung function pointing to early inflammatory pathways in RA-ILD. @RheumNow #ACR25
David Liew drdavidliew
3 months ago
Are the clues of RA there in the EMR, before the diagnosis is made?
Jina off-the-shelf AI with subsequent retraining found the digital fingerprint of RA in @MayoClinic medical notes, years before formal diagnosis.
The clues are there
#ACR25 ABST2260 @MyasoedovaElena @RheumNow https://t.co/onGlKUmefd
Jiha Lee JihaRheum
3 months ago
In the CLOSE-UP study of UPA in RA
- 61% in remission with responses sustained to 24 mo
- Benefit consistent irrespective of prior DMARD use
- No new safety signals
@RheumNow #ACR25 Abstract#2281
Richard Conway RichardPAConway
3 months ago
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
Poster Hall