Cardio/Pulmonary

KORAIL cohort: new RA-ILD progression model (inc. DLCO, ILD pattern/extent, anti-CCP, ± KL-6) stratified risk with high sensitivity & specificity. Adding KL-6 boosted AUC to 0.75. A step toward personalised care in RA-ILD. @RheumNow #EULAR2025 #OP0328 https://t.co/AHqNFw40gk

Links:

Mrinalini Dey @DrMiniDey( View Tweet )
Is #PDE5i protective in development of #SSc #ILD? Maybe 444 w ILD of >4000 #EUSTAR Pts over 1 to 2 yrs f/u #immunesuppressive use maybe or not 🤷‍♀️channeling bias Reduction in new #ILD in #scleroderma PDE5i ✅ Immunesuppression ? @RheumNow #EULAR2025 @eular_org #OP0334 https://t.co/6dtLfybkRV

Links:

Janet Pope @Janetbirdope( View Tweet )
#EULAR2025 Abstr#OP0319 Multicentre study in Canada showed no difference in longterm Lung Transplant outcomes among IIM-ILD, SSc-ILD & IPF. Some differences: IIM-ILD was progressive pre-transplant with prolonged hospitalisation post-surgery. For us to be aware @RheumNow https://t.co/eFdY4XGtlj

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Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
#guidelines everywhere @jeffsparks presents points of interest from #ACR #ILD #recommendations - a joint venture with American College of Chest Physicians While simultaneously the EULAR ILD recommendations are being unveiled! @RheumNow #EULAR2025 @eular_org @ACRheum https://t.co/cfHrqIAbx9

Links:

Janet Pope @Janetbirdope( View Tweet )
Should we screen for #lung #cancer in #SSc high risk Pts? When >10 yrs? Greek cohort of SSc since 1995 Disease duration 12 yrs, smoking lung ca group ⬆️58% vs 29% ⬆️dcSSc ⬆️immunosuppression OR >4X lung ca if dcSSc, IS Less #DU #PO0940 @RheumNow @eular_org #EULAR2025 https://t.co/L2zEkP8pAc

Links:

Janet Pope @Janetbirdope( View Tweet )
Some RA-ILD is less of a worry, some is critical. How do we stratify? Great modelling work from Korea & @jeffsparks - model stratifying really well, even without KL-6. We need to do this more, so we can go really hard early when we need to. #EULAR2025 OP0329 @RheumNow https://t.co/i2djatO3F2

Links:

David Liew @drdavidliew( View Tweet )
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Predictors and Outcomes in Systemic Sclerosis

EurekAlert!

The VEDOSS project has previously shown that 70% of patients with Raynaud’s phenomenon and at least one red flag – systemic sclerosis (SSc)-specific antibodies, puffy fingers, or an SSc pattern on nailfold capillaroscopy –will fulfil the 2013 ACR/EULAR SSc criteria within 5 years.

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EULAR,poster

EULAR 2025 – Day 2 Report

Jack Cush, MD

Day 2 was a full agenda for those attending EULAR 2025 in Barcelona with sessions on the management of RA, Behcets, Lupus and Hand Osteoarthritis. Clinical overviews on MAS, Ehlers-Danlos, Difficult to treat RA and PsA offered a wide variety of options to rheumatologists. Here are a few

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Puzzle pieces

Clinical and Therapeutic Challenges in Connective Tissue Disease and ILD

Mrinalini Dey, MD

Connective tissue diseases (CTDs) and interstitial lung disease (ILD) represent a challenging intersection of systemic autoimmunity and progressive respiratory impairment. Research presented at EULAR 2025 continues to highlight the importance of CTD-ILD and the evolving landscape of therapeutic

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Ultrasound for ILD detection in RA 🫁 Sens 88.6 Spe 92.8 NPV 91.4 PPV 90.7 While if abnormal or high suspicion, HRCT should be the reference, I see this as an interesting tool in clinics for quick screening POS0180 #EULAR2025 @RheumNow https://t.co/pUy0ki7Y6S

Links:

Aurelie Najm @AurelieRheumo( View Tweet )
#HOT topic Lung 🫁 #ultrasound for #RA #ILD #LUS B lines vs HRCT Single site 🇫🇷 study V sensitive & specific 🤔needs standardization & comparison in other groups Abst#POS-180 #EULAR2025 @RheumNow @eular_org https://t.co/PwGE4rgk40

Links:

Janet Pope @Janetbirdope( View Tweet )
New dual-action RA drug? OP0193: CPL’116 targets both JAK & ROCK. In 12-wk RCT, highest dose improved DAS28-CRP, joint counts & pain, with clean labs. Is this a future option for RA-ILD or patients with comorbid CVD risk? #EULAR2025 @RheumNow

Jiha Lee @JihaRheum( View Tweet )

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Psoriatic Arthritis: Hit hard and Early

EurekAlert!

Two recent studies suggest there is no significant benefit of early biologics over standard step-up care with methotrexate2,3, but these did not select for poor prognosis.

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Nailfold Capillaroscopy correlated w/ cardiac ECHO in Systemic Sclerosis. NFC & ECHOs studied in 30 SSc pts. Systolic & diastolic dysfunction most common in late SSc NFC patterns. Cardiac dysfunction seen w/ low capillary density, avascular areas, cap neoangiogenesis https://t.co/pFBKjXqwfr
Dr. John Cush @RheumNow( View Tweet )
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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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POCUS of the lung can detect subclinical ILD and can be a useful, inexpensive, easy to perform screening tool for CTD-ILD. #EULAR2025 @RheumNow https://t.co/KpH05w1S9O

Links:

Adela Castro @AdelaCastro222( View Tweet )
📊 In a 40-yr cohort (n=2818), RA pts had 2.3x ↑ risk of DVT (HR 2.26) & 1.6x ↑ risk of PE (HR 1.61) vs non-RA. Risk ↑ with RF/CCP+, nodules (HR 2.9), BMI ≥30 (HR 1.9), & biologic use in year 1 (HR 2.4–2.9). Remission = ↓ PE risk (HR 0.47) 📍OP0070 @RheumNow #EULAR2025

Jiha Lee @JihaRheum( View Tweet )

#EULAR2025 Abstr#OP0078 #Lupus nephritis is assoc with CVD. Propensity matched analysis comparing GLP-1 agonist vs SLGT2-i using TrinetX database in LN ->favourable risk reduction with GLP-1: -CKD progression -Mortality -MI Validation & mechanistic explanation needed @RheumNow https://t.co/xPDVDm1CHm

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Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
In propensity-matched RA cohort (n=2,449 each) on JAK inhibitors, adding a GLP-1 agonist reduced risk of: • Acute coronary syndromes (RR 0.65, p=0.0009) • DVT (RR 0.69, p=0.007) Overall CV events ↓ by 33% (RR 0.67, p=0.0007) #EULAR2025 @RheumNow Abstract#OP0069 https://t.co/jWI6tvri8O

Links:

Jiha Lee @JihaRheum( View Tweet )
RA pts have ↑ risk of DVT (HR 2.26) & PE (HR 1.61) vs controls in this 40-year, pop-based study. Nodules, obesity, high disease activity & early biologic use ↑ risk. Remission in year 1 halved PE risk. VTE risk persists despite therapeutic advances. @RheumNow #EULAR2025 #OP0070 https://t.co/AaBi2o2cUw

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Mrinalini Dey @DrMiniDey( View Tweet )
RA polygenic risk ≠ MI risk. In >8,700 Swedes w/ or w/o RA, higher genetic risk for RA wasn’t linked to higher MI incidence. Familial clustering of RA & MI likely driven by non-genetic factors. Traditional CV risk still key in RA care. @RheumNow #EULAR2025 #OP0072 https://t.co/KN6Dg0ekt2

Links:

Mrinalini Dey @DrMiniDey( View Tweet )
Clinical determinants of multiple drug failure in D2T RA 2000+ RA cohort 250+ refractory -Low financial status -Cancer Hx -CV comorbidities -Chronic use of NSAID or GCs Protective: Regular participation in leisure activities #POS0030 @RheumNow #EULAR2025 https://t.co/qNHQoHCb80

Links:

Aurelie Najm @AurelieRheumo( View Tweet )
In >228k CTD patients across France, ILD increased mortality risk across all CTDs. Proportion of incident CTD with ILD highest in IIM (37%). Up to 34% of CTD-ILD pts had progressive pulm fibrosis. Supports earlier ILD screening & vigilance in CTDs. @RheumNow #EULAR2025 #OP0033 https://t.co/KkF9xFY4Cn

Links:

Mrinalini Dey @DrMiniDey( View Tweet )
Ph 2 open label RCT TOFA in RA-ILD 52 wks 39pts 92% AE 8% 3 deaths FVC decline -69 ml No diff between UIP, NSIP or antifibrotic No control group #POS0619 #EULAR2025 @RheumNow https://t.co/3lqEUfObG9

Links:

Aurelie Najm @AurelieRheumo( View Tweet )
Can lowering serum urate also lower CV risk? In >116k patients w/ #gout, achieving SU <360 µmol/L in 12m ↓ 5yr MACE risk (HR 0.89, pooled Δsurvival +1.4%). Greater effect in >65s. Gout management = CV prevention? @RheumNow #EULAR2025 #OP0005 https://t.co/NRAerUBemN

Links:

Mrinalini Dey @DrMiniDey( View Tweet )

Recent Blogs

Overlap Syndrome with ILD

Jack Cush, MD
Cush RheumThought ILD

How would you manage a patient with Overlap (anti-synthetase) syndrome, ILD, polyarthritis and myositis?

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Best of 2023: New ACR RA-ILD Treatment Guidelines – What Were They Smoking!?

Richard Conway, MBBChBAO, PhD
Lungs ILD
Rheumatoid arthritis related interstitial lung disease (RA-ILD) is common, with symptomatic RA-ILD affecting approximately 8% of RA patients. There is a very limited evidence base supporting treatment and therefore the recent release of ACR guidelines is to be welcomed. However, the published guidelines appear discordant with the best available evidence base.  Read Post
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