Vector borne diseases that result in arthritis will rise with climate change/ flooding risk
- Chikungunya
- Dengue
- Zika
- West-Nile Virus
@RheumNow #EULAR2025 @bella_mehta https://t.co/CCOYqTjaXE
Dr. John Cush @RheumNow( View Tweet )
Steroids, Not JAKi, Are the Real Infection Risk
Dr. David Liew reporting at EULAR 2025 in Barcelona, Spain.
https://t.co/rLpyo1UNjd https://t.co/bDfdLTEM1N
Links:
Dr. John Cush @RheumNow( View Tweet )
Safety of Recombinant Zoster Vaccine in Rheumatic Patients
New work presented at EULAR focuses on the RZV, which contains recombinant glycoprotein E – the major target of CD4+T-cells. The abstract describes the tolerability and safety of RZV in patients with inflammatory https://t.co/NS3h9CdGIU
Dr. John Cush @RheumNow( View Tweet )
Management of AAV:
1.High dose GC f/b reduced dose taper ‼️caution in pts w/severe renal dz and RTX induction.
2. RTX effective for induction and maintenance, best for relapses.
3.PLEX: in RPGN pts if accesible ⚠️ risk for infection.
4.Avacopan: for faster GC weaning. No https://t.co/kfZ4gM38KG
Links:
Adela Castro @AdelaCastro222( View Tweet )
#ClinicalPearls
For
#cartilage #swelling in #relapsing #polychrondritis
Ask for #pics
#Levamisole in #cocaine
#infection - uncommon - from piercing
Acute #bacterial v chronic
#lymphoma
#malignancy
#vasculitis
#Trauma
Hx, duration, fever can be helpful
#EULAR2025
@RheumNow https://t.co/X2b6VHYsYa
Links:
Janet Pope @Janetbirdope( View Tweet )
Vector borne diseases that result in arthritis will rise with climate change/ flooding risk
- Chikungunya
- Dengue
- Zika
- West-Nile Virus
@RheumNow #EULAR2025 https://t.co/HtHyADsOSX
Bella Mehta @bella_mehta( View Tweet )
Climate Change Impacts #Rheumatology Care Taking
HEAT 🥵 causes:
🔺️⬆️ Hospitalisations
🔺️Renal failure ⚠️ NSAIDs
🔺️Flooding: no access to healthcare
🔺️New Infectious diseases mimics RMDs: Zika...
🔺️Insecurities for drug storage and transportation
#EULAR2025
@RheumNow https://t.co/V9RyxYX6Me
Nelly ZIADE 🍀 @Nellziade( View Tweet )
Dual pandemic in Africa.
Increasing lifestyle diseases and obesity, along with infections and malnutrition.
These may be reflected in rheumatic diseases too (if they could be studied in detail)
#EULAR2025 @RheumNow https://t.co/6ulMRxX8az
Links:
Bella Mehta @bella_mehta( View Tweet )
#Shingrix #vaccination is Impt in #SLE
HZ vaccination works in SLE, safe – 1yr still good humeral & cellular immunity
-attenuation over 1 yr re #immune #responses
No major flares
#shingles is ⬆️ in #lupus
👇
abnormal immune response
#pred, #MMF #IS
POS1005 #EULAR2025 @RheumNow https://t.co/o8lDXgOhE1
Janet Pope @Janetbirdope( View Tweet )
Procalcitonin can be used in the monitoring of infection, but is also high in Stills disease. 89 AOSD pts showed pts w high PCT had more pleuritis, MAS,^LFTs, & correlated w/ Dz activity, CRP, LDH, hi ferritin & normalized w bDMARD Rx. #EULAR2025 abstr #POS1118 https://t.co/NpRA9optd3
Dr. John Cush @RheumNow( View Tweet )
#EULAR2025 Abstr#POS0991 RCT showed Adjuvanted Herpes Zoster vaccination appeared safe in #SLE upto 1 year. However, humoral and cellular responses declined over time. Longer follow up needed to ascertain frequency of vaccine to be repeated @RheumNow https://t.co/FcUi1OfBLu
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
#RITAZAREM: infection risk during RTX induction in AAV was ↑ w/ lung disease & nodules/cavities; ↓ w/ TMP-SMX prophylaxis. Early infections predicted later ones, but risk didn’t differ by RTX vs AZA. Pulmonary damage is a key red flag for infection
@RheumNow #EULAR2025 #OP0167
Mrinalini Dey @DrMiniDey( View Tweet )
The definition of MAS. MAS is secondary HLH. Other causes of secondary HLH are infections, malignancy and iatrogenic.
Georgin-Lavialle S @RheumNow #EULAR2025 https://t.co/CpB78JBlVJ
Links:
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Clinical Pearl's for #MAS
Infections are still the most common cause.
Next is malignancy...
Then other causes like autoimmunity..
Ask a detailed history ! Sometimes check with the family when the pt can't give history..
#EULAR2025 @RheumNow https://t.co/fepercz5Af
Bella Mehta @bella_mehta( View Tweet )
MAS can be triggered by infections in VEXAS syndrome. The threshold is reached leading to a hyperinflammatory state
Georgin-Lavialle S @rheumnow #EULAR2025 https://t.co/NKLL75rOgP
Links:
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
#infections in #JAKi
@drdavidliew
#JAKi sl ⬆️ infection risk vs #TNFi
⬆️HZ w JAKi
JAKi same risk w #latent #TB #LTBI and new TB ⬇️in JAKi v bDMARDs
He didn’t discuss TYK2i
Reassuring - risk⬇️ over time for infection
@RheumNow #EULAR2025 @eular_org
JAKi & infection https://t.co/KVsY2gXVkQ
Links:
Janet Pope @Janetbirdope( View Tweet )
JAKi: expanding RMD indications—but important safety concerns to consider
⚠️ Cancer: Neutral vs MTX/placebo, ↑ risk vs TNF
⚠️ Infection: ↑ with age, disease activity & GC use—not uniformly higher with JAKi
🗣️ Patients rank infection risk as top concern
@rheumnow #EULAR2025 https://t.co/RJRDWQjqNC
Links:
Jiha Lee @JihaRheum( View Tweet )
Age & dose ⬆️ infections in JAKi
Not all JAKi are created w equal risk
@RheumNow @eular_org #EULAR2015 @drdavidliew
#JAKi & #infection https://t.co/F7zLUBuzJR
Janet Pope @Janetbirdope( View Tweet )
Stabilize the pts with HLH with steroids when still trying to figure out the diagnosis of #HLH/ #MAS
Many drugs can be used...but important to balance infection risk with immunosuppression
These are critical pts. Be vigilant..
#EULAR2025 @RheumNow https://t.co/id4ae3SWtj
Links:
Bella Mehta @bella_mehta( View Tweet )
3 Fs of diagnosis of #HLH
-Fever
-Ferritin
-Falling blood count
Raising awareness is the key! Especially in rare diseases like this where the morbidity and mortality is super high!
Collaboration between specialists help
HLH networks will be helpful like this
@RheumNow #EULAR2025 https://t.co/HWbvIma3yx
Bella Mehta @bella_mehta( View Tweet )
ACQUIVAS: RTX-treated AAV patients had poor response to #pneumococcal vaccine PCV-13 (8% vs 45% in non-RTX). Boosting w/ PPV-23 helped a few but 48% failed to mount robust response. Time to rethink vaccine strategies in RTX-treated patients?
@RheumNow #EULAR2025 #OP0173 https://t.co/soU5qfwRib
Mrinalini Dey @DrMiniDey( View Tweet )
POS0627: RA patients aged ≥90 yrs can benefit from biologics/JAKi! In 3,600 pts, 84% of those ≥90 achieved low disease activity, 71% were on JAKi. But serious infections occurred in 21%—mostly pneumonia. Use w/caution in the oldest-old. #EULAR2025 @rheumnow
Jiha Lee @JihaRheum( View Tweet )
What’s worse for infection in GCA: tail end steroid taper, or a JAK inhibitor?
This is exactly SELECT-GCA in the second 6mo. What happened?
upa skews better on serious infection, worse on HZ
JAKi might have infection risk, but not like steroids. OP0057 #EULAR2025 @RheumNow https://t.co/FigxviOW3e
David Liew @drdavidliew( View Tweet )
Case series of 22 PsA pts treats w/ combination bioDMARDs & JAKi,TYK2i or APR
IL17i + JAKi 10.5 PY = 1 mild infectious stomatitis
IL23i + JAKi 3.7 PY = no AE
IL-17i + TYK2i 8.5 PY = 2 mild upper respiratory infections
IL-23i + TYK2i 8.3 PY = 2 mild URIs, 1 folliculitis
TNFi + https://t.co/Qg9HIwuslJ
Aurelie Najm @AurelieRheumo( View Tweet )
Rheumatologists can’t ignore hypereosinopilic syndrome anymore, not when it borders on our diseases and therapies. Great takeaways on subtypes and therapies from Giacomo Emmi in an elegant talk #EULAR2025 @RheumNow https://t.co/vqZajY0nUp
David Liew @drdavidliew( View Tweet )
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