Treating During Pregnancy (11.14.2025)
Dr. Jack Cush reviews the journal articles, news and guidelines from this past week on RheumNow.com
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In 2024, 77 pts referred to Rheum for possible PMR were ultimately Dx w/ B19 viral infx. 96% had arthralgia & 7% had PMR-like features (5/5 w/ BL shoulder/neck. prolonged AM stiff, fever & Hi CRP/ESR - none had hip pain. 4/5 were male, w/ mean age of 55 yrs. None were RF/CCP+ https://t.co/AiK2K9whBH
Dr. John Cush @RheumNow( View Tweet )
#GCA & #PMR @ACRheum #ACR25
#gamechangers #ACRBest
Yr 2 Select-GCA abst#776
#upadacitinib in yr2 of GCA REDUCES flares
HELPFUL info ?ability to get drug for 2 yrs hopefully
Failed Phase3 RCT of #secukinumab in #GCA helped #PMR abst#1175 &
+Ph3 for PMR REPLENISH RCT
@RheumNow https://t.co/5lH6HXhnfg
Links:
Janet Pope @Janetbirdope( View Tweet )
The next VEXAS, but also maybe we can treat it?
IDH1/2
Another clonal hematopoesis known to cause heme malignancy, but also some inflamm sequelae (autoinflamm-like e.g. PMR/GCA)
& you can directly inhibit it
Wow. We will hear more
#ACR25 LB21 @RheumNow
https://t.co/WL2ai5zb8Q https://t.co/Yi31xkhLO9
Links:
David Liew @drdavidliew( View Tweet )
PMR patients need healthcare professionals who know a bit about their disease.
Survey of US HCPs, amongst responders:
- 68% were not aware/unsure about PMR
- of those who were aware, knowledge was… not great (see below)
PMR needs everyone’s respect
#ACR25 ABST1617 @RheumNow https://t.co/SpyEnAW8lI
David Liew @drdavidliew( View Tweet )
REPLENISH - Secukinumab Works in Polymyalgia Rheumatica
Novartis announced the results of their REPLENISH trial showing the efficacy of secukinumab (Cosentyx) (SEC) in adults with polymyalgia rheumatica (PMR).
https://t.co/CLmCdBXiOf https://t.co/z20nWd2NSM
Dr. John Cush @RheumNow( View Tweet )
#1627 SLR informing the 2025 @eular_org recommendations for PMR & LVV 🔍
141 studies (30 RCTs) reviewed: new & further evidence for IL-6, JAK & B-cell-targeted therapies. Data will underpin updated management guidance. @RheumNow #ACR25
Mrinalini Dey @DrMiniDey( View Tweet )
#1614 Another SLR informing the 2025 EULAR recommendations for PMR & LVV 🧭
Fast-track clinics cut blindness & diagnostic delays; multimodal imaging pathways outperform biopsy alone. Key data shaping future referral & diagnosis guidance. @RheumNow #ACR25
Mrinalini Dey @DrMiniDey( View Tweet )
ACR25 - Day 1 Report
ACR 2025 began today in Chicago with throngs of rheumatologists, fellows, ARP members, APPs and pharma folk taking to the meeting halls and rooms for tons of novel content.
The annual meeting began with a great "Year in Review" featuring Drs.
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In case there was any doubt:
GCA leads to ischemic vision loss
PMR does not
#ACR25 ABST0753 @RheumNow https://t.co/mCS9B4Flgl
David Liew @drdavidliew( View Tweet )
Project from my group & rheum-bound resident Mary Peng!
As expected, ischemic vision loss for GCA compared to PMR (HR 5.4) and gen pop (HR 5.6) 😬
NO difference for PMR vs gen pop (aHR 1.10, 95% CI 0.86–1.41)
Reassuring for pts w/PMR!
#ACR25 @RheumNow Abstr#0753 #ACRBest https://t.co/HKzc7OOzmP
Mike Putman @EBRheum( View Tweet )
🔥 Hot off the press
Prof John Stone shares results from Phase 3 of REPLENISH, out only a few days ago, in which secukinumab met all primary endpoints in treatment of PMR.
https://t.co/RlcQWybKrR
#ACR25 @RheumNow https://t.co/ucNt2HxJpW
Links:
Mrinalini Dey @DrMiniDey( View Tweet )
REPLENISH - Secukinumab Works in Polymyalgia Rheumatica
Novartis announced the results of their REPLENISH trial showing the efficacy of secukinumab (Cosentyx) (SEC) in adults with polymyalgia rheumatica (PMR).
https://t.co/qa9RzmNFU4 https://t.co/dCEkelJzni
Links:
Dr. John Cush @RheumNow( View Tweet )
REPLENISH - Secukinumab Works in Polymyalgia Rheumatica
Novartis announced the results of their REPLENISH trial showing the efficacy of secukinumab in adults with polymyalgia rheumatica (PMR).
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Methylprednisolone plus Methotrexate in Giant Cell Arteritis
What is the optimal glucocorticoids (GC) regimen in giant cell arteritis (GCA)? Does methotrexate (MTX) work in GCA?
A multicenter trial from Spain shows equivalent outcomes when GCA patients were treated with a combination of intravenous methyl-prednisolone (IVMP) pulse
Glossary for Giant Cell Arteritis
Dejaco and colleagues have published a glossary of terms often used in conjunction with giant cell arteritis. The glossary of definitions for 23 signs and symptoms of GCA was developed through a consensus process involving international experts.
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2025 BSR Recommendations for ANCA-associated Vasculitis
The British Society for Rheumatology (BSR) and British Health Professionals in Rheumatology (BHPR) have published a guideline for the management of adults with ANCA-associated vasculitis (AAV); specifically three conditions: granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA)
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PMR & GCA not assoc w/ increased mortality, Norway study of 274 isolated PMR (mean age 72 yrs) & 63 GCA (age 72 yrs) pts. After mean F/U 13.7 yrs 96% were deceased. Standardized mortality ratio was Not incr for PMR (0.97)or GCA (1.10), but men w/ PMR had , lower all-cause https://t.co/03lNpQiVYZ
Dr. John Cush @RheumNow( View Tweet )
CKD & Osteoporosis Rx Revisited (7.25.2025)
Dr. Jack Cush reviews the news, journal and FDA updates from this past week on RheumNow.com.
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PMR & GCA not assoc w/ increased mortality, Norway study of 274 isolated PMR (mean age 72 yrs) & 63 GCA (age 72 yrs) pts. After mean F/U 13.7 yrs 96% were deceased. Standardized mortality ratio was Not incr for PMR (0.97)or GCA (1.10), but men w/ PMR had , lower all-cause https://t.co/Mgq920awbD
Dr. John Cush @RheumNow( View Tweet )
ICYMI: Secukinumab promise in PMR is real
Choice is not just good, it is often necessary, and secukinumab promises just that in both PMR and GCA.
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Sometimes you hear:
“PMR dose steroids don’t really matter”
Errrrr…
(You wouldn’t accept this steroid exposure in any other disease. Never)
#EULAR2025 POS0139 @RheumNow https://t.co/o6w2RpaGBj
David Liew @drdavidliew( View Tweet )
In the United States, IL-6R inhibitors have continued to help PMR patients get off steroids.
Hopefully more use and more options mean that, in the future, PMR patients get no more steroids than PsA or RA patients
#EULAR2025 POS0948 @RheumNow https://t.co/JT7gFDC5rl
David Liew @drdavidliew( View Tweet )
Secukinumab promise in PMR is real
GCA is getting steroid-sparing therapy choices, and PMR doesn’t want to miss out. Most PMR patients with current therapy approaches incur multiple grams of cumulative prednisolone exposure, even though they’re often exactly the kind of https://t.co/GuD0l7zSfj
Dr. John Cush @RheumNow( View Tweet )
Fast track PMR clinics in Denmark led to more patients seen, and time to referral went down.
If we don’t get in early with a right diagnosis (and maybe early steroid-sparing) then PMR patients deteriorate.
We shouldn’t let PMR be an end stage disease #EULAR2025 POS0136 @RheumNow https://t.co/pqwveamhJP
David Liew @drdavidliew( View Tweet )
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