EULAR 2025 - Day 1 Report
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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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 )
Secukinumab for PMR?
-post hoc analysis of the TitAIN study (phase 2 RCT on new onset/relapsing GCA) showed:
-Numerical reduction in patients experiencing PMR symptoms when treated with secukinumab compared to placebo.
-Safety profile was similar to the overall GCA study
Adela Castro @AdelaCastro222( View Tweet )
IL-17 inhibition for PMR? In the secukinumab ph2 in GCA (TitAIN), patients with PMR did really well, seemingly outperforming steroid taper in the placebo arm. Real promise, will be great to see how the ph3 in PMR (REPLENISH) goes OP0062 #EULAR2025 @RheumNow https://t.co/cisA0GiUx1
David Liew @drdavidliew( View Tweet )
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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Secukinumab Use in Refractory Giant Cell Arteritis
In 2023, the phase 2 TitAIN study showed that the effectiveness and safety of secukinumab in 52 patients with giant cell arteritis (GCA) who had an inadequate response to tocilizumab. While we await the results of a larger phase 3 trial, there is a 6 patient case series also suggesting
The IL-17A inhibitor, secukinumab, is in late-stage development forthe treatment of giant cell arteritis and polymyalgia rheumatica. https://t.co/JzzqS7bSjd https://t.co/9Qm0YsJmOL
Dr. John Cush @RheumNow( View Tweet )
2024 Rheumatology Year in Review
2024 was a year of surprising new growth in technology, with the expansion of new therapeutic options for many patients and clinicians. While these many advances offer new hope, they are countered by disappointments and gapping unmet needs in rheumatology. Below is my top 10 list
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TheDaoIndex @KDAO2011
@UnaMakris wants us to shift our approach to #GeriRheum. #RNL2025– remember the 5 M’s Multimorbidity Mind Medications Mobility what Matters most
https://t.co/MIVnpw87rW https://t.co/D4AmrYhyWH
Links:
Dr. John Cush @RheumNow( View Tweet )
Adela Castro @AdelaCastro222
Are your patients aging with RA, or are they diagnosed with Late Onset RA (LORA)? -LORA pts tend to present acutely -High inflammatory markers~PMR Like -Seronegative/Decreased titers of RF/CCP @UnaMakris #RNL2025 https://t.co/tLrGBV6P1i https://t.co/53HVvUmrG4
Links:
Dr. John Cush @RheumNow( View Tweet )
TheDaoIndex @KDAO2011
Late onset RA (LORA) aka RA diagnosed at an older age — pts have higher inflammatory markers, presents like PMR; they also have polypharmacy, comorbidities, frailty, etc that can complicate management @UnaMakris #RNL2025 @RheumNow #GeriRheum… https://t.co/E2WFwfCsWD https://t.co/tKF0OnUFQH
Dr. John Cush @RheumNow( View Tweet )
@RichardPAConway on PMR
#RNL2025 @RheumNow
PMR mimics: look for mimics in unusual/refractory cases
- Suspect the mimics to avoid undertreatment or over-treatment
Conway: PMR is NOT easy. Easy to misdiagnosis, easy to mistreat. "One of our most challenging cases" https://t.co/WqPWwCuutF
Eric Dein @ericdeinmd( View Tweet )
Late onset RA (LORA) aka RA diagnosed at an older age — pts have higher inflammatory markers, presents like PMR; they also have polypharmacy, comorbidities, frailty, etc that can complicate management
@UnaMakris #RNL2025 @RheumNow #GeriRheum https://t.co/zqEcyg2ejw
TheDaoIndex @KDAO2011( View Tweet )
@UnaMakris #RNL25 @RheumNow
Older patients w RA
1/3 of pts onset >60-65
- More acute onset, more systemic, more PMR-like, larger jts
- Higher IL-6, lower TNF-a, less RF, higher ESR
-Co-morbidities, polypharmacy, cognition, depression
Age does not equal frailty, but does correlate https://t.co/5qb60WyKkP
Eric Dein @ericdeinmd( View Tweet )
Are your patients aging with RA, or are they diagnosed with Late Onset RA (LORA)?
-LORA pts tend to present acutely
-High inflammatory markers~PMR Like
-Seronegative/Decreased titers of RF/CCP
@UnaMakris
#RNL2025 @RheumNow https://t.co/aOCwb3lHef
Adela Castro @AdelaCastro222( View Tweet )
BACHELOR Trial - Baricitinib in Early Polymyalgia Rheumatica
Lancet reports a French study demonstrating the efficacy of baricitinib in patients with polymyalgia rheumatica (PMR).
Glucocorticoids are the mainstay of therapy in PMR patients and may be problematic in older… https://t.co/svLmE6OBWm https://t.co/K8sdROswxV
Dr. John Cush @RheumNow( View Tweet )
BACHELOR Trial - Baricitinib in Early Polymyalgia Rheumatica
Lancet reports a French study demonstrating the efficacy of baricitinib in patients with polymyalgia rheumatica (PMR).
Great table re:side effects of even low dose steroids in RA
Likely generalizes to other diseases ie PMR, SLE
P in prednisone stands for poison!
#ACR24 @RheumNow https://t.co/2bFy6dwl96 https://t.co/YDtjSX054I
Links:
Dr. John Cush @RheumNow( View Tweet )
54K Peptic Ulcers Annually (12.13.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com
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ICYMI: Say Goodbye to Methotrexate in PMR?
For decades, glucocorticoids (GCs) have formed the backbone of polymyalgia rheumatica (PMR) management. Whilst previously there was a sense that a “low” GC dose with limited duration was used, we now appreciate just how heterogenous the disease course of PMR can be, with many
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ACR24: Rheumatology Roundup
Join Drs. Jack Cush and Artie Kavanaugh as they review 15+ presentations and abstracts from the 2024 ACR Convergence meeting in Washington, DC.
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The Case for JAKi in PMR
Dr. David Liew abstract 0858, Baricitinib in Early Polymyalgia Rheumatica (BACHELOR Study), presented at #ACR24.
https://t.co/NLF75PuMOb https://t.co/FpUUdbtrwf
Dr. John Cush @RheumNow( View Tweet )
Say Goodbye to Methotrexate in PMR?
Despite mixed results on its clinical efficacy in three previous randomised controlled trials (RCTs)1-3, methotrexate is considered the most widely used GC sparing agent. #ACR24
https://t.co/Q5Sw9dvYqJ https://t.co/jvEmg6aPcq
Dr. John Cush @RheumNow( View Tweet )
@drceowen @TheLancetRheum @RheumNow Efficacy in newly diagnosed & established PMR is not necessarily interchangeable
different treatment paradigm
?different immunologically
Many other diseases have different Rx for induction vs maintenance, early dx vs established.
Having said that: doesn't look great for MTX. https://t.co/89lByaYdYq
David Liew @drdavidliew( View Tweet )
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