Imaging and Early Detection in Psoriatic Arthritis
At EULAR 2025, there have been new developments in imaging in PsA. Two key poster presentations (POS0104 and
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NMA of 14RCTs (>2500 pts) eval relative efficacy of bDMARDs and tsDMARDs in mostly biologic naïve nr-axSpA pts.
-All therapies studied significantly improved ASAS40 response rates compared to placebo.
-Certolizumab and Golimumab were the most effective therapies, followed by https://t.co/BJLRpEDYrv
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Adela Castro @AdelaCastro222( View Tweet )
👁️Uveitis in axSpA:
-Up to 40% can present before SpA dx
-NMA of 44 RCTs showed tx with TNFi, JAKi and IL-17i protective effects against uveitis
-Low rates of uveitis in axSpA pts on BIME trials suggests its possible beneficial effects.
#EULAR2025
@RheumNow https://t.co/mPuSMnD1Zs
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Adela Castro @AdelaCastro222( View Tweet )
Tofacitinib vs biologics in PsA:
📍MI/stroke ✅ similar
📍Serious infection ✅ similar
📍Malignancy ✅ similar
📍VTE ❌ higher vs TNFi (aHR 0.26)
Large US claims study (n=48k)
Abstract POS0296 @RheumNow #EULAR2025
Jiha Lee @JihaRheum( View Tweet )
Should we still be worried about lymphoma developing in RA patients?
Incidence has plummeted with modern therapy, although still a small risk. TNFi and other bDMARDs don’t seem to confer any real risk.
So what should our approach be?
Karin Hellgren #EULAR2025 @RheumNow https://t.co/9ZodpojSaz
David Liew @drdavidliew( View Tweet )
In PsA, can we better pick IL-17A inhibitor responders (after TNFi failure)?
Transcriptomic profiling is going to get better at telling us which pathways are truly important for response to specific treatments
POS0232 #EULAR2025 @RheumNow https://t.co/uycuXB0TFK
David Liew @drdavidliew( View Tweet )
Cancer risk in rheumatoid arthritis: anything new?
Is there a higher risk of cancer that comes with the disease? Or with the treatments? So many confounding parameters, such as disease duration, disease state, and disease activity come into play. A promising session explored comorbidities in Rheumatoid Arthritis, in particular cancer and
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EULAR 2025 – Day 2 Report
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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#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 )
#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
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Janet Pope @Janetbirdope( View Tweet )
In #axSpA post #TNFi-IR
What to use next?
👇
#ATTRA registry
90% #SpA on #bDMARDs are captured
Comparison of
TNFi to ▶️
2nd TNFi vs
#IL17i
▶️No diff in #retention
✅better #BASDAI and other outcomes w TNFi!
❎less safety
🤔
#EULAR2025 @RheumNow @eular_org
Abst#POS0116 https://t.co/7mqFfD4Amf
Janet Pope @Janetbirdope( View Tweet )
Nordic registries (n=13,872): D2T-PsA varied 37% (≥2 b/tsDMARDs failed) to 0.6% (strictest). Female predominance increased with therapy failures (≥4 failures: 67% female). Median time to failure: 5–7 years.
Abstract OP0177 @RheumNow #EULAR2025 https://t.co/lchPnTCEx7
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Exciting results from ARGO trial:
-Phase 2 of Sonelokimab (dual IL-17A-IL17F) nanobody in PsA.
-Met primary endpoint of ACR50 at week 12 vs PBO.
-62% achieved MDA
-48% achieved composite of ACR 70+PASI 100
Looking forward to phase 3 results!!!
Abstract #OP0096 #EULAR2025 https://t.co/1D52eG8ReS
Links:
Adela Castro @AdelaCastro222( View Tweet )
Biomarker data suggest TNFi non-responders in PsA exhibit upregulation of IL-17F gene signatures after treatment failure. Supports IL-17A/F blockade rationale with bimekizumab in TNFi-experienced patients Abstract#OP0091 @RheumNow . #EULAR2025 https://t.co/CWR6ArDRRW
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
SPEED RCT: In early PsA with poor prognostic factors, PASDAS at 24wks:
•Early TNFi: 3.7
•Combo csDMARDs: 4.1
•Step-up csDMARDs: 4.7
Early TNFi beat step-up by -1.09 (p<0.001); combo csDMARDs also superior (-0.69, p=0.02). Early TNFi benefit sustained at 48wks. Abstract#OP0089 https://t.co/MpazF8BIr2
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Precision immunotherapy in axial spondyloarthritis: TRBV9xCD3 bispecific antibodies selectively depleted autoreactive TRBV9+ T cells from HLA-B27+ AS patient samples while sparing over 95 percent of the T cell repertoire. TRBV9xCD3 bispecific antibodies selectively depleted https://t.co/8UXqEaDYnS
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
In vitro, balinatunfib (TNFR1-selective inhibitor) preserved Treg expansion in CD4+ T cells co-cultured with IL-2 and memTNF (Treg 8.99 percent, p<0.0001), unlike adalimumab and etanercept which reduced Tregs by 27.5 to 41 percent. Confirms TNFR2 sparing with selective TNFR1 https://t.co/xaczz87Xrd
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
VEGF-Grab (PB101/PB102), dual VEGF/PlGF decoy receptor, inhibited angiogenesis, RA-FLS invasion, and Th17 cell differentiation in RA and MS models. PB102 reduced IL-17 and GM-CSF co-expressing Th17 cells, suppressed pannus and joint destruction in CIA, and outperformed IFN-β in https://t.co/qhVRYT4RbK
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
❓️How effective and safe is it to combine bDMARDs and tsDMARDS (i.e. TNFi/ IL17i + JAKi/TYKi) in #psoriatic_arthritis?
🅰️ Reassuring data from a case-series study presented by Andre Lucas Ribeiro
#EULAR2025
OP0090
@RheumNow
#Strategy https://t.co/W8fuzSgxbJ
Nelly ZIADE 🍀 @Nellziade( View Tweet )
Ph 2 RCT Sonelokimab (IL-17A- & IL-17F-inhibiting Nanobody) 24wks
207 pts SON 120 MDA 51% vs. 45% ADA
Subgroups: female 52%, weight ≥100kg 53%, ≥3% BSA 55%
Composite ACR70/PASI100 SON 120 48% vs. 19% ADA
No new safety signal
Ph 3 on the way 2 doses SON 60 &120
#OP0096 https://t.co/w5QtpKbi1W
Links:
Aurelie Najm @AurelieRheumo( View Tweet )
❓️Is early intensive therapy with combination csDMARDs or TNFi superior to standard step care for the treatment of moderate to severe #psoriatic_arthritis?
🅰️ Yes
🔅Check out the SPEED RCT presented by @DrLauraCoates at #EULAR2025
OP0089
@RheumNow
#Strategy https://t.co/24e7wUV2FB
Nelly ZIADE 🍀 @Nellziade( View Tweet )
GI symptoms in axSpA
-Cohort of 370 pts with axSpAfrom New Zealand
-Elevated fecal calprotectin ➡️ positive correlation with GI symptoms and high disease activity
-Bowel symptoms associated with reduced quality of life.
-Use of TNFi improved bowel symptoms over time. https://t.co/wA37G3HWyi
Links:
Adela Castro @AdelaCastro222( View Tweet )
MONITOR PsA 200+ pts secondary care "real-life" cohort
65 treated w/ combi csDMARDs
48weeks outcome and 96 weeks
49% bioDMARDs, 29% retention and 23% deescalation to 1 csDMARD
‼️reasons for discontinuation was AEs in 60% cases not inefficacy
Caveat: analysis not adjusted for https://t.co/L8EczgZTpP
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Aurelie Najm @AurelieRheumo( View Tweet )
Xeligekimab in AS:
-IL-17A blocker
-Phase 3 study on Chinese pts showed sustained efficacy until week 48.
-Significant improvement on DAI measures as well.
-Fully humanized IgG4 mab may last longer in system and possible less ADAs.
Abstract #OP0102 #EULAR2025 @RheumNow https://t.co/vyNHZ9ssFt
Links:
Adela Castro @AdelaCastro222( View Tweet )
REGULATE-RA and REGULATE-HS FIH CAR-Treg targeting Cit-P
Refractory RA (at least 3 MoA)
3 RA pts dosed & 3 Hidradenitis Suppurativa 0 SAE, DLTs or CRS
Grade 1 TEAs mainly, one Grade 2
Efficacy and PD analysis ongoing
#POS0034 #EULAR2025 @RheumNow https://t.co/Glw3NNFepF
Links:
Aurelie Najm @AurelieRheumo( View Tweet )
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