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‼️Diagnosis of axSpA is clinical -MRI is a tool but still has a lot of limitations. -Improve reports by directly communicating with radiology and be specific on pt clinical info. -Unified algorithms are needed to apply AI in dx of SIJ inflammation on MRI. #EULAR2025 Dr. John Cush

🚨Diagnostic delays are real in axSpA: -Can lead to more extra-msk manfieststions (EMMs) in PsA and axSpA. -Increases disease burden and productivity losses. -EMMs can present before articular sx -Uveitis and IBD associated with longer dx delays. -Diagnosis has improved since

🔍MRI lesions in early axSpA vs non axSpA with chronic back pain: -Data from SPACE cohort -n 318 (214 axSpA vs 108 non-axSpA). -Baseline imaging (CR and MRI) and at 2y f/u -Minimal progression on CR in both early axSpA and non-axSpA CBP. -On MRI, significant increase in the

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

👁️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 Dr. John Cush

#EULAR2025 Congress dinner with the best of the best Azmad Kareem Cathy Melong taleng

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

Pearls on EGPA: 1. GC are mainstay for mild dz 2. Organ threatening/relapsing➡️CYP (RTX alternative) 3. W/o organ threatening➡️ anti-IL-5/IL-5R. 4. IL5i are less effective for ENT 5. Consider sx for nasal polyps. #EULAR2025 Dr. John Cush

EULAR Points to consider for the definition of #D2M #Psoriatic_Arthritis 1️⃣ Failure >= 2 b/tsDMARDs with >=2 different MOA 2️⃣ Perceived as problematic 3️⃣ Evidence of persistent disease (active disease, EMM, inflammation) #EULAR2025 Dr. John Cush

Tips for Dx RP: 1. Suspect the dx and recognize chondritis. 2. Rule out mimickers 3.Tracheal involvement shows swelling>stenosis (helps ≠from GCA) 4. CV, heme, derm manifestations 🧐VEXAS. 5. biopsy not useful unless ≠ from GCA. Fantastic session by Laurent ARNAUD

Management and prognosis of RP by Laurent ARNAUD 1. Pts with mild disease respond to GCs 2. NSAIDs/colchicine good alternatives 3. Most common biologics used: TNFi and IL6i 4. Consider CYP in life threatening dz/ICU pts 5. Dynamic CT assess tracheal collapse. 6. PET-CT can ≠

Results from open label extension of BE-OPTIMAL: -Bimekizumab in bDMARD naïve pts showed sustained efficacy after 1y until 3y. -No significant major tolerability issues or major SE. abstract #POS1294 #EULAR2025 Dr. John Cush

✅Exciting results from POETYK PsA-1: -Deucravacitinib (TYK2i) in PsA -ACR 20 was achieved in significantly more patients treated with deucravacitinib vs placebo at W16 (54.2% vs 34.1%; P < 0.0001), with similar results for ACR 50 and ACR 70 -Also met 2dary endpoints. -Post hoc

Biologic switching in PsA: -Retrospective study on 3,851 PsA pts initiating bDMARDs, 1,848 (48%) switched therapy at least once. -TNFis were the initial therapy. -IL17i were the first switch in both single-switch and multi-switch scenarios. -Subsequent switches: back to TNFi

#WIN in systemic sclerosis (SSc): -Ongoing trials now targeting multiple pathways. -CONQUEST platform may reshape research in Ssc and other autoimmune diseases. -Revised CRISS could replace single organ endpoints for approval. #EULAR2025 Dr. John Cush

APEX study showed significant inhibition of structural damage progression with both dosing regimens (Q4W and Q8W) of GUS (IL-23i) in biologic-naïve pts with active PsA. Abstract #LB0010 #EULAR2025 Dr. John Cush

Efficacy and Safety of Xeligekimab in AS Dr. Adela Castro reports on abstract OP0102 at the EULAR 2025 meeting in Barcelona, Spain buff.ly/jOLBrQY

Expanding the IL-17 Therapeutic Landscape IL-17 inhibitors are an effective therapeutic for a broad spectrum of inflammatory and autoimmune diseases and its blockade has revolutionized management of diseases such as psoriasis, psoriatic arthritis and SpA.

EULAR 2025 – SpA Panel Discussion x.com/i/broadcasts/1…

Delighted to join panel members Dr. John Cush Peter Nash Antoni Chan MD (Prof) Adela Castro where we discussed our favourite abstracts on #Spondyloarthopathy presented at #EULAR2025. Please find our video below 😃