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OP0195: MTX+LEF isn’t commonly used—but could it be a viable option after all? In >1,100 RA pts, no link to liver fibrosis (FIB-4/APRI), modest ALT ↑, and fewer hospitalizations. real-world safety data worth a second look. Dr. John Cush #EULAR2025

OP0179: In a psoriasis cohort, 68% of PsA onset sites showed prior subclinical inflammation (26% tender, 32% US+, 42% both). Should we redefine when PsA truly begins? Dr. John Cush #EULAR2025

POS0150: From 12 RA registries, JAKi starts fell by ~13% after FDA safety alerts. Tofa & bari took biggest hits; upa growth slowed but offset losses. Real-world prescribing adapts—but doesn’t abandon. Dr. John Cush #EULAR2025

🎯 Early MTX hits the mark — but only in ACPA-negative. In TREAT EARLIER, 1 year of MTX led to lasting benefits at 5 years: ➖ Less RA ➖ Better function ❌ No benefit in ACPA+ Abstract#OP0324 Dr. John Cush #EULAR2025

The ARIAA trial shows that 6 months of ABA can delay RA onset in ACPA+ at-risk patients with benefits persisting up to 5 years. Yet nearly 70% still developed RA. Is delaying RA enough? #OP0325 Dr. John Cush #EULAR2025

Even when inflammation is controlled, 1 in 3 early RA pts report persistent symptoms and disability. In #CareRA trials, these patients were more likely to escalate to b/tsDMARDs—raising concern for overtreatment. Abstract OP0330 Dr. John Cush #EULAR2025

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 Dr. John Cush #EULAR2025

📊 SIJ findings in PsA (n=581): 🧠 31% = MRI-confirmed axSpA 🦴 Only 29% met r-mNY criteria MRI-axPsA group: younger, more male, HLA-B27+ Clinical + radiographic definitely underperform vs MRI #POS0297 Dr. John Cush #EULAR2025

PsO + recent arthralgia—but no PsA. Treat or wait? 🧠 18% developed PsA in 3 yrs, most in year 1 🔍 Predictors: tender joints, disability, enthesis erosion Consider early rheum input for these patients Abstract POS0299 Dr. John Cush #EULAR2025

Can RZB deliver in real-world early PsA? 💥 9-month results say yes: ✅ Dactylitis gone in 79% ✅ Enthesitis in 90% ✅ 97% MDs & 88% pts satisfied Early intervention may pay off. Abstract POS0304 Dr. John Cush #EULAR2025

Delay hurts. Dx delay in axial SpA costs UK £3.1 billion annually. Avg time to dx = 8.5 yrs Avg dx cost = £187k/person Fixing delay could save £167k/person. Early Dx isn’t just better care—it’s economic policy. #EULAR2025 Dr. John Cush #AxialSpA #RMD

67% of HCPs knew of EULAR’s CVD risk guidelines in RMDs—but few could apply them. ✅ Only 13% linked SLE control to CVD risk 🚫 0% picked correct BP/statin use in RA/AS/PsA Barriers? Time, knowledge, and local guideline gaps. POS0410-HPR Dr. John Cush #EULAR2025

Deucravacitinib, the first oral TYK2 inhibitor, delivers in PsA: ✅ ACR20: 54% vs 34% (placebo) ✅ Skin, joints, fatigue, QoL 📉 Post hoc: less radiographic progression No new safety signals at W16. LB0001 Dr. John Cush #EULAR2025

Older adults with chronic MSK pain report lower physical health—but better mental health—than younger peers. Fewer missed work days, too. Is this resilience, adaptation, or shifting expectations with age? POS0402 Dr. John Cush #EULAR2025

Presenteeism and absenteeism in RA aren’t just about joints. In this UK study, comorbid anxiety, depression, and OA drove lost productivity. Treating RA is not enough —holistic management matters. POS0403 Dr. John Cush #EULAR2025

Tapering in RA? In SORAIRO (n=149), pts in remission on ozoralizumab+MTX: 🧪 49% became MTX-free ⏱ 80% spaced OZR to q8w CDAI ≤10 maintained in >90% if baseline remission + albumin >3.8 LB0006 Dr. John Cush #EULAR2025

Leaky pipeline in rheumatology: In a 23-country survey, women left hospital practice earlier—26% at trainee level vs 7% of men. Top reasons? 🚫 Unfair promotion 🚫 Poor communication 🚫 No career path Workplace equity still lags. POS0407 Dr. John Cush #EULAR2025

Guselkumab in APEX study (PsA, n=1020, biologic-naïve): 🦴 Less joint damage: 0.55 vs 1.35 (placebo) 💪 More responders: 67–68% hit ACR20 on GUS 🛡 Safety: similar to placebo GUS - selective IL-23i - delivers joint protection and symptom relief LB0010 Dr. John Cush #EULAR2025