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7 Rheumatology Headlines You Missed in October 2025
October 2025 brought a range of important updates across rheumatology, highlighting advances in systemic lupus erythematosus (SLE), lupus nephritis (LN), rheumatoid arthritis (RA), Sjögren disease (SjD), and psoriatic arthritis (PsA). New data from the American College of Rheumatology (ACR) Convergence 2025 underscored progress in both established and investigational therapies, from dual B-cell targeting in SLE and SjD to novel T-cell and JAK-targeted approaches in RA, as well as head-to-head biologic comparisons in PsA.
In SLE and LN, telitacicept and obinutuzumab demonstrated robust disease-modifying effects, while in RA, rosnilimab and upadacitinib offered evidence for deeper, upstream disease control and optimal post–TNF inhibitor sequencing. In SjD, telitacicept and monthly ianalumab provided clinically meaningful improvements in disease activity and patient-reported outcomes, and in PsA, secukinumab outperformed ustekinumab in TNFi-experienced patients, reinforcing new strategies for biologic treatment selection.
Check out this October 2025 rheumatology month in review for a recap of HCPLive’s coverage of the top news and research from the past few weeks:
New ACR Research - Lupus
1. Telitacicept Significantly Improves Lupus Response Rates Above SOC Alone
The dual BAFF/APRIL inhibitor telitacicept achieved more than double the clinical response of placebo in patients with systemic lupus erythematosus (SLE) when added to standard therapy, according to results from a phase 3 trial. At week 52, 67.1% of patients receiving telitacicept met the modified SRI-4 response versus 32.7% with placebo, though higher rates of treatment-related adverse events, including infections and reduced immunoglobulin levels, were observed.
2. REGENCY: Obinutuzumab’s Deep B-Cell Depletion in Kidney Supports Benefit for Lupus Nephritis
In the phase 3 REGENCY trial, obinutuzumab (Gazyva) achieved near-complete B-cell depletion (−98%) and significantly reduced plasma cells within kidney tissue in patients with lupus nephritis (LN), marking the first demonstration of intra-renal B-cell and plasma cell depletion by an anti-CD20 agent. The data further support obinutuzumab’s October 2025 FDA approval for adults with LN.
Updates in RA
3. Rosnilimab: A New Era of Upstream RA Disease Control, With Jonathan Graf, MD
In a phase 2b trial presented at ACR 2025, rosnilimab, a first-in-class monoclonal antibody targeting PD-1–high pathogenic T cells, significantly reduced disease activity in patients with moderate to severe RA, achieving greater DAS28-CRP improvements versus placebo (–2.06 to –2.12 vs –1.69; P < .01). The therapy depleted over 90% of disease-driving Tph and Tfh cells while sustaining clinical and patient-reported benefits through 28 weeks.
4. Switch, Don’t Cycle: Upadacitinib Outperforms Adalimumab in RA Post-TNFi, With Eduardo Mysler, MD
The phase 3b/4 SELECT-SWITCH trial demonstrated that upadacitinib (Rinvoq) achieved significantly higher rates of low disease activity (43.3% vs 22.4%) and remission (28.4% vs 14.5%) than adalimumab (Humira) at week 12 in patients with RA who failed a prior TNF inhibitor (P <.001 for both). These findings provide the first direct evidence favoring a mechanism switch over TNF inhibitor cycling.
New ACR Research - Sjögren
5. Telitacicept Improves Sjögren Symptoms Over Placebo in Phase 3 Trial
In a phase 3 trial of 381 patients with SjD, telitacicept significantly improved disease activity and symptom severity versus placebo at both 80 mg and 160 mg doses through 48 weeks, with the higher dose yielding the greatest benefit. The therapy maintained a favorable safety profile and demonstrated consistent clinical improvements across key endpoints.
6. NEPTUNUS-1 and 2: Monthly Ianalumab Significantly Improves Sjögren Disease Activity
Subcutaneous ianalumab achieved significant reductions in disease activity across both phase 3 NEPTUNUS-1 and NEPTUNUS-2 trials, meeting primary endpoints in patients with SjD. Monthly ianalumab 300 mg led to greater improvements in ESSDAI scores, patient- and physician-reported outcomes, and salivary function compared with placebo, with a favorable safety profile and consistent efficacy across key secondary endpoints.
New ACR Research - PsA
Secukinumab demonstrated superior efficacy to ustekinumab in TNFi-experienced patients with psoriatic arthritis in the phase 3b AgAIN trial. At week 28, 57.1% of patients receiving secukinumab achieved HAQ-DI response versus 27.0% with ustekinumab (P = .002), with greater improvements across joint, skin, and pain outcomes, and fewer discontinuations due to loss of efficacy.
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