Tsvetoslav Georgiev

Not all endothelial markers behave the same in spondyloarthritis. In our study, VCAM-1 tracked inflammatory activity and treatment status, especially in ankylosing spondylitis, while ICAM-1 did not. #Rheumatology #Spondyloarthritis link.springer.com/article/10.118…

Stroke in autoimmune rheumatic diseases @YuliyaFedorchen @DDoskaliuk @FedkovDmytro @RusinovichOlga @OlenaZimba @JCRheum @American_Stroke @JSRheumatology pmc.ncbi.nlm.nih.gov/articles/PMC13…

How has the history of cytokines shaped the trajectory of modern precision medicine in rheumatic diseases? This comprehensive review traces the evolution from early "pyrogens" to the revolution of targeted biologics and oral JAK inhibitors. Full text: doi.org/10.35465/0cm8p…

How did I almost miss the new EULAR recommendations for Behçet’s syndrome? A major 2025 update, from colchicine/apremilast to TNF inhibitors in severe organ disease and, tellingly, TNF is mentioned 79 times! doi.org/10.1016/j.ard.…

Systemic lupus erythematosus-related infections in pregnancy: a cross-sectional bibliometric analysis link.springer.com/article/10.100…

AS and PsA show broadly similar carotid vascular biomechanics, while higher augmentation index in PsA suggests altered wave reflection rather than true stiffness. Fulltext👉 doi.org/10.35465/jdzt6…

🔥 New Issue Just Dropped Rheumatology (Bulgaria) 2025;33(4) is LIVE From IL-17i in PsA to carotid biomechanics in SpA and complex SLE cases, this issue delivers real-world, clinically relevant science you can use tomorrow FT👉 rheumatologybg.org/journal/rbj/is… #Rheumatology #MedTwitter

☠️ Mortality remains elevated in spondyloarthritis: multinational real-world data (TriNetX) 📊 32,368 axSpA + 52,402 PsA vs 9.7M controls 📈 axSpA: HR 1.71 vs population; PsA: HR 1.26 👨 Male sex = worse survival in both diseases 💊 TNFi reduced mortality by 47% (axSpA) and 38% (PsA) vs untreated 🔗 doi.org/10.1136/rmdope…

Clinical Practice Guideline for Evaluation and Management of Peripheral Nervous System Manifestations in Sjögren's Disease - Deboo - Arthritis Care & Research - Wiley Online Library #sjogrens #sjogrensfoundation acrjournals.onlinelibrary.wiley.com/doi/10.1002/ac…

UCB announced topline results of the BE-BOLD head-to-head study where bimekizumab (IL-17i) was superior to risankizumab (IL-23i) study; 553 active PsA in achieving an ACR50 response at 16 weeks. Enrolled PsA pts were either bilogic naïve or who had previous exposure to 1 TNFi ucb-usa.com/stories-media/…

Ethics in publishing: From plagiarism to artificial intelligence @OlenaZimba @EMEUNET @eular_org @ACRheum @PanlarJ @PanlarLeague @ELIDEK_HFRI @medenuth sciencedirect.com/science/articl…

Honored to serve as the new Editor-in-Chief of Rheumatology (Bulgaria). We aim to strengthen the journal through rigorous science, careful peer review, and high editorial standards. #Rheumatology #AcademicPublishing

LETTERS TO THE EDITOR IN MEDICINE SHOULD NOT BE GENERATED BY AI | Central Asian Journal of Medical Hypotheses and Ethics @sakir_rheum @prakashini_ @BurhanFatihKoy1 @ahmetak20160685 @anarsiknotrofil @abdulvahap_md @GeorgievMD @TUMS_CVDRI @UlianaPidvalna cajmhe.com/index.php/jour…

@RheumNow Turns out nuance ages better than absolutes.

Hydroxychloroquine for Everyone Nearly 25 years ago, while lecturing on best therapies for rheumatoid arthritis (RA), I loudly stated that hydroxychloroquine was “useless” and, deservedly, I was “boo-ed” off stage. My point then was that rheumatologists needed to be aggressive, if not overly aggressive, in treating all RA patients. And my view was that HCQ was representative of under-treatment. buff.ly/DgppcVk

Novartis announced top line results of its ianalumab (VAY736;B cell inhibitor) in primary Sjögren’s dz. 2 RCTs, NEPTUNUS-1 and NEPTUNUS-2, met met primary endpoints w/ statistically significant improvements in disease activity in Sjögren’s patients. buff.ly/c6COFPw

New global survey: 92% of #rheumatologists use #socialmedia professionally, but 57% feel overwhelmed by content. Regional gaps persist—connectivity issues in lower HDI regions, legal barriers in higher HDI areas. Time for structured SM training? tinyurl.com/fhej5z96 #MedEd

The GRAPPA 2025 consensus introduces new definitions for PsA: complex-to-manage and treatment-refractory PsA, aiming to standardize how we define and study D2T disease. #PsoriaticArthritis #RheumTwitter #GRAPPA2025. Do these categories fit ur needs? doi.org/10.1038/s41584…

Quantitative US grayscale histogram of metacarpal head cartilage shows promise for earlier detection of RA cartilage damage. Could this become a standard tool in early RA imaging? #rheumatology #RA #ultrasound doi.org/10.1186/s42358…

Axial Spondyloarthritis: an overview of the disease @GeorgievMD @OlenaZimba @NeslihanGken7 @anarsiknotrofil @BurhanFatihKoy1 @Abraham_RMI @hande_snc @AcerSevtap @Official_ASAS @eular_org @JCRheum @PanlarLeague @RheumAFLAR @Reumatologia_uy @GencTRASD pubmed.ncbi.nlm.nih.gov/38689098/

😍😍Click on "2025 Systemic Lupus Erythematosus Guidelines" here: rheumatology.org/lupus-guideline @ACRheum @ACR_Journals Some of my favs: ✅ Though they recommend SLEDAI for disease activity, they realistically acknowledge that many rheumatologists are WAY too busy to realistically measure it every visit. ✅ T2T is remission. They acknowledge that DORIS remission (a research tool) is the most widely used tool, but they note that T2T RCTs are needed. 😡I DO NOT like DORIS in clinical practice!! It allows patients on steroids. That is NOT remission. Remission should be no active inflammation clinically (SLEDAI, PGA, and BILAG = 0 and no steroids)! ✅ They give very nice, practical advice for general rheumatologists about some common manifestations, eg not over treating asx cytopenias, and how to treat leukocytoclastic vasculitis (don't 'over treat). ✅They recommend UV protection in ALL SLE patients. Though they did not state this, they are silently acknowledging that almost all SLE patients are UV sensitive even if they do not get photosensitive rashes. ✅ They recommend the use of quinacrine for CLE. To learn how to RX quinacrine, go to: lupusencyclopedia.com/quinacrine ✅They recommend lenalidomide instead of the more dangerous thalidomide in severe CLE. ✅ Though the summary makes it sound like they recommend biologics "down the road" in lupus arthritis, thankfully, the manuscripts acknowledges that "there will be individuals for whom biologic therapy ... is preferable." We CANNOT allow some of our patients to progress to Jaccoud's. Rapid remission is important! What I do not like: ✅ They recommend up to 1000 mg IV methylprednisolone. There is NO evidence that 1000 mg works better than 500 mg. However, retrospective studies show that 1000 mg is clearly associated with more severe infections! (see the studies referenced in Porta et al, link below). ✅ Unfortunately, they do not recommend using more high dose IV pulse methylprednisolone to take advantage of its safer and faster working non-genomic effects and its ability to greatly lower oral steroids faster. @eular_org and our European counterparts are way ahead of us on this one. Everyone should read pubmed.ncbi.nlm.nih.gov/32839376/ ✅ For the zero steroids recommendation, they recommend within 6 months. That is TOO LONG for most patients. Use steroids per Porta et al, test HCQ drug levels every visit, start with combination tx immediately in moderate to severe SLE, and 5 mg is easily achievable much faster than 6 mo in the vast majority of SLE patients. ✅ So, so sad that they don't recommend HCQ drug levels. How much more evidence do you need? I can plop a huge pile of studies on your desks. Nathalie Costedoat-Chalumeau has been publishing convincing evidence since 2006. I've used them since 2016 (recommended by Michelle Petri) and it has GREATLY transformed my clinic into more remissions and markedly less steroids. Rheumatologists who are not using it every visit are missing poor adherence, and allowing patients a higher risk for retinopathy (too many with levels above 1200 ng/mL), and too many patients below the therapeutic goal of 750 ng/mL). My final verdict: Over all... wonderful job Guidelines Committee! Since this is a living document... please go back and add using HCQ drug levels!