Alain Sanchez, MD

Rheumatologist and Internist @ABCcentromedico | Professor @TECccm Former Research Fellow, Division of rheumatology @MayoClinic, Rochester, MN

[Alain Sanchez, MD @lain_sanchez]

The most dangerous phrase in our language is “we have always done it this way”

[Alí Duarte, MD @AliDuarteMD]

In lupus nephritis (LN), “activity” gets the spotlight—but chronic scarring often decides the long game. So: which chronicity score best predicts outcomes—NIH Chronicity Index (NIH-CI) or the Mayo Clinic Chronicity Score (MCCS)?
https://t.co/eyt9txJqQr

[Alain Sanchez, MD @lain_sanchez]

@AAcosta_MedMD @DanaFarber @MayoHemeOnc @Ash @DrCCutler Congratulations!! 🎉🎈🍾

[Alain Sanchez, MD @lain_sanchez]

https://t.co/VK5cA0yvAB

[Dr.Mukesh , MD , DM @dr_immuno29]

🫁 ERS/EULAR 2026 CTD-ILD Guidelines — Key Takeaways

🔹 Covers SSc, RA, IIM, Sjögren, SLE & MCTD–ILD
🔹 Built on 25 PICO + 28 narrative questions using GRADE methodology

📌 Screening

👉 HRCT = gold standard
🚫 Do NOT replace HRCT with PFTs or lung ultrasound (high miss rates)
✅ Screen ALL SSc & MCTD
✅ Screen RA / SjD / IIM if risk factors present

📌 Baseline risk assessment

Assess globally using:
• HRCT extent/pattern
• FVC + DLCO
• Autoantibodies
• CRP/ESR
• Clinical severity

📌 Monitoring

🔁 PFTs every 3–6 months initially, then 6–12 monthly
🔁 HRCT:
• SSc/RA: every 1–2 yrs
• IIM (high-risk): as early as 3–6 months

📌 Treatment recommendations

🟢 SSc-ILD
• Tocilizumab (strong)
• MMF / Rituximab / Cyclophosphamide (conditional)
• Nintedanib for progressive fibrosis
• MMF + Nintedanib combination allowed

🟢 IIM-ILD
• Immunosuppression strongly recommended

🟢 RA / SjD / SLE / MCTD-ILD
• Immunosuppressants suggested
• RA-ILD (UIP): Pirfenidone may help

🟢 Progressive fibrosing CTD-ILD
• Add Nintedanib

🚫 Lung biopsy NOT routine
✅ BAL only if infection / alternate dx suspected
✅ PROMs + 6MWT for severity/prognosis

⸻

🔥 TAKE-HOME MESSAGE

Early HRCT screening + structured monitoring + timely immunosuppression/antifibrotics = cornerstone of CTD-ILD care. Missing ILD = missed survival opportunity.

⸻

📄 Eur Respir J 2026
DOI: 10.1183/13993003.02533-2024

#CTDILD #InterstitialLungDisease #Rheumatology #Pulmonology #SystemicSclerosis #RA #Myositis #Sjogrens #SLE #ERS #EULAR #ILD #MedTwitter #RheumTwitter #PulmTwitter

[Alí Duarte, MD @AliDuarteMD]

Volver a México y compartir con colegas siempre es una alegría: colegas increíbles, preguntas buenísimas y mucha conversación. Gracias al Colegio Mexicano de Reumatología por la invitación. 🇲🇽

[ACR_Journals @ACR_Journals]

Call for new applicants for Rheum With a (re)View—a mentoring program focused on cultivating manuscript reviewers for the ACR’s 3 scientific journals. ACR/ARP members with research experience are encouraged to apply by March 31

▶️ Details → https://t.co/TGM9gHWux4

[Mithu Maheswaranathan, MD @MithuRheum]

🆕 2025 ACR Guideline for Treatment of Systemic #Lupus Erythematosus 🦋

Just Released: Nov 3 #ACR25 🔥
🔸Review organ-specific treatment recommendations
🔸Steroid & HCQ Use Guidance

➠ Read the Full Guideline: https://t.co/jNwvKWbFpE

#RheumX #RheumTwitter #Rheum @RheumNow

[ACR_Journals @ACR_Journals]

Now published: The 2025 ACR Guideline for the Treatment of Systemic Lupus Erythematosus

📄 Read the paper: https://t.co/56eOK86lmn

ℹ️ See additional content and resources on this guideline at https://t.co/PVEyOkY14w

[Alain Sanchez, MD @lain_sanchez]

@ACRheum @ACR_Journals Thanks so much for this opportunity! You guys are great!

[Alain Sanchez, MD @lain_sanchez]

Thanks so much for this opportunity!!

https://t.co/9YxL9bodhT

[American College of Rheumatology @ACRheum]

NEW EPISODE! Alain Sanchez-Rodriguez, MD, joins the podcast to discuss delays in #lupus diagnosis & care based on findings from the Lupus Midwest Network (LUMEN)🎙️LISTEN NOW → https://t.co/8UZWFRmHJJ @ACR_Journals

[American College of Rheumatology @ACRheum]

Over 20 years have passed since the ACR last issued a broad treatment guideline for #SLE. In our NEWEST episode, Lisa R. Sammaritano, MD, summarizes the major updates in the soon-to-be-released 2025 guideline.🎙️LISTEN → https://t.co/Z38VEjrlLh

[Alain Sanchez, MD @lain_sanchez]

@luccyferpeutz

[World Stroke Academy @WorldStrokeEd]

#ESOC2025
🏃🏻‍♀️ESCAPE MEVO sub analysis

👉🏻 prognosis by image 🧠
👉🏻EVT <12 hs not > good functional outcome
👉🏻 Good collateral status > benefit
👉🏻 ⏱️<180 min > benefit

[Alí Duarte, MD @AliDuarteMD]

1/ 🧵The 2024 ACR Guidelines for Lupus Nephritis (LN) are here! Big shifts in screening, combo therapy, and steroid minimization. Let's break it down. Full text: https://t.co/OMkTkdqnDD

[ACR_Journals @ACR_Journals]

Now published simultaneously in AC&R + A&R, the 2024 ACR Guideline for the Screening, Treatment, and Management of Lupus Nephritis

See ACR guideline page for resources - https://t.co/zhvkPxCTcr

DOI link - https://t.co/Hllq83J7Kc

Download the article - https://t.co/uAJ7JaO7pz

[Alain Sanchez, MD @lain_sanchez]

@luccyferpeutz Chi

[Alain Sanchez, MD @lain_sanchez]

@CarlosBaOch Uffff 💰 🤑

[Jose A. Meade, MD @JoseMeadeMD]

Welcome Jaime! 🤩⭐️🤩⭐️

[Jose A. Meade, MD @JoseMeadeMD]

Rheumatologist when someone automatically calls an ANA (+) “undifferentiated connective tissue disease”

[Alain Sanchez, MD @lain_sanchez]

@JoseMeadeMD Jajajajajajajajaja