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Are we putting the CAR-T before the horse?
CAR T-cells have been a revolutionary development in rheumatology. We have seen a population of patients with severe refractory autoimmune conditions almost overnight presented with the prospect of not just improvement, but of a cure.
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Plenary 3, HCQ blood levels in SLE
HCQ level > 1150: 1.9x risk of HCQ toxicity
HCQ level < 750: 1.4x risk of active SLE
HCQ dose < 5mg/kg: 1.9x risk active SLE
My take home? Blindly reducing dose to <5mg/kg is BAD; use levels instead!
@RheumNow #ACRBest #ACR25 Abstr1722 https://t.co/UCBPAKAyon
Links:
Mike Putman EBRheum ( View Tweet)
#ACR25 Please find my video interview with Prof Edward Vital @edvital on their work on International Consensus of Glucocorticoid Tapering Guideline in #SLE #lupus Abstr#1526 @RheumNow
https://t.co/MnQdcdASkG https://t.co/b7GMcnFU2m
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#ACR25 Please find my video and take on Abstr#0646. Promising new Bi-specific T-cell engager (BiTE) other than Blinatumomab in #SLE @RheumNow
https://t.co/5JrLG41nsD https://t.co/KeY6AkHUNK
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#ACR25 Please find my video and take on Abstr#0803. Should we use Belimumab before- or after a trial of concentional immunosuppressant in #SLE? @RheumNow
https://t.co/ExIvrdJXw5 https://t.co/AVb5ohWwXZ
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Progressive BiTE in SLE 2 https://t.co/ykMQmSAdlb
More on BiTES in SLE by the one and only @Yuz6Yusof
Bi specific Tcell engager ( CD3-CD19).
@RheumNow
#ACR25
Links:
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
Abstract 1718: Immune checkpoint inhibitors (ICI) in pre-existing #SLE
Compared to non-SLE pts, those with SLE receiving ICIs had:
🔹 ↑ risk of thrombocytopenia & pancytopenia
🔹 No significant difference in all-cause mortality
@RheumNow #ACR25 https://t.co/N1iOvxbsAZ
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
#ACR25 Abstr#1532 “The more the merrier” or “Too many cooks..” Preliminary data of CTA313, dual CD19-BCMA CAR-T in 15 #SLE pts showed deep depletion & good response. Global study is planned. Will have to keep on eye on safety (G3 herpes zoster, pneumonia & neutropenia) @RheumNow https://t.co/0KQa9K6bYB
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#ACR25 SMILE RCT of Incomplete #SLE (ANA+ but not meeting SLICC) showed HCQ didn’t slow down SLE progression. But multiplex arrays showed reduction in autoantibodies with HCQ that were distinct from abs assoc. w progression. Would biomarker endpoints be the answer? @RheumNow https://t.co/XcvacgObVo
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Global survey from the 2024 Adelphi Lupus Dse Specific Programme evaluated pt burden & MD/Pt Tx preferences:
Efficacy & safety - top 2 MD-reported reasons for tx initiation
OD, oral dosing-most preferred mode by MD & Pts
Shared decision-making is key
#ACR25 @RheumNow Abs1551 https://t.co/rmpCATCa78
sheila RHEUMarampa ( View Tweet)
This poster is absolutely bonkers & I LOVE it
Huge table. Frequency of everything over time
Really interesting to see which activity persists / how much damage is accumulated
Every trial should be obligated to share this (esp SLE!)
#ACR25 @RheumNow #ACRBest Abst#1608 https://t.co/blRrvwi3qP
Mike Putman EBRheum ( View Tweet)
Interim analysis of Ph3 TULIP-SC trial:
Anifrolumab 120mg SC or PBO weekly + SOC x 52wks
Primary endpt met: BICLA response w/Anifrolumab (60.3%) vs. PBO(43.9%)[p=0.014]
Pts on Ani had sustained BICLA response upto wk 52 (HR 2.1)
Promising results.
#ACR25 @RheumNow Abs1545 https://t.co/nqse1BiGq2
Links:
sheila RHEUMarampa ( View Tweet)
In a prespecified exploratory analysis of REGENCY trial data by DrRovin et al,
Bet. wks 24 and 76:
Obinutuzumab ⬇️ LN flares vs. PBO (HR 0.44; p=0.0074)
Pts on Obi had less unfavorable kidney outcomes vs. PBO (HR 0.37; p=0.0039)
Addtl tx option for LN
#ACR25 @RheumNow Abs1521 https://t.co/N5K9Nzh71E
sheila RHEUMarampa ( View Tweet)
Post-hoc analysis of CARE(Ph2B) Study to assess sustained responses in mSLEDAI-2K vs. PBO x 12mos in pts given Cenerimod
Sustained response in Cenerimod Ex-4mg (63.5%) > PBO (50%); HR 1.43
Ongoing research, further data needed.
#ACR25 @RheumNow Abs1519 https://t.co/cQbVVIIyxW
sheila RHEUMarampa ( View Tweet)
Safety & benefit of #Deucravacitinib in #SLE #LTE #PAISLEY #RCT
👇
over 4 yrs
Stable response sustained over 4 yrs
No new Safety signals
Await Ph3 RCT results - fully enrolled
#SoTyktu
Abst#LB10 #ACR25 @RheumNow @ACRheum https://t.co/ZpmzOYVnq9
Janet Pope Janetbirdope ( View Tweet)
#1639
In 2 lupus cohorts (n=619), 1 in 4 had mismatch between self-reported & measured physical function.
Higher BMI, disease activity & depression linked to underreporting ability ➡️ self-report ≠performance! Important for SLE care & research. @RheumNow #ACR25 https://t.co/kMlChreJPh
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR25 Abstr#1526 Finally it’s here! Consensus-based guidance on GC #steroid tapering in patients with #SLE. Included considerations before tapering, tapering schedules and monitoring during tapering. Looking forward to the uptake and hearing patients’ views @RheumNow #ACRBest https://t.co/FFl2TFhtTa
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#0851
Urinary Tenascin C predicts kidney function loss in lupus nephritis
170 AMP-LN patients: Tenascin C (from renal myofibroblasts) was the top predictor of eGFR decline (HR 4.6)
Proteomic 11-marker risk score (AUC 0.91) outperformed proteinuria for prognosis #ACR25 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
#0853 Olink proteomics in anti-Ro+ pregnancies identifies macrophage-derived IL-6 & CCL3 as serum predictors of foetal AV block
These pro-inflammatory proteins predicted fAVB independent of maternal diagnosis or Ab titres, pointing to new pathogenic pathways. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR25 Abstr#1525 Find me at poster hall. Super-responders exist with rituximab, not just confined to CAR-T! Our cohort study = 23/114 (20%) had resp duration >3-yrs; 15/23 were IS-Free. Poor prognostics (Non-White, APS) & shorter #SLE duration predicted super-tesponse @RheumNow https://t.co/nJQFmiIj2n
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
