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CD19 CAR T Cell Therapy in SLE (9.16.2022)

Jack Cush, MD

The big news this week: the approval of deucravacitinib (a new class of drug?) for psoriasis; the 2022 ACR guidance on glucocorticoid-induced osteoporosis; a national poll of older adults over the age of 50 who claimed self-reported or doctor-diagnosed arthritis; and much more. Let's review these and other news, journal reports and announcements from this past week.

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COVID infection mask

COVID Outcomes in Dermatomyositis

Jack Cush, MD

A retrospective study of dermatomyositis (DM) patients with COVID-19, shows that DM patients without comorbidities fair well (with regard to mortality and hospitalisation).

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Does Fibromyalgia Need B12? (9.9.2022)

Jack Cush, MD

Can we predict the bad outcomes? Like when ITP evolves into SLE; or when psoriasis will develop arthritis; or if Sjogren's will develop lymphoma? Let's dive in and review these journal reports and this past week's news from RheumNow.com.

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Does Dendritic Cell Targeted Therapy Work in SLE?

Jack Cush, MD

A phase 2 trial using litifilimab, a humanized monoclonal antibody binding to blood dendritic cell antigen 2 (BDCA2), demonstrated clinical efficacy in adults with systemic lupus erythematosus (SLE).

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DPGN, lupus, nephritis, GN, glomerulonephritis, biopsy, kidney

Voclosporin Efficacy and Safety in Lupus Nephritis

Jack Cush, MD

An integrated analysis of two pivotal trials of voclosporin, a calcineurin inhibitor, in lupus nephritis patients saw significant improvement in complete renal responses (CRR) at one year.

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Autoimmune Disease Augments Cardiovascular Risk

Jack Cush, MD

A large UK database study suggests that young adults with autoimmune diseases have an associated increased risk for cardiovascular disease.

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Immunosuppresive (IST; MMF or AZA) withdrawl in 96 stable Lupus Nephritis pts also on HCQ. After 2 years, Relapse occurred in 12.5% w/ IST continued & 27.3% with IST D/C (Not noninferior). Less Severe SLE flares (renal & extrarenal) w/ IST continuation https://t.co/TM6Ng3vzeS https://t.co/UNBdg1Oh6z

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Dr. John Cush RheumNow ( View Tweet)
Anti-CD19 CAR T cell therapy for refractory #SLE published in Nature Medicine. 5 pts (22yrs) w/ refractory dz, active SLE (SLEDAI=16). Autologous pt T cells transduced to CD19 CAR Tcells, and lead to remission in 5/5 w/in 3 mos & maintained median 8 mos https://t.co/0epnffCNEN https://t.co/IMRzhOzgei

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Dr. John Cush RheumNow ( View Tweet)
Lupus (LUMEN) registry of 440 SLE compared to non-SLE pts, shows lupus pts have less screening for cervical cancer (HR 0.75), but SLE has more screening for HTN (HR 1.35), DM (HR 2.46), hyperlipidemia (HR 3.19) & Influenza & pneumovax vaccines https://t.co/e5ZGJswVds https://t.co/WQmhM0OZgl

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Dr. John Cush RheumNow ( View Tweet)
I just posted "Free Lupus Encyclopedia Book give away ... register to win... even international addresses are welcome" on Reddit https://t.co/Pa4h75vcW1

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Donald Thomas, MD lupuscyclopedia ( View Tweet)

The 2022 ACR abstracts are published and posted for you. Let the Learning begin! https://t.co/ZqMAc8jV3U https://t.co/3iCGnzsPI5

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Dr. John Cush RheumNow ( View Tweet)
A summary slide from #grandrounds this morning on a talk about trying to differentiate #lupus #nephritis from #preeclampsia #RheumTwitter #MedTwitter https://t.co/R2rhhgQYIm
Catherine Sims, MD DrCassySims ( View Tweet)
Immunosuppresive (IST; MMF or AZA) withdrawl in 96 stable Lupus Nephritis pts also on HCQ. After 2 years, Relapse occurred in 12.5% w/ IST continued & 27.3% with IST D/C (Not noninferior). Less Severe SLE flares (renal & extrarenal) w/ IST continuation https://t.co/XWmJpkqhG9 https://t.co/gYM24QIiYz

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Dr. John Cush RheumNow ( View Tweet)
Rheums! Have a Rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/1aSrRsLkel https://t.co/gmh155ty6w

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Dr. John Cush RheumNow ( View Tweet)
Study of 130 patients with ITP (w/ 10 later Dx SLE (30 mos F/U). Risk factors for ITP developing SLE included young age (< 40yrs; OR 6.3), organ bleeding (OR 13.7), and ANA (≥ 1:160; OR 6.6) https://t.co/XSJdio2rR1 https://t.co/oCyFjJnxTX

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Dr. John Cush RheumNow ( View Tweet)
Voclosporin Efficacy and Safety in Lupus Nephritis An integrated analysis of two pivotal trials of voclosporin, a calcineurin inhibitor, in lupus nephritis patients saw significant improvement in complete renal responses (CRR) at one year. https://t.co/LSjmRB2Zr3 https://t.co/z9MoJ0uRzz

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Dr. John Cush RheumNow ( View Tweet)
ANA Increasing? Part of the NHANES survey, ANA (IIF on HEp-2 cells) was performed on 13,519 in 3 periods: 1988-1991, 1999-2004, and 2011-2012. ANA+ was 11% 1988-1991 11.4% 1999-2004 16.1% 2011-2012 (P <0.0001) Meaning ~22.3, ~26.6, &~41.5 mil had +ANAs https://t.co/vWYJci3uDV https://t.co/SEIbrYRoRJ

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Dr. John Cush RheumNow ( View Tweet)
✅ Probably one of my most important slides ⬇️ WHY IS MY #TREATMENT NOT WORKING (or not working enough) 😭 This is really a question we're dealing with everyday in #rheumatology when taking care of patients with #autoimmune and other rheumatic diseases 👍 https://t.co/osUPYSvuWf
Laurent ARNAUD Lupusreference ( View Tweet)
Autoimmune Disease Augments Cardiovascular Risk A large UK database study suggests that young adults with autoimmune diseases have an associated increased risk for cardiovascular disease. https://t.co/TtiH9ZBkR8 https://t.co/jVZBk8l4XD

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Dr. John Cush RheumNow ( View Tweet)
Phase 2 RCTs are evaluating TLR 7 & TLR 8 blockade in SLE - BMS has afimetoran and Merck has enpatoran (both blocking TLR7/8) https://t.co/lSvnAkRvxB https://t.co/i7ZORYyKHP

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Dr. John Cush RheumNow ( View Tweet)
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