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Beyond the Breakthrough: Equity and Access in CAR-T Cell Therapy for RA
At ACR Convergence 2025, abstract 1039 entitled, “Global Cost-Effectiveness and Equity in CAR-T Cell Therapy for Rheumatoid Arthritis” adds a critical dimension to the growing enthusiasm around cellular therapies in autoimmune disease.
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Will #PAD4 levels predict pts w #CCP positive #arthralgia who will develop #RA?
Leeds study - 79 at risk pts
PAD4 levels may predicting #rheumatoid #arthritis development
#ACR25 @RheumNow @ACRheum abst#832 https://t.co/dnAA6z3NJQ
Janet Pope Janetbirdope ( View Tweet)
Meta analysis evaluating age specific incidence across multiple registries (n=882)
Incidence 9.3 for women & 1.4 for men per 100k person-years
1. Wider distribution than I would have guessed
2. Much less age-dependency for men
@RheumNow #ACR25 Abstr#29W06 https://t.co/46dNGBZ45V
Links:
Mike Putman EBRheum ( View Tweet)
Phase 1 study of CAR-Treg in difficult to treat RA
4/6 pts had 50% reduction in TJC/SJC, no CYC/fludrabine required & good prelim safety data
CAR-T remains exciting, but less of the "totally magical everyone cured" stuff we saw w/initial CAR-T reports
@RheumNow #ACR25 https://t.co/kjBIkLCYpF
Links:
Mike Putman EBRheum ( View Tweet)
"Achieving good control of joint disease activity is probably the key objective of treatment of patients with RA-ILD"
- Gregory McDermott (Epi Abstracts, #2662)
Totally agree with this! SARD guidelines recommendingn drugs with mediocre activity in RA was surprising
@RheumNow
Mike Putman EBRheum ( View Tweet)
Excited about this target trial emulation in RA-ILD
Compared to RTX, NO significant difference in hospitalization/transplant/death for JAK, ABA, IL6 or TNF
Trends toward ABA and JAK looking better than RTX
Need trials for sure, but I like this project a lot
@RheumNow #ACR25 https://t.co/FQcphRvyHK
Links:
Mike Putman EBRheum ( View Tweet)
#2686 Using HR-pQCT, researchers tracked bone changes in RA & PsA. Seropositive RA showed worst bone density & microstructure, worsening with disease activity. TNFi, RTX & BARI improved MCP bone density, highlighting the impact of inflammation and treatment. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
Will CAR-Treg Rx be helpful in active #refractory #rheumatoid #arthritis?
Early data n=6 treated w low dose (3 per arm), ongoing and doses will escalate
Improvemt in #clinical #disease #activity
less inflammation on #synovial #biopsies 3 pts
#LB23 #ACR25 @RheumNow @ACRheum https://t.co/PkhsvztVjx
Janet Pope Janetbirdope ( View Tweet)
GLP-1 RA vs DPP4i & risk of rheumatic disease: propensity score matched cohort study using TriNetX
🔹 Lower incidence of OA, RA & gout w/ GLP-1 RA
🔹 No significant differences for PsA, SSc, axSpA, or SLE
@RheumNow #ACR25 https://t.co/BIVw3ajrFZ
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
#2662
Using Medicare data to emulate real-world RA-ILD trials, investigators compared RTX vs ABA, TOC, JAKi & TNFi
No sig differences in mortality, resp, hospitalisation or lung transplant across groups, suggesting other b/tsDMARDs may be as safe as RTX for RAILD
@RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
Abstract 2694: Neutrophil:Lymphocyte ratio (NLR)- a practical step towards clinical monitoring of interferon?
Log₂NLR significantly correlated with all three IFN signatures across patients with SLE, systemic sclerosis, rheumatoid arthritis, and myositis
@RheumNow #ACR25 https://t.co/ujaOQGvAUV
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
McDermott et al. Target trial emulation of different b/tsDMARDs in RA-ILD. RTX as SOC. No significant differences seen in hospitalisation or death. Trends to abatacept and JAKi looking better... @RheumNow #ACR25 Abstr#2662 #ACRBest https://t.co/ghHEKztvgz
Richard Conway RichardPAConway ( View Tweet)
#PD1 Ab looks good and safe in active RA
Rosnilimab, a Selective and Potent Depleter of Pathogenic T
Many failed several Rx already
No safety signals compared to another PD1i
Proof of benefit in biospecimens too!
abst#LB19 #ACR25 @RheumNow @ACRheum
#ACRBest https://t.co/TmEOCfuHZU
Links:
Janet Pope Janetbirdope ( View Tweet)
#2661 In >5000 veterans with RA-ILD, 8 distinct FVC trajectories were identified. >1/2showed a progressive decline (≥0.7%/yr). These progressive patterns predicted higher mortality & respiratory hospitalisations, underscoring major disease heterogeneity. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
#2682 In a randomised trial of 320 RA patients, the recombinant zoster vaccine (RZV) was safe and did not trigger disease flares. But methotrexate use and older age significantly blunted antibody responses ➡️key factors to consider for vaccine strategies in RA. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
Inflammation skews lipid levels in RA: the “lipid paradox”
Using data from CERTAIN and VARA, inflammation (hsCRP)-adjusted TC & LDL better predicted ASCVD events than standard lipids.
Are we missing RA pts who need statins?
@RheumNow #ACR25 A#2681
Jiha Lee JihaRheum ( View Tweet)
#2681 Tackling the “lipid paradox” in RA: inflammation-adjusted TC & LDL (using hsCRP correction) improved ASCVD risk prediction and flagged more high-risk patients than standard lipids. A smarter way to guide statin use in RA. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
In the epidemiology session on the final day of #ACR25, a large cohort study (>430k pts) showed that GLP-1 receptor agonists were linked to lower incidence of RA, gout & OA vs DPP-4 inhibitors. Adds to the growing case for GLP-1 benefits beyond glucose control. @RheumNow #2657
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR25 Clinical Preview by Prof Coates to be applied tomorrow!
Early Tx
Abstr#1677 First-line TNFi for 12-mth vs step-up = better outcomes at 5-Yr
Abstr#2662 Target emulation trial = No differences in hospitalization, death/transplant RTX vs TNFi, ABA, JAK, IL-6i @RheumNow https://t.co/yostJyc5T9
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Click on the link to see my take on implantable vagal nerve stimulation RCT in RA 🎥👇🏼
https://t.co/CZrFKouSqp
@RheumNow #ACR25 #ABSTRACT1675
Aurelie Najm AurelieRheumo ( View Tweet)
