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SLE Conference Preview: progress in biologics
The pharmacology treatment including biologics, cellular-based therapies, and Bi-specific T-cell Engager (BiTE) in systemic lupus erythematosus (SLE) is a rapidly expanding field of research that provides excitement and optimism to both the patients and the physicians.
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FDA Approves Obinutuzumab for Active Lupus Nephritis
The FDA has approved obinutuzumab (Gazyva) for the treatment of lupus nephritis. This is good news for the more than 1.7 million people worldwide with lupus nephritis.
https://t.co/Wr3tG5izCi https://t.co/P8A5PUCIX0
Dr. John Cush RheumNow ( View Tweet)
#ACR25 Beyond blinatumomab, A-319, CD3xCD19 BiTE in 12 patients with #SLE in China reported dose-dependent depth of B-Cell depletion but not efficacy or safety. One withdrew due to AE. No CRS/ICANS. Be interested to see results in larger trials & longer follow-up @RheumNow https://t.co/e5RuZlFI6i
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
After propensity matching, this retrospective cohort study showed that #lupus nephritis patients on GLP-1 agonists had ⬇️ CKD progression, mortality & AMI risk vs. LN pts on SGLT2is.
Interesting data but what could explain it? Further studies are needed
#ACR25 @RheumNow Abs0841 https://t.co/FtsGbMDcCv
sheila RHEUMarampa ( View Tweet)
#ACR25 Abstr#645. Dapirolizumab, anti-CD40L-i met primary endpoint, BICLA in Phase 3 RCT non-renal SLE. Key secondary endpoints showed higher rates of & time in LLDAS and remission in DAP vs PBO. Meaningful targets re: damage accrual & better longterm outcomes @RheumNow https://t.co/IxesXhi34R
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#ACR25 Abstr#641 Phase 1/2 CASTLE Basket Trial fully recruited N=24 (10 SLE, 9 SSc, 5 IIM). Short-term data of autologous CD19-CAR T
Zorpocabtagene-autoleucel/MB19.1:
- 22/24 high degree efficacy
- no relapse
- no high grade CRS/ICANS
*Need larger Phase prior approval @RheumNow https://t.co/sp1nieeCvl
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Abstract 0806
Compared to belimumab, Anifrolumab associated with:
↑ infection risk b (HR 1.40, 95% CI 1.05–1.88)
↑ herpes zoster (HR 3.94) & COVID-19 (HR 1.66)
No diff in mortality or hospital use
📈 3-yr infection: 38.3% vs 21.3%
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Real world effectiveness of voclosporin for SLE
Reduction in UPCR from 2.1 at b/l to 0.9 at 6 months, no improvement in eGFR; as expected based on trials
Wonder about market share of BEL vs voclo vs ANI - anyone seen pubs on this?
#ACR25 @RheumNow Abstr#0661 https://t.co/l7i7IWhLSe
Mike Putman EBRheum ( View Tweet)
Statins and SLE: To add or not to add? 💊
Abstract #0599: In an emulated target trial of patients with SLE, statin users vs non-users had significantly⬇️ risk of all-cause death in both ITT & per-protocol analyses.
- No significant differences in MACE or ESKD.
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
SLE & arthritis: Is there a difference?
Abstract #0629:
- Non-deforming (ND): 73% | Jaccoud’s: 19% | Rhupus: 8%
- Vs ND, Rhupus had lower odds of type I IFN signature
- Time to deformities: Jaccoud's ~2 yrs vs Rhupus ~5 yrs
- RNP+ predictive of Jaccoud’s
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Managing lupus is complex. How do we ensure quality care?
Abstract #0218 convened 8 focus groups:
✅ Support for patient navigators
⚠️ Barriers: low resources, staff turnover
💻 Solution: EHR outreach workflow to flag missed visits & labs
@RheumNow #ACR25 https://t.co/BWaIMMEPit
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Abstract #0607: The age at diagnosis of SLE is rising in US based cohort📈
Those diagnosed ≥30 yrs were:
⬆️ More likely to have oral ulcers, hematologic features, +ANA
⬇️ Less likely to have malar rash or proteinuria
@RheumNow #ACR25 https://t.co/pMPVLg1xTZ
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Abstract 0196: Too many referrals, too few slots? A hybrid RN + MD referral cut wait times for patients with SLE by 26%
Median time to appointment 69 days --> 51 days
Next steps: streamline high-risk triage, reduce manual chart review
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Dr. Werth on the #SLE guidelines on tx of cutaneous LE:
🔅All patients should be on hydroxychloroquine unless with CI.
☝️Important! For SLE pts presenting with new-onset rashes, review/ask about medications; consider drug-induced SCLE.
#ACR25 @RheumNow https://t.co/ok5jAi7uO0
Links:
sheila RHEUMarampa ( View Tweet)
#ACR25 In a rush and wondering which abstract to look out for pertaining to new update on Biologics in #SLE #lupus? Please find my article on conference preview @RheumNow
https://t.co/usIXPsj5bm https://t.co/4wmWvDyv83
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#ACR25 Abstr#0772. Should we be worried of #SLE patients with low uPCR 0.25-0.49? Kidney biopsy in N=28 + poor prognostic (Non-White, active serology or active sediment)
- 71% had LN (No class IV or Mixed)
- 46% actionable LN
Cost-effectiveness data needed.
#ACRBest @RheumNow https://t.co/Bt3fuA3aJh
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Organ Specific Recommendations-ACR guidelines for Management of SLE by Dr Lisa Sammaritano. @RheumNow #ACR2025 https://t.co/ilKWG8CQbe
Dr M Nazibur Rahman, MD (Rheumatology) NaziburM ( View Tweet)
Plenary session at #ACR25!
#0772 When should we biopsy in SLE?
In pts with uPCR 0.25-0.49 g/g + LN predictors, 69% already had LN (many Class III/V). Low C3/C4 were most important factors.
0.5 g/g cutoff may delay diagnosis and treatment. Time to rethink thresholds? @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
Early, low level proteinuria is a harbinger in SLE. ~50% with elevated UPCR but <0.5 had actionable LN on early bx.
Risk factor = low c3/c4
Urine biomarkers promising
#ACRBest #ACR25 @RheumNow https://t.co/WuNPKeqeid
Links:
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
From Dr. Petri at Plenary - even small amounts of proteinuria are a PROBLEM. Reduction of microalbuminuria by even 10% improves mortality! #ACR25 @RheumNow https://t.co/hjmH26vXIb
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
