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Another toxicity signal to watch in the CAR T space: LICATs
Abstract 1537 reports a new immune-related toxicity distinct from CRS or ICANS:
🔹Affects organs prev involved in autoimmune dx: skin (35%) and kidneys (22%)
🔹Mostly mild (Grade 1–2); 3 cases Grade 3
@RheumNow #ACR25 https://t.co/mtZh47nWtv
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
I've always (very) simplistically considered post-CAR-T CRS and HLH/MAS in the same bucket, and there certainly are substantial similarities.
It raises the obvious question - can we borrow therapies?
@CarolineDiorio @ChildrensPhila in the #ACR25 BCRC pre-meeting @RheumNow https://t.co/2HkHxpl89u
David Liew drdavidliew ( View Tweet)
What dictates how severe CRS is following CAR-T?
(Often the critical question, and will especially be in the autoimmune space, where CAR-T is largely less time-critical)
@CarolineDiorio @ChildrensPhila in the #ACR25 BCRC pre-meeting @RheumNow https://t.co/u0w4lx7YVn
Links:
David Liew drdavidliew ( View Tweet)
@CarolineDiorio @ChildrensPhila eloquently told the #ACR25 BCRC pre-meeting about the lessons they've learned about CRS and ICANS, the major CAR-T toxicities.
Many questions still to answer, but they've also understood a lot we can learn from.
@RheumNow https://t.co/Jhk1eCLpD4
Links:
David Liew drdavidliew ( View Tweet)
CAR-T vs bispecific antibodies - what's the difference?
@andrew02114 @MGHCancerCenter with the heme-onc point of view in the #ACR25 BCRC @RheumNow https://t.co/7KJCfiQKWM
Links:
David Liew drdavidliew ( View Tweet)
CAR-T toxicity in hematology
(the things we have to look out for in rheumatology, as application of CAR-T potentially broadens)
@andrew02114 @MGHCancerCenter with the heme-onc point of view in the #ACR25 BCRC @RheumNow https://t.co/1YjadL7LCF
Links:
David Liew drdavidliew ( View Tweet)
Andrew Yee @andrew02114 of @MGHCancerCenter details out how quickly the CAR-T paradigm changed in myeloma/lymphoma - from newsworthy to routine. Now that much more about CAR-T has been worked out, will adoption be quicker in autoimmune disease? #ACR25 BCRC pre-meeting @RheumNow https://t.co/oNuPXCwWQ9
Links:
David Liew drdavidliew ( View Tweet)
Post-CAR-T myelopathy has been an issue in heme onc, and is still an unpredictable quantity without a clear cause. Will this be a problem for autoimmune CAR-T as we gain more experience? @CarolineDiorio @ChildrensPhila in the #ACR25 BCRC pre-meeting @RheumNow https://t.co/RhhdOiyEAX
Links:
David Liew drdavidliew ( View Tweet)
RheumNow’s expanded coverage of the #ACR25 annual meeting is sponsored by Bristol Myers Squibb, Novartis, and UCB. All coverage content is independently selected by RheumNow and its faculty.
Dr. John Cush RheumNow ( View Tweet)
In AxSpA, an 8-week personalized exercise program improved trunk strength (+14.1%), mobility (+14.9%), and cardiorespiratory fitness ( increased oxygen pulse, ventilatory efficiency, anaerobic threshold). BASDAI and chest expansion also improved. Supports tailored rehab based on https://t.co/jawosa2AJK
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Abstract 2690: Food as a Medicine
Mediterranean vs low-calorie DASH vs control diet in PsA (multicenter RCT):
🔹 All 3 groups showed significant weight loss & DAPSA by wk 24
🔹 Weight loss not diet type may be the driver of clinical improvement
@RheumNow #ACR25 https://t.co/rBS3HR1HXl
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Abstract 2696: Phase 1/2 study of rapidly engineered CD19 CAR T showed:
- rapid depletion of CD19 B cells w/ recovery by Day 90
- Days 180 and 360: returning B cells largely naive (CD27-IgD+)
- Interferon expression ↓ after CAR T treatment
@RheumNow #ACR25 https://t.co/FzdFbqWwtE
Links:
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
#ACR25 Clinical Preview by Prof Coates to be applied tomorrow!
GC #steroid burden & Mx
Abstr#738 Survey of #GCA patients in US & EU: 3/4 were still on GC; mean 5.3mg/d
Abstr#1526 International consensus of GC taper in #SLE is available & can be applied in clinic
@RheumNow https://t.co/paw7NGjs4p
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Does diet matter in PsA?
Randomized study comparing advice, DASH low calorie, Mediterranean diet
Seems that weight loss corresponds better with benefit than diet. BMI reduction remains focus in PsA
Laura Coates #ACR25 meeting review @RheumNow https://t.co/CqR25sJdDc
David Liew drdavidliew ( View Tweet)
New biomarkers in axSpA. In early axSpA (DESIR cohort), higher baseline Phospholipid transfer protein (PLTP) activity was linked to sacroiliac radiographic progression over 5 years. Lower zonulin and lipopolysaccharides (LPS) levels also associated with progression. Highlights https://t.co/1uBtR4QA97
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
“We’ve got to do better for our patients with GCA” - Laura Coates, doing the #ACR25 meeting review
She told us she is speaking about diseases outside her comfort zone but she is bang on.
As she said: not good enough real world all the people not on steroid-sparing Rx
@RheumNow https://t.co/4WiEORwPgI
David Liew drdavidliew ( View Tweet)
Clinical Year in Preview
SpA: no difference in efficacy rotating vs switching bDMARD MoA for next steps
@RheumNow #ACR25 #LB09 https://t.co/shCLgk7Yqz
Jiha Lee JihaRheum ( View Tweet)
The DIPSA study: can diet improve PsA?
Finally a RCT, and the general message is Loose weight, regardless of the diet!
3 arms:
-Mediterranean diet 31pts
-Low-calorie Dietary Approaches (DASH-LC) 30pts
-Standard of care 31pts
Primary outcome change in DAPSA wk 12
DASH-LC https://t.co/XH9Xdn0g96
Aurelie Najm AurelieRheumo ( View Tweet)
Use of AI in AxSpA imaging for diagnosis. ASembleNet, a hybrid deep learning model, achieved 99% accuracy on coronal and 98.1% on axial MRI for AS classification, outcomes higher than ResNet50, Xception, and InceptionV3. Validated on ASAS cases, with Grad-CAM interpretability and https://t.co/yU8shaIdP2
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Fighting fire with butyrate 🔥🚒
♦️probiotics and prebiotics
Dr. Nisha Manek on inflammation and butyrate - it reduces gut inflamm thru the NFKB pathway
#ACR25 @RheumNow https://t.co/19XTrKn1iN
sheila RHEUMarampa ( View Tweet)
