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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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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
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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
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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)
Nice to see a Dietary intervention study in the
"Top Abstracts That Will Change My Practice in the Near Future" by L. Coates for Year in Preview
Small RCT but fibres significantly improve response to treatment in the MTX treated RA group with a mean reduction of DAS28 of https://t.co/vMeIAK1P5u
Aurelie Najm AurelieRheumo ( View Tweet)
