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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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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)
Albach et al. CAR T-cells in D2T RA. 6 patients. Safety looks ok. ACR20 in 4/6, ACR50 in 2/6. ACPA and RF disappeared. Results maybe not as positive as we might have anticipated? @RheumNow #ACR25 Abstr#471 https://t.co/TaEVWiWsNm
Richard Conway RichardPAConway ( View Tweet)
#0776
In the 2-yr SELECT-GCA trial, continued upadacitinib 15mg maintained remission in 69% vs 29% who switched to PBO, cutting flare risk by 90% and reducing steroid exposure by ~1g.
No new safety signals in older adults (mean 71yrs). @RheumNow #ACR25 https://t.co/KC9sm3ic3q
Mrinalini Dey DrMiniDey ( View Tweet)
Singla et al. In secukinumab phase 3 trials, fungal (inc candida) infections uncommon. 5.51 for sec vs 3.39 for PBO per 100PY. @RheumNow #ACR25 Abstr#585 https://t.co/g78zUsxD5a
Richard Conway RichardPAConway ( View Tweet)
Post-hoc PEXIVAS study, estimating risk of relapse from baseline variables
Lotsa fancy stats, mostly corroborated known risk factors, but model predicted relapse reasonably well!
Probably useful for approach to monitoring... mayyybe treatment?
#ACR25 @RheumNow #Abstr0722 https://t.co/XI9y8KgDNR
Links:
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)
Plenary 1: SELECT-GCA (RCT, UPA vs PLBO in GCA)
Pts in remission re-randomized at wk52
Higher maintenance of remission in pts who continued UPA15 (69%) vs switchers from UPA15->PLBO (29%)
Argues strongly for continuing tx in GCA for >1yr!
@RheumNow #ACR25 Ab#0776 #ACRBest https://t.co/exmmIcpgbP
Links:
Mike Putman EBRheum ( View Tweet)
Ribeiro et al. Case series of combination bDMARD/tsDMARD in PsA from Toronto. 24 patients, median just over a year follow-up. Appear effective, especially for objective skin and joint measures. No major safety concerns but short follow-up to date. @RheumNow #ACR25 Abstr#565 https://t.co/Zk3odT2EX2
Richard Conway RichardPAConway ( View Tweet)
#0775
Higher circulating microbial small RNA tDR-1 linked to lower risk of developing RA in CCP3+ individuals (AUC 0.86).
tDR-1 downregulates interferon-response genes in vitro, suggesting microbiome-mediated anti-inflammatory mechanism in RA pathogenesis. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
#0774
Multi-omic profiling of anti-CCP3+ “at-risk” individuals reveals Tph & cytotoxic CD8+ expansions, altered gene/chromatin profiles and predictive model (AUC 0.77) for RA conversion
PTPN22 locus accessibility & Tph ≥ 2.45% identify highest risk. @RheumNow #ACR25 https://t.co/JDSMkdmoGv
Mrinalini Dey DrMiniDey ( 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)
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)
For #SLE pleuropericarditis: recommendation intentionally tries to leverage use of colchicine/NSAIDs vs. GCs
But there are special situations where GCs are req’d:
> Concomitant active SLE
> CI to NSAIDs/Col
> Recurrent pericarditis
> Late pregnancy
> 💊interxns
#ACR25 @RheumNow https://t.co/sLL72t3Qhf
Links:
sheila RHEUMarampa ( View Tweet)
Year in Review: Regency Trial showed that LN pts given obinutuzumab achieved CRR at 76 wks (46.4%) vs. PBO.
Take note: the Regency trial did not evaluate the extrarenal effects of Obinutuzumab in #SLE, thats for a diff study.
#ACR25 @RheumNow https://t.co/WJssU1DbzZ
sheila RHEUMarampa ( View Tweet)
Saphnelo (anifrolumab) has been recommended for approval in EU by CHMP for systemic lupus erythematosus (on top of standard therapy) as a once-weekly pre-filled pen.
Recommendation based on TULIP-SC Phase III trial. https://t.co/UurvtLNP7S https://t.co/xeKVdVYu3z
Dr. John Cush RheumNow ( View Tweet)
🔥 Hot off the press
Prof John Stone shares results from Phase 3 of REPLENISH, out only a few days ago, in which secukinumab met all primary endpoints in treatment of PMR.
https://t.co/RlcQWybKrR
#ACR25 @RheumNow https://t.co/ucNt2HxJpW
Links:
Mrinalini Dey DrMiniDey ( View Tweet)
Summary of updates in Vasculitis by Dr John Stone: 1. Anti-CD19 in IgG4Rd, 2. IL6 6R blockade in GCA/IL17i in PMR, 3. IL5RA+ ritux in EGPA. CART in AAV? @RheumNow #ACR2025 https://t.co/HxPNRE98Vl
Gabriela Martinez Zayas, MD MartinezZayasMd ( View Tweet)
