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Telling You Where to Go (12.19.2025)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. Who would've thunk - a PsA FMF connection? Labs to diagnose SSc-ILD? IgA-RF may be important or RZV may not work in JAK inhibitor treated patients?
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B Cell Targeting in Idiopathic Thrombocytopenic Purpura
EurekAlert!
The New England Journal of Medicine has published a phase III clinical trial showing that a B cell targeting monoclonal antibody, ianalumab, was effective in more than half of the patients with primary immune thromboc
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A New Disease Activity Score for Antiphospholipid Syndrome?
EurekAlert!
APS is a systemic autoimmune disorder. It is characterised by the presence of antiphospholipid antibodies and a broad spectrum of clinical features, causing obstetric as well as thrombotic, microvascular and non-thrombotic (TMN) symptoms.
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B Cell Targeting in Idiopathic Thrombocytopenic Purpura
The New England Journal of Medicine has published a phase III clinical trial showing that a B cell targeting monoclonal antibody, ianalumab, was effective in more than half of the patients with primary immune https://t.co/VN0KjE478B
Dr. John Cush RheumNow ( View Tweet)
Serum IL-1Ra levels are elevated in Lg vessel vasculitis - 21 active, Rx naive LVV pts (13 GCA, 8 TAK), IL-1Ra higher in TAK (465 pg/mL) & GCA (385 pg/mL) vs NLs (170). IL-6 also incr. in LVV, but IL-1β & IFN-γ incr in GCA & ^ IL-17in TAK. IL-1Ra correlate w/ CRP in GCA & https://t.co/TFDpK5DqcJ
Dr. John Cush RheumNow ( View Tweet)
Robinson et al has published that Epstein-Barr virus infects and reprograms autoreactive B cells to drive the systemic autoimmune response in SLE https://t.co/vjpvILrJOt https://t.co/JfcycqHvhl
Dr. John Cush RheumNow ( View Tweet)
20-40% of Autoimmune hepatitis (AIH) is associated with other autoimmune diseases - lead by autoimmune thyroiditis, type 1 DM, ulcerative colitis, Crohn disease, & celiac (but less so for RA, PBC, SLE, Sjögren syndrome, vitiligo). AIH Dx Abs include ANA, ASMA, LKM1. https://t.co/FphWZwwohx
Dr. John Cush RheumNow ( View Tweet)
Taking a closer look: B-Cell depletion beyond the blood
At #ACR25, we have seen an exciting wave of cellular and immune therapies reshaping the landscape of autoimmune disease treatment. Following the landmark case series by the Erlangen group, multiple cellular therapies have https://t.co/GIrPwlGKE2
Dr. John Cush RheumNow ( View Tweet)
Robinson et al has published that Epstein-Barr virus infects and reprograms autoreactive B cells to drive the systemic autoimmune response in SLE https://t.co/vjpvILrJOt https://t.co/HepyZrYW5L
Dr. John Cush RheumNow ( View Tweet)
Off the Shelf: CAR-T
Dr. Akhil Sood reports on abstract 0663 (iPSC-Derived Off-the-Shelf anti-CD19 CAR T cells Deliver Improved Clinical Outcomes in Lupus with Reduced or No Conditioning Chemotherapy) presented at#ACR25.
https://t.co/mj4b5cCInC https://t.co/s34atFCMlx
Dr. John Cush RheumNow ( View Tweet)
Are we putting the CAR-T before the horse?
CAR T-cells have been a revolutionary development in rheumatology. We have seen a population of patients with severe refractory autoimmune conditions almost overnight presented with the prospect of not just improvement, but of a cure. https://t.co/gF9FXjAZ7F
Dr. John Cush RheumNow ( View Tweet)
B Cell Depletion: Check the Lymph Node
Dr. Akhil Sood reports on abstract 2695 (B-cell depletion and lymphoid follicle disruption upon different B-cell depleting agents) presented at #ACR25.
https://t.co/bvZMGWNzfe https://t.co/dB6iQlgoYx
Links:
Dr. John Cush RheumNow ( View Tweet)
IgG4: Rare, but new treatments on the horizon
IgG4 is a rare autoimmune disease with excessive IgG4 immunoglobulins that can affect multiple organs yielding plasma cell deposition (inflammation) and fibrosis.
https://t.co/v07Kp5tQXg https://t.co/rIvOF0mrM1
Links:
Dr. John Cush RheumNow ( View Tweet)
B Cell Depletion: Check the Lymph Node
Dr. Akhil Sood reports on abstract 2695 (B-cell depletion and lymphoid follicle disruption upon different B-cell depleting agents) presented at #ACR25.
https://t.co/BjgIC3Kng0 https://t.co/flfyLZYW8q
Dr. John Cush RheumNow ( View Tweet)
If you missed this pattern, you missed an autoimmune classic
What’s it? https://t.co/zO48zPCkqP
DocXus docxusofficial ( View Tweet)
The Rapidly Evolving Landscape of Cellular and Immune-based Therapies
When Henry Ford unveiled the Model T in 1908, the automobile industry was forever changed. A similar transformation is now underway in rheumatology, where cellular and immune therapies are redefining how we https://t.co/RQuVETSTG4
Dr. John Cush RheumNow ( View Tweet)
Why are vaccine Abs maintained after CAR-T
-depletion of pathogenic #Abs are dampened/eliminated
Clonal repetoire expansion
Remission=naive B cell pop'n
Reset immune system sparing memory cells
vs ?not all pathogenic cells eliminated in tissue
#ACR25 @RheumNow @ACRheum
#26S21 https://t.co/jb3dD5Ssip
Janet Pope Janetbirdope ( View Tweet)
Needle in a haystack
What T cell to target for #autoimmune diseases
T cell repetoires (TCR) not all are sequenced and many can exist to present antigens
Diff scales of approaches
Implications CAR-T
CD19
CD20
BCMA
Treg
HLAB27
etc!
#ACR25 @ACRheum @RheumNow
Alok Joglekar
#26S08 https://t.co/Qgw8Akz1xk
Links:
Janet Pope Janetbirdope ( View Tweet)
While post-CAR-T CRS might be semi-familiar for rheumatologists, ICANS is a new concept to get our heads around, and one which is far from heterogenous.
@CarolineDiorio @ChildrensPhila in the #ACR25 BCRC pre-meeting @RheumNow https://t.co/qX2jKMG2oB
David Liew drdavidliew ( 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)
