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CAR-T

Taking CAR-T for a Test Drive

Michael Putman, MD, MSCI

When the ACR Convergence 2024 abstract site went live, the first query I typed into the search bar was, “CAR-T.” I consider myself a CAR-T skeptic and would be surprised if the magical results from this NEJM case series replicate at scale, but it seems likely that CAR-T will revolutionize the care for (some) patients with rheumatic diseases. What new data will be presented at ACR?

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Are Emulation Trials a Fantasy?

Janet Pope, MD, MPH, FRCPC

Are emulation ‘trials’ helpful, despite the biases that occur with observational data, or do they truly mimic the results of randomized controlled trials (RCTs)?

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back, LBP, spine, AS

Difficult to Manage Axial Spondyloarthritis

Adela Castro, MD

Studies show that patients with difficult-to-manage axSpA have a higher disease activity; however, the lack of a consensus definition led researchers and clinicians to utilize their own proposed definition, resulting in variability of the characteristics of non-responders.

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Impressive Plenary @andreafava just finished Novel urine protein panel id 12 proteins that predict NIH activity on renal bx better than existing options Improving at 3 mos predicts response at 1 year Could reduce biopsies / modulate tx! #ACR24 @RheumNow Abstr#1642 #ACRbest https://t.co/Gi6u6hAGzj

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Mike Putman EBRheum ( View Tweet)
A study presents a novel urinary biomarker panel that predicts histologically active lupus nephritis (LN) with high accuracy. Key findings: - AUC of 90% for predicting NIH Activity Index > 2, outperforming traditional biomarkers. - Identified 12 critical proteins linked to… https://t.co/6ZhqNaxpQM

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)

Phase 2 DBRCT of daxdilimab, an immunoglobulin-like transcript 7 to target plasmacytoid dendritic cells No difference in primary outcome... but kiiiinda looks like something there? I dislike Phase 2's; should go straight to Phase 3 if able #ACR24 @rheumnow Abstr#1542 https://t.co/osDWDskfnA

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Mike Putman EBRheum ( View Tweet)
Systematic review & meta-analysis by DrHChaudhary et al @DaoudAnsaam @mmagrey1 showed that males w/ axSpA who were treated with biologics had ⬆️ BASDAI150 response & likely w/ ASDAS low dse activity vs. females w/axSpA Again, effect of gender differences @RheumNow #ACR24 abs599 https://t.co/2DPYC8exES

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sheila RHEUMarampa ( View Tweet)
Coming from somewhere where biosimilars are SOC for many years, I just find it wild how things are biosimilar wise in the US. Reflected by so many abstracts, including lots of oral presentations, essentially on showing biosimilars work. #ACR24 @RheumNow

Richard Conway RichardPAConway ( View Tweet)

How does #cardiovascular risk vary with #ACPA & #biologics in #RA? ⬆️BMI assoc with ⬆️MACE risk in ACPA+ pts In ACPA- pts, BMI inversely assoc with MACE risk among pts on biologics Further evidence to consider ACPA, BMI & MACE as part of RA management Ab0870 #ACR24 @RheumNow https://t.co/UkkC146DWS

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Mrinalini Dey DrMiniDey ( View Tweet)
Stone et al. Phase 3 RCT B-cell depletion with CD19 targeting agent Inebilizumab in IgG4-RD. HR 0.13 (0.06, 0.28) for flare. @RheumNow #ACR24 Abstr#0775 https://t.co/Kd4Xmoc5e6 https://t.co/Al6gOA1F8K

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Richard Conway RichardPAConway ( View Tweet)
Medication-assisted weight loss has boomed in recent yrs. How does weight loss affect disease activity & PROs in RMDs? ≥5% weight loss, after taking a med, led to better disease activity & QoL Data may inform RCTs to explore effect of these meds in RMDs Ab0845 #ACR24 @RheumNow

Mrinalini Dey DrMiniDey ( View Tweet)

Results from MANDARA- #EGPA pts treated with benralizumab or mepolizumab Eosinophil-targeting biologics rapidly control airway- & non-airway-related manifestations Few pts had worsening of disease that progressed to organ damage over 52W Ab0828 #ACR24 @RheumNow https://t.co/hIn9iyNVWQ

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Mrinalini Dey DrMiniDey ( View Tweet)
Ab#0458 #ACR24 10 year outcomes of 176 patients with seroneg RA 32 pts (18%) had change in dx - SpA (11), seropos RA (6), OA (5), crystal (3), CTD (3), Ifn-related/paraneopl/RS3PE, sarcoid (1) 40 (23%) had drug-free remission 30 (17%) started b/tsDMARD @RheumNow

Eric Dein ericdeinmd ( View Tweet)

Langford et al. Abatacept NOT effective in GPA in ABROGATE RCT. 65 patients. Relapse/worsening in 62% vs 68%. No difference in any secondary end-point. @RheumNow #ACR24 Abstr#0823 https://t.co/yRFZ2diJFF https://t.co/LgXkPnDArE

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Richard Conway RichardPAConway ( View Tweet)
Briefly highlighting this poster, always looking for a non-Georg Schett CAR-T study to see if their results replicate All 10 pts in this one had a "complete humoral response," normalizing antibodies & experiencing long term drug-free remission #ACR24 @RheumNow Abstr#0673 https://t.co/pjOjRnJVhO

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Mike Putman EBRheum ( View Tweet)
A cohort of 9 patients with Anti-MDA5 DM with RPILD who was treated with combination of RTX, JAKi, and GCS had significantly bettery survival compared to historical cohort in this abstract! #ACR24 @RheumNow https://t.co/2t8xcYJ3UV

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Gabriela Martinez Zayas, MD MartinezZayasMd ( View Tweet)
This is likely an oversimplification, but I've been looking for exactly this diagram Inhibiting various TYKs/JAKs corresponds to various downstream cytokine inhibition @EricFMorand does it make sense to see this as anifrolumab+ustekinumab? No? @rheumnow #ACR24 Abstr#0662 https://t.co/thti6s5TR3

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Mike Putman EBRheum ( View Tweet)
FDA has given FDA Breakthrough Therapy designation to Nipocalimab for treatment of adults w/ moderate-to-severe Sjögren’s disease. NIPO is an Ab to neonatal Fc receptor (FcRn), & was tested and shown effective in Sjog in the Phase 2 DAHLIAS study - a plenary presentation at… https://t.co/aQDp7iPKXD https://t.co/hJ8fe6JwxC
Dr. John Cush RheumNow ( View Tweet)
De Lorenzis et al. MMF in LcSSc. Target Trial Emulation. 1435 patients. Incidence vasodilator treatment escalation over 41 months, 1/100py in MMF vs 7.3/100py in controls. @RheumNow #ACR24 Abstr#0688 https://t.co/D3qTUHyIIc https://t.co/6azvaS0ElL

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Richard Conway RichardPAConway ( View Tweet)
The risk of discontinuing first line biologics was twice higher in non-radiographic female patients compared to males. Abstr#0572 @RheumNow #ACR24 https://t.co/1tQUhsbqUu

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
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