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Beyond the Needle: Redefining the Assessment of Lupus Nephritis

Akhil Sood, MD

Lupus nephritis is one of the most silent and severe manifestations of SLE. When not captured early, patients are at high risk of progressing to end-stage renal disease, which would require dialysis or transplantation. Renal biopsy remains the gold standard for diagnosis and disease classification. However, the procedure is invasive and very painful. Non-invasive measures are critical for early detection and continuous monitoring.

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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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Meeting audience conference

ACR 2024 - Day 1 Report

Jack Cush, MD

ACR Convergence 2024 opened today with a full slate of presentations, posters and specialty meetings.  The meeting began with a flip: the plenary sessions started at 9AM and the poster session began at 1030 AM. Below are some of the highlights from day one in Washington, DC.

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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)

What is my risk of developing SLE? Abstract 0843 highlights a predictive model that accurately classifies SLE risk using genetics, lifestyle, and environmental factors. Model 3 (genetics + environment + lifestyle) performed the best compared to models 1 and 2. @RheumNow #ACR24 https://t.co/sk9oG0OY3W

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Akhil Sood MD AkhilSoodMD ( View Tweet)
Is it pre-eclampsia or lupus nephritis flare? Abstract 0809: The sFlt-1/PlGF ratio may help distinguish preeclampsia from lupus nephritis in pregnancy. A low ratio ruled out preeclampsia, while a high ratio ± proteinuria suggests increased risk. @RheumNow #ACR24

Akhil Sood MD AkhilSoodMD ( View Tweet)

#Disparites posters #ACR24 - Analyzed 954 SLE patients - Black and Asian patients had higher severe damage events - Neighborhood disadvantage (ADI) linked to increased severe damage - Older age and comorbidities increased damage risk abst#0362 @rhuemnow

Bella Mehta bella_mehta ( View Tweet)

Disparities posters #ACR24 - Analyzed 10,604 SLE patients - 18.7% in the lowest SES group experienced functional status decline vs. 12.5% in the highest SES group - African American patients and Greater neighborhood deprivation did worse #ACR24 abst#0190 @RheumNow

Bella Mehta bella_mehta ( View Tweet)

Contraception counselling in #SLE post intervention - Contraceptive counseling rates improved from 33.9% to 55.7% - Women over 35 were 4.09 times more likely post-intervention - Non-Hispanic Black women were less likely than Hispanic women #ACR24 abst#0184 @RheumNow https://t.co/sOZXnAe4ov

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Bella Mehta bella_mehta ( View Tweet)
High serum BAFF as a novel RF for dev't of preeclampsia in pregnant SLE pts? This study by Dr. C Sims et al showed that SLE pregnancies w/preeclampsia had significantly higher BAFF levels during the 1st trimester, and likely w/ ⬆️dsDNA or ⬇️ complement @RheumNow #ACR24 abs424 https://t.co/kNzyuT03r2

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sheila RHEUMarampa ( View Tweet)
This interesting systematic review showed that the prevalence of ILD was 15% in patients with SLE. This higher than previously reported! #ACR24 @RheumNow https://t.co/O1aZUUL4Ho

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Gabriela Martinez Zayas, MD MartinezZayasMd ( View Tweet)
Researchers developed a digital messaging program to reduce fatigue in SLE - Grounded in social cognitive and self-determination theories - Reviewed 148 messages, refined based on patient feedback - High patient ratings, future will see more of these #ACR24 abst#0362 @RheumNow

Bella Mehta bella_mehta ( View Tweet)

Ab#0427 #ACR24 HSS: menopause & systemic rheum disease severity 1/3 women report worse disease associated w menopause Reported more flares, menopausal symptoms Findings were similar between SLE and RA, but SLE patients were >2x more likely to discuss w their rheum @RheumNow

Eric Dein ericdeinmd ( View Tweet)

#ACR24 abst#0430 - Analyzed 61 SLE pregnancies - Higher early gestational Mean Arterial Pressure before 20 Weeks linked to increased preeclampsia risk - MAP trends at 8-10 and 17-19 weeks showed highest predictive accuracy for risk prediction @RheumNow https://t.co/37mg0WX43v

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Bella Mehta bella_mehta ( View Tweet)
FDA recently approved - fms-like tyrosine kinase 1 (s-Flt1) / placental growth factor (PlGF), for diagnosing preeclampsia. sFlt1:PlGF≤38 rules out preeclampsia in SLE sFlt1:PlGF>85 modestly predicts preeclampsia Proteinuria impacts prediction accuracy #ACR24 abst#0809 @RheumNow

Bella Mehta bella_mehta ( View Tweet)

Nationwide US study -Prevalence of HLH in SLE: 0.13% -Higher risk in younger, female, and racial minority patients - Strong association with high mortality #ACR24 abst#0619 @RheumNow

Bella Mehta bella_mehta ( View Tweet)

Study on #AI-augmented remote care for SLE: - Combined biometric, self-reported, and NLP-extracted data - Moderate to strong correlations with physician global assessment - Potential to improve remote disease management - but now very accurate for now #ACR24 abst#0635 @RheumNow

Bella Mehta bella_mehta ( View Tweet)

Interim analysis of a Phase 4 study of ARD (RA 25%, SLE 25%) patients shows recombinant herpes zoster vaccine(RZV) good safety profile, with no impact on disease activity (flare rates: 13.6% vs. 12.4%). Immunogenicity: 93% response in ARDs vs. 99% in controls. Rituximab & MMF… https://t.co/U3s48fLduX https://t.co/WTvD5shtXB

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Study on socioeconomic factors in SLE hospitalizations - US wide data - No insurance & non-metro areas linked to shorter LOS, lower costs, higher mortality - Higher income & age increase charges - Targeted interventions needed to improve outcomes #ACR24 abst#0615 @RheumNow

Bella Mehta bella_mehta ( View Tweet)

Study on pregnancy outcome disparities in SLE: - Analyzed 685 women, 1888 pregnancies - Pre-SLE state linked to fewer live births, higher preeclampsia risk - Outcomes worse post-SLE diagnosis #ACR24 abst#0440 @RheumNow https://t.co/NpEYQZ73uo

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Bella Mehta bella_mehta ( View Tweet)
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