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CD19 CAR T Cell Therapy in SLE (9.16.2022)

d Jack Cush, MD

The big news this week: the approval of deucravacitinib (a new class of drug?) for psoriasis; the 2022 ACR guidance on glucocorticoid-induced osteoporosis; a national poll of older adults over the age of 50 who claimed self-reported or doctor-diagnosed arthritis; and much more. Let's review these and other news, journal reports and announcements from this past week.

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IBD Ups Risk of Psoriatic Disease

d Jack Cush, MD

Findings of a new study suggest a causal effect between inflammatory bowel disease (IBD) and psoriasis (PSO) as well as psoriatic arthritis (PsA), but not vice versa.

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Does Methotrexate Use Lead to Melanoma?

d Jack Cush, MD

A systematic review suggests that low-dose methotrexate (MTX) use is associated with an increased melanoma risk, but the absolute risk increase could be considered negligible.

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2022 New ACR Guidance on Glucocorticoid-Induced Osteoporosis (GIOP)

d ACR

The ACR has updated this guideline and includes recommendations on abaloparatide (PTHrP) and romosozumab, which are newly available since the ACR’s 2017 GIOP guideline.

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Does Methotrexate Use Lead to Melanoma? A systematic review suggests that low-dose methotrexate (MTX) use is associated with an increased melanoma risk, but the absolute risk increase could be considered negligible. https://t.co/aLFBoB7M48 https://t.co/A1sHLaguqy

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2022 New ACR Guidance on Glucocorticoid-Induced Osteoporosis (GIOP) The ACR has updated this guideline and includes recommendations on abaloparatide (PTHrP) and romosozumab, which are newly available since the ACR’s 2017 GIOP guideline. https://t.co/byehJlihCY https://t.co/xnKPC1V0l7

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Dr. John Cush RheumNow ( View Tweet)
Disease Activity Drives Adverse Pregnancy Outcomes in RA Two large RA registries have shown that pregnancy outcomes in rheumatoid arthritis (RA) patients is more related to RA disease activity rather than treatments use to control RA. https://t.co/HtCdjhU5iv https://t.co/FLMjO56xZV

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Dr. John Cush RheumNow ( View Tweet)
The 2022 ACR abstracts are published and posted for you. Let the Learning begin! https://t.co/fNkzQVXHJx https://t.co/9AuamLB0Ha

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A longitudinal study of 506 ANCA-associated vasculitis (AAV) pts showed pts w/ negative ANCA serologies within 180 days of induction had signif lower risk of relapse (HR 0.55; 0.38 to 0.81) but not for ESRD or death within 5 years. https://t.co/qFb2Usov8L https://t.co/faogbabc2W

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Dr. John Cush RheumNow ( View Tweet)
Immunosuppresive (IST; MMF or AZA) withdrawl in 96 stable Lupus Nephritis pts also on HCQ. After 2 years, Relapse occurred in 12.5% w/ IST continued & 27.3% with IST D/C (Not noninferior). Less Severe SLE flares (renal & extrarenal) w/ IST continuation https://t.co/TM6Ng3vzeS https://t.co/UNBdg1Oh6z

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Dr. John Cush RheumNow ( View Tweet)
CD19 CAR T Cell Therapy in SLE Dr. Jack Cush reviews the news, journal reports, ACR and FDA announcements from the past week on RheumNow. https://t.co/OJ8WFyB3jc https://t.co/11wanMBjkO

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Anti-CD19 CAR T cell therapy for refractory #SLE published in Nature Medicine. 5 pts (22yrs) w/ refractory dz, active SLE (SLEDAI=16). Autologous pt T cells transduced to CD19 CAR Tcells, and lead to remission in 5/5 w/in 3 mos & maintained median 8 mos https://t.co/0epnffCNEN https://t.co/IMRzhOzgei

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Dr. John Cush RheumNow ( View Tweet)
Lupus (LUMEN) registry of 440 SLE compared to non-SLE pts, shows lupus pts have less screening for cervical cancer (HR 0.75), but SLE has more screening for HTN (HR 1.35), DM (HR 2.46), hyperlipidemia (HR 3.19) & Influenza & pneumovax vaccines https://t.co/e5ZGJswVds https://t.co/WQmhM0OZgl

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Open label, noninferiority study TNFi withdrawal in 64 PsA & 58 axSpA pts. 2/3 tapered by dz activity T2T strategy (N=81) & 1/3 continued TNFi. At 12 mos. LDA seen in 69% w/ Tapering (~avg 53% dose) vs 73% no-tapering group (91% dose) https://t.co/K6WFaesyRt https://t.co/zqo6nVGtqW

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Ischemic Forearm Exercise Test - used by McArdle, notes absence of elevated blood lactate levels during exercise w/ myophosphorylase deficiency (McArdle Dz). Deficiency impairs impairs glycogen metabolism & Nl lactate production in muscle https://t.co/t4PS1ghj5d https://t.co/YUDM1GCOfn

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534 PsA & 470 AS pts (SERENA study) on Secukinumab for avg of ~88wks - 5.8% PsA & 8.9% AS pts had sudden stop of SEC (for avg ~25wks) (reasons? Mostly AE 58% or pt decision 10%). While TJC & SJC increased, dz control returned w/ restarting SEC https://t.co/GFxj3b06Ra https://t.co/B2ubakq8Ql

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2022 Univ of Michigan Natl Poll on Healthy Aging finds that 70% of older adults reported joint pain (more in Women 75% vs 65%M). 30% have a HCP dx of #OA, 8% RA, 7% gout or pseudogout & 5% w/ another kind of arthritis https://t.co/yno8RgCRQS https://t.co/yTMLHsbGOU

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Dr. John Cush RheumNow ( View Tweet)
New York is the best state for patients with #rheumatic diseases to live in, while Wyoming was ranked worst in the United States #RheumTwitter https://t.co/ulYd0uNKZO

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Healio Rheumatology HealioRheum ( View Tweet)

I just posted "Free Lupus Encyclopedia Book give away ... register to win... even international addresses are welcome" on Reddit https://t.co/Pa4h75vcW1

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Donald Thomas, MD lupuscyclopedia ( View Tweet)

New download available! COVID Deaths at 3 Mos vs. 30 Mos https://t.co/SLGJGh5NX1 https://t.co/QhWdvNHntk

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Dr. John Cush RheumNow ( View Tweet)
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