Lupus

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.

A retrospective cohort study presented at #ACR24 explores the benefits of GLP-1Ras in reducing the risk of end-stage renal disease (ESRD) for patients with lupus nephritis. Drawing on data from the TrinetX global research database, the study examines how GLP-1Ras may reduce ESRD progression in a population where 10-20% progress to ESRD within five years, even with immunosuppressive therapies.

A 52-week has demonstrated the safety and efficacy of ianalumab, a dual B cell depleter) in patients with active Sjögren's disease (SjD).

Join Drs. Jack Cush and Artie Kavanaugh as they review 15+ presentations and abstracts from the 2024 ACR Convergence meeting in Washington, DC.

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.

When should you consider off-label use of JAKi?

The global population is aging and none of our rheumatic diseases are immune to the impact of the complexities and so-called “geriatric syndromes”, including sarcopenia, frailty, falls and cognitive impairment, associated with the aging process. Whilst we are increasingly aware of these syndromes, it is sometimes overwhelming to consider just how we may incorporate the unique needs of our older patients into our already busy clinical practice –

Randomized controlled trials (RCTs) drive guidelines; guidelines drive clinical practice. Because updated guidelines lag trials by many years and dissemination of guidelines takes additional time, rheumatologists often practice “behind the data.” The 2024 ACR Guidelines for the Management of SLE Nephritis reaffirmed many of our typical practice patterns, including hydroxychloroquine for all, renin/angiotensin blockade, and favoring mycophenolate

Sleep plays a critical role in regulating inflammation and overall health. In rheumatic diseases like lupus and rheumatoid arthritis (RA), disrupted sleep is common and can exacerbate symptoms and disease progression. Experts Dr. Al Kim, Patty Katz, and Dr. Yvonne Lee emphasized the importance of addressing sleep disturbances in these conditions.

Suppose you have a patient with lupus returning for follow-up. Their joint symptoms are well controlled. The kidneys—managed with a combination of biologic DMARD and mycophenolate—show no signs of active urinary sediment or protein. Yet, during the routine visit, your patient brings up fatigue and difficulty remembering things. How do you address this? Several studies presented at ACR24 focused on cognitive impairment in lupus.

Highlights from Day 3 at ACR24 included the plenary session presentation on Nipocalimab (previously reviewed), but the big highlight was the Lupus Nephritis guideline recommendations.

A retrospective cohort study presented at #ACR24 explores the benefits of GLP-1Ras in reducing the risk of end-stage renal disease (ESRD) for patients with lupus nephritis. Drawing on data from the TrinetX global research database, the study examines how GLP-1Ras may reduce ESRD progression in a population where 10-20% progress to ESRD within five years, even with immunosuppressive therapies.

the predictive value of a positive ANA test—especially in the absence of other clinical symptoms—remains a challenge. A positive test often leads to further testing, yet it does not necessarily indicate whether a patient truly has an underlying autoimmune disease. The development of AI and machine learning algorithms presents an opportunity to interpret autoantibody tests and predict autoimmune diseases. Here are three studies looking at this

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.

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?