Novel Rx

Following the landmark case series by the Erlangen group, multiple cellular therapies have entered the race—each with unique targets, constructs, and mechanisms. Yet, a fundamental question remains: How deep is the B-cell depletion? In clinical practice, peripheral blood counts often serve as our surrogate for depletion. But these may only tell part of the story.

Prof. Sandra Navarra and colleagues compared the efficacy and safety of tacrolimus and glucocorticoids vs. mycophenolate mofetil (MMF) as a continuous induction-maintenance treatment for class III/IV+V lupus nephritis.

Drs. Jack Cush & Arthur Kavanaugh, two of rheumatology’s most trusted voices, provide a breakdown of the latest breakthroughs and hottest topics in rheumatology from the 2025 ACR Convergence meeting in Chicago.

Here's the last installment of our "ACR Best" abstracts as chosen by the RheumNow faculty.  Most of these were from the final, day 4, but a few were noteworthy holdovers from day 3. Enjoy!

A new player is entering the IL-23 arena — and it’s a tablet! Icotrokinra (ICO), a first-in-class peptide that binds and blocks the interleukin-23 receptor (IL-23R), is showing encouraging efficacy and safety across a range of psoriasis (PSO) and psoriatic disease (PsD) studies.

After several failures of therapies in Phase 3 trials of Sjogren’s disease (SjD) over many years, all hope is not lost! At this year’s ACR25 Convergence Conference in Chicago, not one but two drugs presented their efficacy and safety data in patients with moderate to severe disease activity as defined by ESSDAI score ≥ 5 points.

At ACR Convergence 2025, abstract 1039 entitled, “Global Cost-Effectiveness and Equity in CAR-T Cell Therapy for Rheumatoid Arthritis” adds a critical dimension to the growing enthusiasm around cellular therapies in autoimmune disease.

Psoriatic arthritis (PsA) is a complex inflammatory disease often complicated by obesity, which not only worsens disease activity but also impairs treatment response. At ACR Convergence 2025, three compelling studies spanning pharmacologic, lifestyle, and longitudinal observational data converged on a central theme: weight loss is a powerful modulator of PsA outcomes, regardless of the intervention used.

IgG4 is a rare autoimmune disease with excessive IgG4 immunoglobulins that can affect multiple organs yielding plasma cell deposition (inflammation) and fibrosis.There has been great progress in treatment. Traditionally, glucocorticoids were used and if ineffective, then an oral immunesuppressive (ex: Azathioprine, MMF) and, if needed, rituximab. Many patients can improve sufficiently on this regimen.

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.

A growing arsenal of therapeutic targets in psoriatic arthritis (PsA) has enhanced the landscape of treatment in patients with this disease.

ACR 2025 began today in Chicago with throngs of rheumatologists, fellows, ARP members, APPs and pharma folk taking to the meeting halls and rooms for tons of novel content. 

At ACR Convergence 2025, the American College of Rheumatology’s annual meeting, researchers presented pivotal Phase III studies highlighting novel therapeutic options for patients with gout, particularly those with limited treatment choices or uncontrolled disease. The findings underscore continuing progress in addressing a significant unmet need for safer, more effective therapies in this common and often debilitating condition.

Is there ‘bang for the buck’ using big data to help predict who will develop RA in at-risk populations and similarly to predict response to csDMARDs, TNFi and JAKi in RA?

The pharmacology treatment including biologics, cellular-based therapies, and Bi-specific T-cell Engager (BiTE) in systemic lupus erythematosus (SLE) is a rapidly expanding field of research that provides excitement and optimism to both the patients and the physicians.