CAR T Therapy
Akhil Sood MD, MS AkhilSoodMD
3 months ago
LB23: Regulate-RA- ongoing Phase 1 trial of autologous CAR-Tregs in refractory RA (no lymphodepletion)
🔹 4/6 pts had ↓ DAS28-CRP by wk 4 with rapid onset & ↓ joint counts at dose level 2
🔹 Synovial biopsies to date showed ↓ inflammatory score post-tx
@RheumNow #ACR25 https://t.co/JMBbLIEmJG
Akhil Sood MD, MS AkhilSoodMD
3 months ago
LB04: Another approach to CAR-T, CD20+/BCMA bispecific CAR-T in refractory proliferative LN:
🔹100% discontinued biologics & IS at follow-up
🔹Renal response ~78%
🔹CRS mostly Grade 1–2 (~70%); ≥Grade 3 AEs = transient & hematologic
@RheumNow #ACR25 https://t.co/oNK4wtLGYV
Akhil Sood MD, MS AkhilSoodMD
3 months ago
Abstract 1563: Ongoing Phase 1/2 trial of Rese-cel CAR-T in systemic sclerosis
🔹Pt with severe skin involvement showed improvement in mRSS (42→34), PFTs & nailfold capillaroscopy at 6 mo
🔹Grade 2 CRS, no ICANS or DLT reported
Early but exciting findings
@RheumNow #ACR25
David Liew drdavidliew
3 months ago
While post-CAR-T CRS might be semi-familiar for rheumatologists, ICANS is a new concept to get our heads around, and one which is far from heterogenous.
@CarolineDiorio @ChildrensPhila in the #ACR25 BCRC pre-meeting @RheumNow https://t.co/qX2jKMG2oB
David Liew drdavidliew
3 months ago
@CarolineDiorio @ChildrensPhila @RheumNow Indeed, there are a lot of familiar HLH/MAS friends in the post-CAR-T CRS mix...
(indeed, rheum friends from many places)
@CarolineDiorio @ChildrensPhila in the #ACR25 BCRC pre-meeting @RheumNow https://t.co/OzWu3MV1FA
Akhil Sood MD, MS AkhilSoodMD
3 months ago
Another toxicity signal to watch in the CAR T space: LICATs
Abstract 1537 reports a new immune-related toxicity distinct from CRS or ICANS:
🔹Affects organs prev involved in autoimmune dx: skin (35%) and kidneys (22%)
🔹Mostly mild (Grade 1–2); 3 cases Grade 3
@RheumNow #ACR25 https://t.co/mtZh47nWtv
David Liew drdavidliew
3 months ago
I've always (very) simplistically considered post-CAR-T CRS and HLH/MAS in the same bucket, and there certainly are substantial similarities.
It raises the obvious question - can we borrow therapies?
@CarolineDiorio @ChildrensPhila in the #ACR25 BCRC pre-meeting @RheumNow https://t.co/2HkHxpl89u
David Liew drdavidliew
3 months ago
What dictates how severe CRS is following CAR-T?
(Often the critical question, and will especially be in the autoimmune space, where CAR-T is largely less time-critical)
@CarolineDiorio @ChildrensPhila in the #ACR25 BCRC pre-meeting @RheumNow https://t.co/u0w4lx7YVn
David Liew drdavidliew
3 months ago
@CarolineDiorio @ChildrensPhila eloquently told the #ACR25 BCRC pre-meeting about the lessons they've learned about CRS and ICANS, the major CAR-T toxicities.
Many questions still to answer, but they've also understood a lot we can learn from.
@RheumNow https://t.co/Jhk1eCLpD4
David Liew drdavidliew
3 months ago
CAR-T vs bispecific antibodies - what's the difference?
@andrew02114 @MGHCancerCenter with the heme-onc point of view in the #ACR25 BCRC @RheumNow https://t.co/7KJCfiQKWM
David Liew drdavidliew
3 months ago
CAR-T toxicity in hematology
(the things we have to look out for in rheumatology, as application of CAR-T potentially broadens)
@andrew02114 @MGHCancerCenter with the heme-onc point of view in the #ACR25 BCRC @RheumNow https://t.co/1YjadL7LCF
David Liew drdavidliew
3 months ago
Andrew Yee @andrew02114 of @MGHCancerCenter details out how quickly the CAR-T paradigm changed in myeloma/lymphoma - from newsworthy to routine. Now that much more about CAR-T has been worked out, will adoption be quicker in autoimmune disease? #ACR25 BCRC pre-meeting @RheumNow https://t.co/oNuPXCwWQ9
Janet Pope Janetbirdope
3 months ago
What to use in future for active #Sjogren's #SjD
B cell depletion, signal attenuation
Ianalumab 2+ phase3 RCTs
Telitacept +RCT
Nipocalimab FcRn +Ph2
Dazodalibep CD40L +Ph2
+RCTs
HCQ+Lef
Rituximab
?BTKi
#ACR25 @ACRheum @RheumNow
abst#LB24, LB11
David Liew drdavidliew
3 months ago
Post-CAR-T myelopathy has been an issue in heme onc, and is still an unpredictable quantity without a clear cause. Will this be a problem for autoimmune CAR-T as we gain more experience? @CarolineDiorio @ChildrensPhila in the #ACR25 BCRC pre-meeting @RheumNow https://t.co/RhhdOiyEAX
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.
Poster Hall