Lupus

A prosp cohort study by Dr Muñoz et al described prevalence of HPV infxn & cervical cyto in SLE pts 31 pts had cervical lesions, majority HSIL (64.5%) HPV+ in most HSIL and all LSIL cases 12 women w/normal cyto were HPV+ HPV screen & vax in SLE are key! @RheumNow #ACR26 ABS0297 https://t.co/LugnwE3cIe

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Lots of B-cell talk in SLE. What about T cells? Abstract 0258 targets the Treg By repleting lupus mice with IL-2 nanoparticles + histone peptides → • ↑ Tregs expansion • protection against protineuria and GN in lupus mice • ↑ Tregs in vitro of pts with SLE #ACR26 @RheumNow

Abstract 0262: Which patients get more steroids in LN? • Increased GC exposure linked to Prior hospitalizations • Nephrology vs rheumatology Rx associated with persistent high GC exposure • ↑ outpatient use linked to ↓ odds of some higher-exposure groups #ACR26 @RheumNow https://t.co/fOLQBBAMNj

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Abs #0255 Your patient’s C4 isn’t budging on a biologic? Small retrospective SLE cohort (n=84): C3 ↑ across biologics C4 trajectories: • Anifrolumab: flat • Belimumab: gradual ↑ • Rituximab: early ↑ Mechanism-related? Needs validation in larger cohorts. @RheumNow #acr26 https://t.co/De5gtii9uf

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Beyond CD19 CAR-T in SLE: γδ T, NK, iNKT: allo, MHC-independent, less GVHD CAAR-T hits only autoreactive B cells, but SLE has too many autoantigens CAR-Treg: non-depleting, no B-cell aplasia, low CRS Anca Askanase @RheumNow #ACR26 https://t.co/kh412q9Pnh

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LN biopsy after CAR-T: Peds case: IgG, C3, C1q deposits gone at 6 mo Adults rebiopsied for proteinuria post CAR-T (n=6): activity improved or resolved in 5 Residual proteinuria: class V and chronic damage Rebiopsy before calling it failure. Anca Askanase @RheumNow #ACR26 https://t.co/0nkzl87CmV

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Can we predict which myositis patients may respond best to IVIG based on clinical or antibody features? Not yet. Analysis of population in ProDERM trial: The only factor associated with response was receiving the drug. Go figure. #ACR26 @RheumNow https://t.co/rCQ8gVWQ5k

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CAR therapy in SLE, pooled: 31 studies, 243 pts SLEDAI 13.0 → 2.2 at 6 mo Autologous > allogeneic for SLEDAI 0 (HR 2.33) CD19 vs CD19/BCMA: no SLEDAI difference Severe infx 7.6%, 1 pneumococcal death, unvaccinated Vaccinate before CAR-T. Anca Askanase @RheumNow #ACR26 https://t.co/YT5dOspHAC

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What is new in IgG4? Obexelimab: significant efficacy compared to placebo with no major safety signals. -Non B cell depletion -Rapid B cell recovery -Long-term safety advantage of not depleting B cells yet not available. -Benefit in fibrotic, multisystem or refractory disease is https://t.co/whNiZwDSjI

Can urinary biomarkers predict lupus nephritis outcomes? In GLADEL, the RAIL score (NGAL, KIM-1, MCP-1, adiponectin, hemopexin & ceruloplasmin) predicted inactive LN at 12 months (AUC 0.73). A step toward non-invasive, biomarker-guided monitoring! @RheumNow #ACR26 https://t.co/PMAuzNlrxg

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Are AAV patients who experience hypogammaglobulinemia from RTX more protected against relapse? Unfortunately not. In fact, Abst#0201 suggests low IgG patient may relapse SOONER @RheumNow #ACR26 https://t.co/5MqGjsklgZ

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Myositis partners in crime: MDA5 and Ro-52 Antibodies. Associated with more severe disease, RP-ILD.. why? MDA5 Abs = drive Type 1 Interferon Ro-52 Abs = Reduced antibody degradation via disrupted ubiquitination pathway Both antibodies present = bad news #ACR26 @Rheumnow https://t.co/g0xVDL6O9q

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Inebilizumab beyond 1 year for IgG4-RD? Abst0177 reports open-label extension of MITIGATE trial ALL patients receiving INE in MITIGATE who continued q6 mo tx in OLE remained flare free GC requirements were low How long should we treat for?? @RheumNow #ACR26 https://t.co/uOzuhGxkdS

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Retrospective real-world SLE cohort study evaluated thoracic CT findings: Parenchymal, pleural & vasc abn similar bet A/symptomatic pts Parenchymal abn assoc w/older age at dx, higher ESR Pleural abn assoc w/higher CRP, ptnuria, low HCQ use & freq RTX use @RheumNow #ACR26 ABS0294 https://t.co/cnpj87DYKO

Abstract 0875: Nipocalimab (FcRn blocker) in SLE – Phase 2 JASMINE trial Nipocalimab 15 mg/kg IV q2w vs Placebo: SRI-4 wk24: 53.5 vs 46.7% (1° EP) SRI-4 wk52: 53.6 vs 39.7% LLDAS wk52: 37.5 vs 20.5% ↓IgG, anti-dsDNA; ↑C3 by Wk 52 Well tolerated #ACR26 @RheumNow

RCT of Sirolimus 1.5mg/day for active SLE: Sirolimus (54.3%) showed improvement of SRI4 respose at wk 24 vs. PBO, incl improvement in C3, C4 More AEs seen in SIR arm: dyslipidemia, cytopenias, menstrual changes Limitations: short pd 24wks, limited cntrs @RheumNow #ACR26 ABS0874 https://t.co/14W6X7mxi6

Edecesertib (EDE) is a sel. IRAK4 inhibitor Ph2 RCT of EDE for CLE: EDE 30mg vs PBO OD x 12wks EDE achieved prim endpt, assoc w/ greater reduxn of CLASI-A score vs. PBO at wk 12 (MPC from BL -62% vs -15%, resp.) TEAEs/TELAs gr. 1or2 only. Promising data @RheumNow #ACR2026 ABS0269 https://t.co/f0pSWr7dle

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X-sectional study by Dr Chen et al eval'd if the clin frailty scale (CFS) correlates w/ SLICC-FI in ID of SLE pts w/ frailty Strong pos. correlation w/CFS & SLICC-FI (p<0.001) CFS >/=4, agreement substantial for both interesting data, further testing reqd @RheumNow #ACR26 ABS0310 https://t.co/YpkQjbqi3L

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Multicenter retro study of ANI in SLE w/active severe hema conditions: statistically sign. improvement of cytopenias & dse activity, decr pred dose </=5mg/day & flares. 17 pts dev’d mild URTI. small pop’n but supports ANI use for severe hema assoc-SLE @RheumNow #ACR26 ABS0253 https://t.co/wfx5diqHFc

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Litifilimab (anti-BDCA2) in CLE: CLASI-70 gains kept building to wk 52 Ph2 AMETHYST Part A, n=59 vs 34 PBO Wk 16: 22.5% vs 5.7% Wk 24: 21.7% vs 5.8% Wk 52: 28.8% on drug, 35.4% after PBO switch Secondary endpoints, nominal p. Phase 3 decides. @RheumNow #ACR26 Abstr#P0872 https://t.co/qpNyKIi31v

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Newer SLE Rxs, SRI-4 delta vs PBO: Telitacicept 34 Obinutuzumab 24 Dapirolizumab pegol 19 Anifrolumab 16 Belimumab 14 Cross-trial data with different PBO rates and populations. Choose by organ involvement and phenotype. Liana Fraenkel, Year in Review @RheumNow #ACR26 https://t.co/dB5cbfsEWj

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Yr in Rvw #ACR26 Telitacicept - BLyS and APRIL P3DBRCT in China for active SLE SRI-4 response 67 vs 33 in PBO, GC sparing But P3 program outside of China terminated @RheumNow https://t.co/8B42jbz9Yl

Yr in Rvw #ACR26 Obinitizumab, Furie NEJM 2026 P3DBRCT for active SLE SRI-4 response 77 vs 53 PBO, GC sparing at wk 52 DORIS remission 34 v 14 Increase serious ifn 9% vs 5% in PBO @RheumNow https://t.co/PGpBc3HPTE

Article

The shifting sands of glucocorticoid use in SLE

Sheila Reyes, MD Nov 08, 2026

Despite the rapid development of emerging therapies for SLE, glucocorticoids remain an important component of disease management. "How well do our current corticosteroid prescribing habits align with current treatment guidelines?" On day 1 of the SLE poster sessions, several abstracts have

Yr in Rvw #ACR26 Low dose belimumab 120 mg, Ann Rheum Dis 2026 Study in low disease activity SELENA-SLEDAI Flare within 52 wks, study stopped early 2/2 COVID Possible option for lower BEL dose @RheumNow https://t.co/8uSW8VXTyP