CAR T Therapy

CAR-T Therapy: Where is it Heading? Dr. Peter Nash summarizes several abstracts looking at CAR-T therapy from #ACR25. https://t.co/bC8p1LnZMW https://t.co/KKn3jjsBW0

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Dr. John Cush @RheumNow( View Tweet )
Off the Shelf: CAR-T Dr. Akhil Sood reports on abstract 0663 (iPSC-Derived Off-the-Shelf anti-CD19 CAR T cells Deliver Improved Clinical Outcomes in Lupus with Reduced or No Conditioning Chemotherapy) presented at#ACR25. https://t.co/mj4b5cCInC https://t.co/s34atFCMlx

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Dr. John Cush @RheumNow( View Tweet )
Are we putting the CAR-T before the horse? 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. https://t.co/gF9FXjAZ7F
Dr. John Cush @RheumNow( View Tweet )
CART

Beyond malignancy, look out for LICATS with CAR-T

Md Yuzaiful Md Yusof, MRCP(UK), PhD

CAR T cell therapy took the centre stage in 2022 where data pertaining to a successful case series of 5 patients with refractory SLE were published by Prof Schett’s group. Since then, this area of therapeutic has expanded exponentially. Our growing enthusiasm was slightly dampened though when

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B CELL DEPLETION

Taking a closer look: B-Cell depletion beyond the blood

Akhil Sood, MD

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

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Cush and Kavanaugh

ACR 2025 Rheumatology Round Up

Jack Cush, MD

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.

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acr_session2.jpeg

ACR25 Best Abstracts - Day 4

Jack Cush, MD

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!

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NEPTUNUS: Ianalumab in Sjogren's https://t.co/K9Xm51Kb5X Finally good news in Sjogrens disease. @RheumNow #ACR25

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Nouf Al hemmadi @NoufAhmedAlham2( View Tweet )

Why are vaccine Abs maintained after CAR-T -depletion of pathogenic #Abs are dampened/eliminated Clonal repetoire expansion Remission=naive B cell pop'n Reset immune system sparing memory cells vs ?not all pathogenic cells eliminated in tissue #ACR25 @RheumNow @ACRheum #26S21 https://t.co/jb3dD5Ssip

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Janet Pope @Janetbirdope( View Tweet )
CAR T Which cells to target What patients & what disease When is right time In vivo (new) ex vivo Premeds immune suppression What to use, ?if anything Cons Is it safe ?long term effectiveness What is failure rate ICANs and other side effects #ACRBest #ACR25 @RheumNow #26S21 https://t.co/TUSJh1hrPr https://t.co/JiqYzgBmYP

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Janet Pope @Janetbirdope( View Tweet )
Needle in a haystack What T cell to target for #autoimmune diseases T cell repetoires (TCR) not all are sequenced and many can exist to present antigens Diff scales of approaches Implications CAR-T CD19 CD20 BCMA Treg HLAB27 etc! #ACR25 @ACRheum @RheumNow Alok Joglekar #26S08 https://t.co/Qgw8Akz1xk

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Janet Pope @Janetbirdope( View Tweet )
Toxicity is the big question about CAR-T in RA - what did the CRS/ICANS profile look like in this German ph1 in RA? Pretty good so far - but obviously will be under enormous scrutiny when we are looking at diseases with good existing therapies #ACR25 ABST0471 @RheumNow https://t.co/xXyzOwLvx8

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David Liew @drdavidliew( View Tweet )
2465: Dual-target CD19/BCMA CAR-T in refractory SLE (Phase 1) 🔹All pts (n=10) met SRI-4 by wk24 🔹DORIS remission: 5 (wk24), 6 (wk36–48) 🔹Residual proteinuria (n=4); renal bx (n=3) showed resolved IC deposits & inflammation 🔹CRS Grade 1 (n=6); no ICANS @RheumNow #ACR25

Akhil Sood MD, MS @AkhilSoodMD( View Tweet )

What does the FDA regulatory approach look like for CAR-T and T cell engages right now? The FDA session at #ACR25 gave some clues @RheumNow https://t.co/wHNnNTrXaE

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David Liew @drdavidliew( View Tweet )
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

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Akhil Sood MD, MS @AkhilSoodMD( View Tweet )
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

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Akhil Sood MD, MS @AkhilSoodMD( View Tweet )
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

Akhil Sood MD, MS @AkhilSoodMD( View Tweet )

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

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David Liew @drdavidliew( View Tweet )
@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

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David Liew @drdavidliew( View Tweet )
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

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Akhil Sood MD, MS @AkhilSoodMD( View Tweet )
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

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David Liew @drdavidliew( View Tweet )
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

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David Liew @drdavidliew( View Tweet )
@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

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David Liew @drdavidliew( View Tweet )
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

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David Liew @drdavidliew( View Tweet )
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

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David Liew @drdavidliew( View Tweet )
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