ERA, APPs, & Alpha GAL (3.21.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. Listen in for 2 new case questions - Ask Cush Anything.
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J&J announced the FDA jas granted the investigational drug, nipocalimab (FcRn recpt Ab), with Fast Track designation for its study in adult patients with moderate-to-severe Sjögren’s disease https://t.co/5rEYHkGVp2 https://t.co/ny2dv6Jtr5
Dr. John Cush @RheumNow( View Tweet )
2024 Rheumatology Year in Review
2024 was a year of surprising new growth in technology, with the expansion of new therapeutic options for many patients and clinicians. While these many advances offer new hope, they are countered by disappointments and gapping unmet needs in rheumatology. Below is my top 10 list
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Seeing Beyond the Surface: Salivary Gland Ultrasound in IgG4 Related Disease
Presentation by Dr. Amy Trang at the Rheumatology Winter Clinical Symposia - Feb 2025.
https://t.co/DLXKCRz3fF https://t.co/lfobyjElFG
Dr. John Cush @RheumNow( View Tweet )
BSR Guideline on Management of Sjögren disease
The British Society for Rheumatology has published its guideline for the management of adult and juvenile onset Sjogren's disease.
https://t.co/UJOvb937lk https://t.co/P77h91nPuN
Dr. John Cush @RheumNow( View Tweet )
BSR Guideline on Management of Sjögren disease
The British Society for Rheumatology has published its guideline for the management of adult and juvenile onset Sjogren's disease.
This guideline is an update to the 2017 guideline and is based on medical literature review focused on 19 clinical questions. While most of the
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QD Clinic - ANA Negative Lupus
Pregnant ANA negative SLE (?) patients with Sjogrens and FM - what to do?
Features Dr. Jack Cush.
QD Clinics - lessons from the clinic, sponsored by RNL2025 in Dallas, TX; Feb 8 & 9, 2025
Register at https://t.co/2dcFVgu8z6… https://t.co/RyCdiadn4H https://t.co/EvWcQ6KIxQ
Links:
Dr. John Cush @RheumNow( View Tweet )
Fallen Angels (1.17.2025)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com; and pays homage to colleagues who passed away in 2024.
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Best of 2024: Diagnosing Seronegative Sjogren's Disease
Sjögren disease (SjD) is highly prevalent, but diagnosis may be challenged if anti-SSA antibodies or a labial salivary gland biopsy are negative. A recent cohort analysis suggests a novel autoantibody profile has predictive value SSA negative SjD and also in those with a positive labial biopsy
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Efficacy and Safety of Nipocalimab for Sjogren's Syndrome
Dr. Mike Putman reports on abstract 2527, Efficacy and Safety of Nipocalimab, an Anti-FcRn Monoclonal Antibody, in Primary Sjogren’s Disease: Results from a Phase 2, Multicenter, Randomized, Placebo-Controlled,… https://t.co/kkIOCUZRml https://t.co/nL47c5veCp
Dr. John Cush @RheumNow( View Tweet )
Phase 2b Study of Ianalumab in Sjögren's
A 52-week has demonstrated the safety and efficacy of ianalumab, a dual B cell depleter) in patients with active Sjögren's disease (SjD).
https://t.co/08W0N1f3ap https://t.co/lyZwGI56Qq
Dr. John Cush @RheumNow( View Tweet )
Phase 2b Study of Ianalumab in Sjögren's
A 52-week has demonstrated the safety and efficacy of ianalumab, a dual B cell depleter) in patients with active Sjögren's disease (SjD).
The Phase 2b trial enrolled 190 SjD patients who were randomized (1:1:1:1) to either placebo or ianalumab (5, 50, or
#ACR24: What I learned in Sjogren's, Takayasu's and CAR-T
Dr. Janet Pope reviews abstract 2527 and abstract 1696.
https://t.co/rrrGnOhfIV https://t.co/Ht1UTtYOLI
Dr. John Cush @RheumNow( View Tweet )
Differential diagnosis of ACA+
1. SSc
2. Sjogren Syndrome
3. PBC
4. Overalp syndrome https://t.co/JmqDaaZerJ
Dr. Dinesh Khanna @sclerodermaUM( View Tweet )
#Ianalumab
300 mg sc q monthly
B cell depleted and changes BAFF signalling
👇⬇️IFN
May be promising in #lupus #SLE
+data in primary #Sjogrens
ACR24 @RheumNow @ACRheum
Abst#2425
Needs Phase3
➡️I suspect safer than CAR T and Bispecific T cell engagers but
? ⬇️efficacy
Janet Pope @Janetbirdope( View Tweet )
#Positive #RCT of #Nipocalimab a FcRn receptor inhibitor in #Sjogrens #Disease
👏Phase 2 +RCT
ESSSDAI and ESPRI both improved
🤷♀️what it means to lower #antibodoes #Ro #La
Excited for Phase 3 results
#ACRBest #ACR24 @RheumNow @ACRheum abst#2527 https://t.co/NeeYT7VR16
Links:
Janet Pope @Janetbirdope( View Tweet )
A#2291
ESSDAI does not correlate to PROMISE (pt outcomes) in Sjogrens
Symptomatology is complex in SjD and beyond traditional disease activity markers
@RheumNow #ACR24 https://t.co/AhstAFjOVS
Eric Dein @ericdeinmd( View Tweet )
A#2530
ANA reactive CD4 cells: elevated B cell help activation in SjD
Unique autoreactive T cell cluster in SSc shows CD4+ TRAIL+ IFN type I - unique to SSc
Leads to decrease activation of APCs, decrease CD4 T effector fxn
@RheumNow #ACR24 https://t.co/4JnA3SpVM8
Eric Dein @ericdeinmd( View Tweet )
Gottenberg et al. A positive RCT in pSS! DAHLIAS study. Phase 2. 163 patients. Nipocalimab, anti-neonatal Fc receptor (FcRn) mAb. @RheumNow #ACR24 Abstr#2527 https://t.co/M7li4ZoKeY https://t.co/gV9MGnswdR
Links:
Richard Conway @RichardPAConway( View Tweet )
Nipocalimab, an anti-neonatal Fc receptor (FcRn) mAb, reduces circulating IgG including specific autoantibodies (AAb), by selectively blocking IgG–FcRn interactions.
DAHLIAS, the first study of a FcRn blocker in SjD, showed that nipocalimab led to significant improvement vs PBO… https://t.co/zl1tEsEMAj https://t.co/qrkOD2Ccc3
Links:
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
A#2527 DAHLIAS, P2 Nipocalimab: Anti-FcRn Ab in Ro+ SjD IV 5 or 15 mg/kg Prim Endpt: 15 mg/kg has ClinESSDAI at w24 -6.4 v -3.7 PBO p=0.002 Improv dryness, fatigue, pain Better unstim salivary flow Best response in higher Ab titer pts Safety data good #ACRBest #ACR24 @RheumNow https://t.co/O7zahPul66
Links:
Eric Dein @ericdeinmd( View Tweet )
Now that nipocalimab is approved for Sjogren's Disease, what about vaccination response whilst on this FcRn inhibitor (inherently lowers IgG)?
Actually, not bad: takes a little longer to get there, but reassuring!
(always fun to get to know a new med)
#ACR24 ABST1988 @RheumNow https://t.co/IYqIGo5xVP
David Liew @drdavidliew( View Tweet )
Salivary glands in #Sjogens #Disease
Have persistent
#IFN signature
Abnormal morphology
⬇️ secretory ability
In
Differentiated salivary gland organoids
DSGO
May aid in drug screening
Would drugs that
⬇️ #interferon help #Sjogren’s
Abst#1406 @RheumNow @ACRheum #ACR24 https://t.co/dppp0tyFk5
Janet Pope @Janetbirdope( View Tweet )
ACR 2024 - Day 1 Report
ACR Convergence 2024 opened today with a full slate of presentations, posters and specialty meetings. The meeting began with a flip: the plenary sessions started at 9AM and the poster session began at 1030 AM. Below are some of the highlights from day one in Washington, DC.
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FDA has given FDA Breakthrough Therapy designation to Nipocalimab for treatment of adults w/ moderate-to-severe Sjögren’s disease. NIPO is an Ab to neonatal Fc receptor (FcRn), & was tested and shown effective in Sjog in the Phase 2 DAHLIAS study - a plenary presentation at… https://t.co/aQDp7iPKXD https://t.co/hJ8fe6JwxC
Dr. John Cush @RheumNow( View Tweet )
