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 )
Treatment alert for Sjogrens
TWINSS study:
Iscalimab CD40/CD40L monoclonal Ab:
Improves disease activity
Also helps fatigue and sicca, not pain
Dazodalibep - CD40L antagonist also reduce symptoms/disease activity
Year in Review #ACR24 Pillinger
@RheumNow https://t.co/WjHuEpm9XW
Links:
Eric Dein @ericdeinmd( View Tweet )
ACR24 Preview Podcast (11.15.2024)
ACR 2024 starts tomorrow. Here are a few previews of abstracts to be presented, along with my recommendations of sessions you don’t want to miss.
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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/Nq09iEoxJ9 https://t.co/JG4P8zMw9j
Dr. John Cush @RheumNow( View Tweet )
Myelitis Associated With Rheumatologic Dz studied in 41 pts (age 44yrs; 95%women). Dx: SLE (41%), Sjogrens (24%), UCTD (15%), Overlap (12%) w/ APL syndr. Half Dx were AQP4-IgG Ab+ (90% w/ extensive cord lesions), 7% MOGAD Ab+, 44% "double-seronegative" myelitis.… https://t.co/or6vuCZASs https://t.co/UxzSR6yJO5
Dr. John Cush @RheumNow( View Tweet )
Happy Diwali (11.1.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.
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Full read review on the detection & management of #ILD in Autoimmune Dz (AID).
- AID at risk for ILD should be screened with hi-res CT Scan
- ILD should be monitored closely w/ PFTs
- Multidisciplinary Rx includes immunosuppressives & antifibrotics https://t.co/X6Feor2wF5 https://t.co/Z2WBWL3q1W
Dr. John Cush @RheumNow( View Tweet )
Dr. Lindsey Criswell Elected to National Academy of Medicine. Dr. Criswell is the NIAMS Director and is known for her research in SLE, RA, and Sjogrens. Congrats!! https://t.co/3l4VHqnH2m https://t.co/FDcNVGjw4l
Dr. John Cush @RheumNow( View Tweet )
