Sjogrens

#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

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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

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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

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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

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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

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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

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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

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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

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Janet Pope @Janetbirdope( View Tweet )

Meeting audience conference

ACR 2024 - Day 1 Report

Jack Cush, MD

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

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Eric Dein @ericdeinmd( View Tweet )
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ACR24 Preview Podcast (11.15.2024)

Jack Cush, MD

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 )
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Happy Diwali (11.1.2024)

Jack Cush, MD

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

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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

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Dr. John Cush @RheumNow( View Tweet )
Is EBV relevant? It's certainly been linked to the etiol of SLE, RA, Sjögrens, & MS. Ronbinson et al suggests "EBV infection as a potentiator of autoimmune rheumatic diseases" and if Rx targeting of EBV may work in EBV-associated autoimmune diseases. https://t.co/bi630VvHTx https://t.co/tKYtwePaTu

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Dr. John Cush @RheumNow( View Tweet )
ANA+ consult? 2 Yr study of 207 asymptomatic ANA-pos, found only 11% progressed to systemic autoimmune rheum Dz (89% did not). Progressors developed SLE (48%), Sjögren (22%), scleroderma (13%), RA (4%); Arthritis (RR 1.74) more likly in progressors https://t.co/j54Vnsl50V https://t.co/jaPbigaqgS

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Dr. John Cush @RheumNow( View Tweet )
ANA+ consult? 2 Yr study of 207 asymptomatic ANA-pos, found only 11% progressed to systemic autoimmune rheum Dz (89% did not). Progressors developed SLE (48%), Sjögren (22%), scleroderma (13%), RA (4%); Arthritis (RR 1.74) more likly in progressors https://t.co/53bmkQ0qj0 https://t.co/8VUxqxnuGl

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Dr. John Cush @RheumNow( View Tweet )
Retrospective analysis of 63K Alopecia areata pts shows a higher risk of developing psychiatric (aHR 1.3) & autoimmune Dz (aHR 2.7), including SLE (aHR 5.7), atopic dermatitis (4.3), vitiligo (3.8), Sjogrens (3.7), Morphea (3.6), PsO (2.8), RA (1.8) https://t.co/gnEm9TsyoV https://t.co/XWA98sbRLp

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Dr. John Cush @RheumNow( View Tweet )
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… https://t.co/v1Es7vVim2 https://t.co/RKxa2Iyeq0
Dr. John Cush @RheumNow( View Tweet )
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Running with Data (8.30.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com - including tips on steroids, MAS, and myositis testing.

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eyes

Diagnosing Seronegative Sjogren's Disease

Jack Cush, MD

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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