Articles By Michael Putman, MD, MSCI
Sjögren's disease RCTs: Has the Long Drought Ended?
Sjögren's disease has been a difficult space for new FDA approvals. At ACR 2025, two late breaking abstracts have triggered hope for patients suffering from Sjögren's disease.
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The Great Debate – Who Really Won?
My favorite session at ACR Convergence is often the “Great Debate.” The debate this year also evaluated one of my favorite topics – ultrasound in giant cell arteritis (GCA). More specifically, it asked the question of whether biopsy or ultrasound should be the preferred modality for diagnosing GCA.
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Sooner May Still Be Too Late: Kidney Biopsies in SLE
ACR Convergence 2025 will be kicking off with a Plenary Session by Michelle Petri (Abstract 0772: Redefining When to Biopsy the Kidney in Patients with SLE), which is a great place to kick off our coverage of the meeting. As part of a collaboration with the Accelerating Medicines Partnership, Petri and colleagues have given data to what many of us have long suspected: a biopsy threshold of 0.5g/d of proteinuria may be too high.
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Steroids in Lupus Nephritis: No Free Lunch
Today I'm here to talk with you about steroids in lupus nephritis. The impetus for this is the 2024 ACR guideline for the management of lupus nephritis.
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Prophylaxis Against PJP in SLE: I'll Pass
I think we're all somewhat familiar with PJP prophylaxis. This is the thing we do to stop the scary, opportunistic infection that affects people who are immunocompromised. I'm going to start by actually steelmanning the case for doing PJP prophylaxis before I explain why I think you probably shouldn't be doing too much of it.
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ICYMI: Taking CAR-T for a Test Drive
When the ACR Convergence 2024 abstract site went live, the first query I typed into the search bar was, “CAR-T.” I consider myself a CAR-T skeptic and would be surprised if the magical results from this NEJM case series replicate at scale, but it seems likely that CAR-T will revolutionize the care for (some) patients with rheumatic diseases.
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Is Your Practice Up to Date? New Guidelines for SLE Nephritis
Randomized controlled trials (RCTs) drive guidelines; guidelines drive clinical practice. Because updated guidelines lag trials by many years and dissemination of guidelines takes additional time, rheumatologists often practice “behind the data.” The 2024 ACR Guidelines for the Management of SLE Nephritis reaffirmed many of our typical practice patterns, including hydroxychloroquine for all, renin/angiotensin blockade, and favoring mycophenolate mofetil over cyclophosphamide.
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ACR 2024: What Exactly do JAKs and TYKs Do?
Let me start by confessing something embarrassing: the immune system is just too complex for me to understand. I suspect the onslaught of new drugs with new mechanisms at ACR 2024 may have left many of you feeling similarly. This may be particularly true for the TYK/JAK/STAT signaling pathway, where each agent has a slightly-different combination of binding affinity to various JAK and TYK signaling dimers. In this article I want to share some diagrams from ACR 2024 that may help.
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Taking CAR-T for a Test Drive
When the ACR Convergence 2024 abstract site went live, the first query I typed into the search bar was, “CAR-T.” I consider myself a CAR-T skeptic and would be surprised if the magical results from this NEJM case series replicate at scale, but it seems likely that CAR-T will revolutionize the care for (some) patients with rheumatic diseases. What new data will be presented at ACR?
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ICYMI: Effective Treatments for Rheumatoid Arthritis ILD
The American College of Rheumatology guidelines for the diagnosis and management of interstitial lung disease, which includes rheumatoid arthritis interstitial lung disease (RA-ILD), has been one of the most controversial topics in the runup to ACR Convergence.
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