12/14/2024
The American College of Rheumatology held its annual ACR Convergence conference from November 14-19 in Washington, D.C. Healthcare professionals, researchers, and experts in rheumatology gathered to share the latest advancements in research, clinical practices, and the treatment and management of rheumatic diseases. Below are some research highlights from the event.
Are We Putting the CAR-T Before the Horse?
Recently, we reported on research into CAR-T therapy and its potential uses for rheumatoid diseases. Originally developed for cancer, this therapy involves taking a patient’s immune cells, modifying them in a lab to target harmful cells, and then reintroducing them into the patient to fight the disease.
At ACR Convergence 2024, Anca Askanase, MD, MPH, and George Tsokos, MD, discussed the promise of CAR-T therapy but emphasized the need for more research to confirm its safety and effectiveness. They also explored alternatives, such as ready-made T-cells, which could make the treatment more affordable and accessible. Another approach involves a T-cell engager, which teaches T-cells to target harmful B-cells. All of these options require thorough testing.
One concern is that CAR-T cells could survive for months and, in rare cases, grow uncontrollably, potentially leading to leukemia. Experts stress the importance of controlled trials to prove CAR-T’s effectiveness for autoimmune diseases and to ensure its benefits outweigh the risks. With at least 25 CAR-T studies underway, more research is needed to understand its safety, effectiveness, and the patients who may benefit most.
“How Quickly Will I Feel Better with This New Drug?” – Rapidity of Treatment Response in Patients with Axial Spondyloarthritis Treated with Bimekizumab
This abstract presented at ACR Convergence summarizes the results of two phase 3 studies on the effectiveness of bimekizumab (BKZ) for treating axial spondyloarthritis (axSpA).
Bimekizumab (BKZ) is a biologic that targets IL-17F in addition to IL-17A. It was recently approved to treat axSpA. Two large studies, BE MOBILE 1 and BE MOBILE 2, tested how well BKZ works and how quickly it helps patients feel better.
In these studies, patients were given either BKZ or a placebo. Results showed that patients who received BKZ started feeling better quickly. For people with non-radiographic axSpA (nr-axSpA), improvements were seen as early as week 1, and for people with radiographic axSpA (r-axSpA), improvements were seen by week 2. By the 16th week, those on BKZ showed more significant improvements in symptoms compared to those on the placebo.
Overall, the results suggest that BKZ works fast, with many patients seeing improvements in pain and physical function just a few weeks after starting treatment. These findings are important for helping doctors set expectations for patients starting treatment.
Pregnancy Outcomes in Patients with Recent-onset Axial Spondyloarthritis
This study focused on understanding pregnancy outcomes in women with early axSpA. The goal was to identify factors that affect whether these women get pregnant and the likelihood of experiencing complications like miscarriage, pre-term birth, or medical termination. The research followed 381 women over 10 years, collecting both past and ongoing pregnancy data.
The results showed that 77% of the women had at least one pregnancy during the study. Most of these pregnancies, around 81%, resulted in healthy, full-term deliveries. However, 14.9% had unfavorable outcomes, including miscarriages, pre-term births, or medical abortions. The study found that older age affected the ability to become pregnant and have favorable outcomes, but disease activity, medication use, or other health factors did not seem to affect pregnancy outcomes.
In conclusion, the study found that women with early axSpA are likely to have at least one pregnancy during their reproductive years, and most pregnancies result in healthy outcomes. However, there is still a small risk of complications, and age appears to play a role in the ability to get pregnant. These findings can help doctors better support women with axSpA who are planning.
Metabolic Changes and Inflammation in Ankylosing Spondylitis, Psoriatic Arthritis, and Acute Anterior Uveitis
This study focused on understanding the metabolic changes in people with spondyloarthritis (SpA), a group of inflammatory diseases that include ankylosing spondylitis (AS) and psoriatic arthritis (PsA), as well as acute anterior uveitis (AAU), a common eye condition linked to SpA.
Researchers analyzed blood and stool samples from people with these diseases and from healthy controls to find out how their metabolic profiles differed. They looked for specific metabolites (substances produced by metabolism) that might explain the disease processes and how the immune system affects the body’s metabolism.
The results showed both shared and unique metabolic changes in people with AS, PsA, and AAU compared to healthy individuals. People with these diseases had higher levels of inflammatory metabolites in both their blood and stool. They also had lower levels of anti-inflammatory metabolites. Additionally, the HLA-B27 gene was found to affect the metabolic profiles in healthy individuals as well. These findings suggest metabolic changes may explain why some people develop different forms of SpA despite similar genetic factors. Future research could validate these findings and potentially use these metabolites as new markers for diagnosing and treating SpA and other inflammatory diseases.
References
To read more research abstracts from ACR Convergence 2024, visit the ACR website.
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