EULAR 2024 Highlights – SLE and APS

Author: Cristiana Sieiro Santos

Taubmann et al. (OP0027) presented data on the long-term safety and efficacy of autologous CD19 CAR T cell therapy in patients with SLE, IIM and SSc, showing that all treated patients experienced significant clinical improvement and sustained remission, with minimal severe adverse effects, supporting the potential of CAR T cell therapy for achieving drug-free remission in these autoimmune diseases.

Rodziewicz et al. (OP0043) assessed the baseline characteristics and early clinical outcomes of NPSLE patients treated with rituximab (RTX) from the British Isles Lupus Assessment Group Biologics Register (BILAG-BR). In this cohort, 71% of NPSLE patients showed some improvement at 6 months and 74% at 12 months, with a significant reduction in steroid doses, demonstrating RTX’s effectiveness in treating moderate to severe NPSLE in a real-world setting.

Dyball et al. (POS0537) surveyed 501 physicians and found that while both groups prioritize current disease activity and organ involvement when selecting GC doses, Europeans are more concerned with comorbidities and less likely to use weight-based regimens. European physicians also prefer lower doses for severe flares and are more inclined to withdraw GCs after prolonged remission. Both groups agree on tapering GC doses to ≤5 mg/day, but Europeans are less likely to accept ≤10 mg/day. The survey highlights variations in GC management practices influenced by regional differences. 

Nasir et al. (POS0731) validated several novel autoantibodies in a larger cohort of SLE patients, demonstrating their potential in predicting disease activity, flare-ups, and organ involvement. Key autoantibodies identified include those targeting CARD9, PAX5, HMG20B, and ZNF276, which were associated with higher risks of disease flares and severity.

Salman-Monte et al. (POS1020) described the results from the Spanish multicenter registry initiating anifrolumab in SLE patients. With a total of 56 patients, it highlights that anifrolumab is often prescribed to individuals with long-standing SLE refractory to multiple treatments, predominantly due to mucocutaneous manifestations. Further follow-up is necessary to confirm its real-world effectiveness compared to clinical trials. 

Mancuso et al. (POS0430) investigated the prevalence and clinical significance of anti-NET antibodies in patients with SLE, RA and SSc. Among 349 patients, 40% were anti-NET positive. In SLE, anti-NET antibodies were linked to APS and arterial thrombosis. In RA, a significant association with anti-citrullinated protein antibodies (ACPA) was found, and anti-NET levels were higher in RA than in SLE. In SSc, anti-NET positivity was inversely related to gastroesophageal reflux disease (GERD). These findings suggest anti-NET antibodies could serve as biomarkers in these autoimmune conditions.

Karakikla-Mitsakou et al. (POS0176) examined the impact of multidisciplinary care, including access to lupus nurses, on the mental wellbeing of patients with SLE in Europe. Analyzing data from the “Living With Lupus in 2020” survey, the study found that patients who felt they had adequate access to multidisciplinary care reported anxiety and depression symptoms 9.7% less frequently compared to those who did not feel they had such access (40.1% vs. 49.8%; p<.001). Similarly, access to specialized lupus nurses was associated with lower reports of anxiety and depression (41.0% vs. 48.0%; p<.001).

Zen et al. (POS0728) evaluated the 2023 ACR/EULAR antiphospholipid syndrome (APS) classification criteria in a cohort of 205 primary APS patients previously classified by the Sapporo criteria. It found that 16.6% of these patients would not meet the new criteria, potentially leading to inadequate antithrombotic therapy and increased risk of thrombotic events for these patients.

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