August 2024 to November 2024
Authors: Halbert Hernández Negrin and Magda Osipyan
Nirmatrelvir–Ritonavir Reduces Mortality and Sequelae in Immunocompromised COVID-19 Patients
Lin et al. (10.1016/S2665-9913(24)00224-8) investigated the impact of nirmatrelvir–ritonavir on 2,217 immunocompromised COVID-19 patients in Hong Kong. This retrospective cohort study found a 42% reduction in post-acute inpatient death risk (HR 0.58, 95% CI 0.45–0.74, p<0.0001) and a 57% decrease in ARDS-related hospitalizations (HR 0.43, 95% CI 0.20–0.90, p=0.024). While the benefits were less pronounced compared to immunocompetent patients, the findings emphasise the drug’s role in reducing severe outcomes in this high-risk population. The study underscores the need for targeted antiviral therapies for immunocompromised individuals to mitigate the long-term sequelae of COVID-19.
Apremilast Demonstrates Efficacy in MRI-Assessed Psoriatic Arthritis Inflammation
Østergaard et al. (10.1016/S2665-9913(24)00232-7) evaluated apremilast’s effects in a phase 4, multicentre study involving 122 patients with active psoriatic arthritis. Using MRI-based scoring systems (PsAMRIS and MRI-WIPE), they observed a mean reduction of −2.32 (95% CI −4.73 to 0.09) in composite inflammation scores at 24 weeks. While 78% of participants experienced treatment-emergent adverse events, none were serious or linked to apremilast. This study highlights apremilast’s potential to reduce inflammation and the value of MRI as an objective tool for assessing therapeutic efficacy in psoriatic arthritis management.
Home Spirometry Aids Early Detection of Pulmonary Decline in SSc-ILD
Velauthapillai et al. (10.1016/S2665-9913(24)00236-4) explored the validity of home spirometry in systemic sclerosis-associated ILD through a prospective study of 43 patients. Sensitivity and specificity for detecting ≥5% FVC decline were 60% (95% CI 44–76) and 87% (95% CI 75–98), respectively. Moderate agreement (κ=0.40, 95% CI 0.01–0.79) between home and hospital measurements was observed. Longitudinal correlations confirmed its reliability for tracking pulmonary function. These findings support home spirometry as a complementary tool for early detection of disease progression, enabling timely adjustments in management strategies for this high-risk population.
Barriers to CAR T-Cell Therapy in Rheumatology
Lungova and Putman (10.1016/S2665-9913(24)00240-6) analysed the challenges in applying CAR T-cell therapy for rheumatic diseases. Despite promising outcomes in systemic lupus erythematosus and systemic sclerosis, barriers include high costs, limited eligible populations, and risks like cytokine release syndrome and infections. Current approaches relying on B-cell depletion show mixed efficacy. The authors suggest future advances, such as antigen-specific chimeric receptors, could improve safety and outcomes. Addressing these hurdles is crucial for integrating CAR T-cell therapy into rheumatology practice, ensuring broader access to this potentially transformative treatment.
Halbert Hernández Negrin
Halbert is an internist, with a Master’s in Autoimmune Diseases from the University of Barcelona. He is currently a resident in the specialty of rheumatology at the Regional University Hospital of Malaga and PhD student at the University of Malaga. His research interests focus on epidemiological and translational research in systemic autoimmune diseases, specifically in systemic lupus erythematosus. He is currently collaborating in the European project 3TR – Taxonomy, Treatment, Targets and Remission-SLE Study and in the International Multicentre Registry of patients with monogenic and polygenic autoinflammatory diseases (AIDA Project). He is a member of the European Lupus Society and a predoctoral fellow of the American College of Rheumatology (ACR). Halbert served on the EMEUNET Social Media subcommittee and is now a member of the Newsletter sub-committee.
Magda Osipyan
Magda is a rheumatologist at Vardanants Medical Centre for Innovative Medicine and Yerevan State Medical University, Yerevan, Armenia. Her research interests include SLE, Behcet’s disease and systemic sclerosis. Magda is secretary of the Armenian Rheumatological Association and a member of the EMEUNET Visibility and Global Affairs sub-committee.