April 2025 to July 2025
Author: Clementina López-Medina
Baricitinib in early polymyalgia rheumatic (BACHELOR): a randomised, double-blind, placebo-controlled, parallel group trial
Saraux A, et al. (10.1016/S2665-9913(24)00270-4) aimed to test whether baricitinib could control polymyalgia rheumatica without glucocorticoids. In a French multicentre randomised, placebo-controlled trial, 34 recent-onset, glucocorticoid-naive patients were enrolled. At week 12, 78% of patients on baricitinib versus 13% on placebo achieved low disease activity without oral glucocorticoids. Adverse events were more common with baricitinib, mostly musculoskeletal disorders, but no deaths or major cardiovascular events occurred. Baricitinib showed significant efficacy in reducing glucocorticoid need with an acceptable safety profile in polymyalgia rheumatica.
Faecal microbiota transplantation in patients with systemic sclerosis and lower gastrointestinal tract symptoms in Norway (ReSScue): a phase 2, randomised, double-blind, placebo-controlled trial
Fretheim H, et al. (10.1016/S2665-9913(24)00334-5) aimed to assess faecal microbiota transplantation (ACHIM) for gastrointestinal symptoms in systemic sclerosis. In a phase 2 randomised, placebo-controlled trial across four Norwegian centres, 67 patients received either ACHIM (n=33) or placebo (n=34). The primary endpoint—change in worst GI symptom (bloating or diarrhoea) at 12 weeks—showed no significant difference between ACHIM and placebo. Adverse events were mostly mild GI symptoms, reported at similar rates in both groups, with one serious duodenal perforation during gastroscopy. Overall, ACHIM was safe but did not improve lower GI symptoms compared with placebo in systemic sclerosis.
First-line biological versus conventional synthetic disease-modifying antirheumatic drug therapy in adult-onset Still’s disease: a multicentre, retrospective, propensity weighted cohort study
Kernder A, et al. (10.1016/S2665-9913(25)00023-2) compared first-line biological versus conventional synthetic DMARDs in adult-onset Still’s disease (AOSD). In a multicentre German cohort of 86 patients, 44 received biological DMARDs (anakinra, canakinumab, tocilizumab) and 42 received conventional DMARDs (methotrexate or glucocorticoids). Biological DMARDs were strongly associated with sustained, event-free remission (OR 7·20), achieved in 50% versus 12% at week 72. Glucocorticoid-related complications and deaths occurred only in the conventional DMARD group. The study concludes that first-line biologics significantly improve remission rates and reduce complications in AOSD compared with conventional therapy.
Local immune effector cell-associated toxicity syndrome in CAR T-cell treated patients with autoimmune disease: an observational study
Hagen M, et al. (10.1016/S2665-9913(25)00091-8) aimed to characterise autoimmune disease–specific adverse events from CD19 CAR T-cell therapy. In an observational study of 39 patients with SLE, systemic sclerosis, or idiopathic inflammatory myopathy, 77% developed local immune effector cell-associated toxicity syndrome (LICATS). LICATS occurred only in organs previously affected by autoimmune disease, most often skin and kidneys, with onset around day 10 and lasting about 11 days. Most cases were mild (grade 1–2), only three reached grade 3, and all resolved without sequelae. The authors conclude that LICATS is a novel, self-limited, organ-specific, and generally mild toxicity in autoimmune disease patients receiving CAR T-cell therapy.
Trends in the prevalence of autoimmune diseases during pregnancy in the UK, 2000-21: a retrospective cohort study
Singh M, et al. (10.1016/S2665-9913(25)00039-6) aimed to estimate the burden of autoimmune disease in pregnancy using UK data (2000–2021). Among 5.2 million pregnancies, 185,208 had a diagnosis of autoimmune disease, with prevalence rising from 3.5% to 4.7%. Psoriasis was most common, while Hashimoto’s thyroiditis, coeliac disease, Graves’ disease, and type 1 diabetes showed the steepest increases. Higher odds were seen in women from less deprived areas, ex-smokers, those with ≥5 pregnancies, and with metabolic or mental health comorbidities. The authors conclude that the growing prevalence highlights the need for specialised, evidence-based care in pregnancy.
Clementina López-Medina
Clementina is a Rheumatologist and Associate Professor at Reina Sofía University Hospital and the University of Córdoba, Spain. Her main research interest is clinical and translational research in Spondyloarthritis and Psoriatic Arthritis. She also leads the Spondyloarthritis Unit at her hospital. Clementina is a member of the Spanish Society of Rheumatology (SER), the Spanish Group of Interest in Spondyloarthritis (GRESSER), the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), and a full member of the Assessment of Spondyloarthritis International Society (ASAS). She is also a member of the EMEUNET Social Media Sub-committee.