Rheumatology

BAFF‑R antibody ianalumab yields steroid‑sparing, durable responses in moderate‑to‑severe SLE

In this phase 2 trial, monthly subcutaneous ianalumab 300 mg plus standard therapy improved active SLE versus placebo. The primary composite endpoint (SRI‑4 response with corticosteroid taper at week 28) was achieved in 44.1% on ianalumab vs 9.1% on placebo. Responses were sustained to week 52 and replicated when placebo patients switched to open‑label ianalumab, with benefits evident to week 68. Other disease activity outcomes, flare reduction, and corticosteroid use consistently favored ianalumab. Serious adverse events and serious infections were not increased, though nonserious injection‑site reactions were more frequent. 1

KL130008, a JAK1/2 inhibitor, improves RA activity on methotrexate with manageable toxicities

This multicenter phase II trial added once‑daily KL130008 to methotrexate in active RA for 24 weeks. At week 12, ACR20 responses were higher with KL130008 1 mg and 2 mg than placebo (55.0% and 64.1% vs 26.8%). The 2 mg dose also improved ACR50/70, DAS28‑CRP/ESR, and HAQ‑DI, with benefits persisting through week 24. KL130008 reduced blood TNF‑α and IL‑6, showed linear pharmacokinetics, and exhibited mild accumulation. Approximately half of treated patients had drug‑related adverse events, most commonly anemia and hyperlipidemia, underscoring the need for laboratory monitoring. 2

Botulinum toxin shows high healing rates in refractory ischemic digital complications

This systematic review and individual participant data meta‑analysis evaluated botulinum toxin injections for acute digital ischemia, ulcers, and gangrene. Among 119 patients, complete response rates were high for ischemia (93.1%), ulcers (90.1%), and gangrene (87.5%). Adverse events were infrequent, mainly transient muscle weakness (7.6%) and injection‑site pain (5.9%), without major safety signals. Autoimmune etiology and younger age were associated with faster response in Kaplan‑Meier analyses, though not in multivariable models. Findings support botulinum toxin as a safe adjunctive rescue option for refractory digital ischemia in systemic sclerosis and related vasculopathies. 3

A 16‑protein serum ‘Sjögren protein score’ reflects glandular inflammation and autoantibody load

This study used proximity extension assays on paired salivary gland extracts and serum from Sjögren’s disease patients and sicca controls. Twenty‑seven serum proteins associated with Sjögren’s disease in the Swedish cohort, with 16 validated in an independent Norwegian cohort. Levels of these 16 proteins increased stepwise from ANA‑negative to anti‑Ro/SSA and anti‑La/SSB double‑positive patients and associated with HLA‑DRB1*03 and *15. The composite ‘Sjögren protein score’ correlated with salivary gland focus score and distinguished Sjögren’s disease from controls (AUC 0.888; 89% specificity, 76% sensitivity). Several proteins, including CXCL10 and CXCL13, also correlated with extraglandular manifestations, particularly pulmonary involvement. 4