Low-dose blinatumomab in multidrug-resistant rheumatoid arthritis—a case series
Authors' conclusion
Short-term control of RA disease activity, depleted synovial B cells, and reduced fibroblast activation on FAPI-PET were observed 3 months after blinatumomab. Flares after blinatumomab responded to previously ineffective disease-modifying antirheumatic drugs in some patients.
Study context
- Population
- Patients with multidrug-resistant RA (median age 55; DAS28-CRP 5.0; CDAI 28)
- Participants
- 15 patients
- Outcome
- CDAI low disease activity and remission
- Follow-up
- Week 12
Methodological detailsnamed patient use
- Named patient use
Main finding
As reported in the abstract
CDAI low disease activity
9 of 15 patients
CDAI remission
3 of 15 patients
Observational data: associations, not effects.
Further findings
Synovial B-cell depletion
- Synovial B cells depleted (biopsies)
- 4 of 5
- Not depleted in lymph nodes
Fibroblast activation protein inhibitor (FAPI) PET/CT
- Reduced tracer uptake in involved joints after blinatumomab
Flares and later response to previously failed drugs (JAKi, abatacept, TNFi)
- Patients who flared
- 14 of 15
- Responsiveness lasting >3 months to previously failed drugs
- 7 of 15
- Disease activity remained lower
Safety
CRS (grade 1)
- CRS (grade 1)
- 3 of 15 patients
ICANS
- No ICANS occurred
Hypogammaglobulinaemia
- One patient developed hypogammaglobulinaemia
- 1
Fatal cardiovascular event · after 1 year
- One fatal cardiovascular event
- 1
- Adjudicated as unrelated by treating investigators but not independently reviewed
Original publication
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