Inflammation Grand Rounds

CANTOS gave the first large randomized proof that targeting inflammation alone, without lowering cholesterol, can reduce cardiovascular events, a result with direct relevance to patients with rheumatic disease.

ORAL Surveillance compared tofacitinib with TNF inhibitors in older RA patients with cardiovascular risk factors and reshaped how we select patients for JAK inhibitors.

ADVOCATE showed that complement C5a receptor blockade with avacopan could replace a standard prednisone taper in ANCA vasculitis, adding to a decade of trials that have reduced glucocorticoid exposure.

An ancillary study of the VITAL trial found that vitamin D supplementation reduced incident autoimmune disease in older adults, raising the question of whether simple supplements can prevent autoimmunity.

Several randomized trials have now tested whether treatment during the at-risk phase of RA can prevent or delay arthritis, with abatacept showing the clearest signal so far.

Early case series of CD19-directed CAR-T cell therapy in refractory lupus and other autoimmune diseases have reported drug-free remissions, but the approach is emerging and investigational and is not FDA approved for autoimmune disease.