ABSTRACT
Systemic sclerosis, a severe inflammatory autoimmune disease, shares a common thread with cancer through the underlying mechanism of inflammation. This inflammatory milieu not only drives the immune dysregulation characteristic of autoimmune diseases but also plays a pivotal role in the pathogenesis of cancer. Among the cellular components involved, B cells have emerged as key players in hematologic tumor and autoimmune disease, contributing to immune dysregulation and persistent tissue fibrosis in systemic sclerosis, as well as tumor progression and immune evasion in cancer. Consequently, novel therapeutic strategies targeting B cells hold promise in both conditions. Recent exploration of CD19 CAR T cells in severe systemic sclerosis patients has shown great potential, but also introduced possible risks and drawbacks associated with viral vectors, prolonged CAR T cell persistence, lengthy production timelines, high costs, and the necessity of conditioning patients with organotoxic and fertility-damaging chemotherapy. Given these challenges, alternative CD19-depleting approaches are of high interest for managing severe systemic autoimmune diseases. Here, we present the pioneering use of blinatumomab, a bispecific anti-CD3/anti-CD19 T cell engager in a patient with progressive, severe systemic sclerosis, offering a promising alternative for such challenging cases.
Subject(s)
Antibodies, Bispecific , Antigens, CD19 , Scleroderma, Systemic , Humans , Antibodies, Bispecific/therapeutic use , Scleroderma, Systemic/drug therapy , Scleroderma, Systemic/immunology , Antigens, CD19/immunology , T-Lymphocytes/immunology , T-Lymphocytes/drug effects , Female , CD3 Complex/immunology , CD3 Complex/metabolism , Middle Aged , Immunotherapy, Adoptive/methodsABSTRACT
OBJECTIVE: The "Comprehensive ICF Core Set for rheumatoid arthritis" represents the typical spectrum of problems in functioning of patients with rheumatoid arthritis according to the International Classification of Functioning, Disability and Health (ICF). The objective of this study was to validate this ICF Core Set from the perspective of physicians. METHODS: Physicians experienced in rheumatoid arthritis treatment were asked about the problems they commonly treat in patients with rheumatoid arthritis in a 3-round survey using the Delphi technique. Responses were linked to the ICF. RESULTS: Seventy-nine physicians in 41 countries named 512 patients' problems. Two hundred and 27 ICF categories were linked to these answers. Twenty-six ICF categories were not represented in the Comprehensive ICF Core Set for rheumatoid arthritis and 19 aspects were not covered by the ICF. CONCLUSION: The content validity of 3 ICF components was well supported. However, several body functions were identified that are not covered and need to be investigated further.
