P2, N=76, Completed, University of Chicago | Active, not recruiting --> Completed | Trial completion date: Dec 2026 --> Mar 2026

P2, N=90, Active, not recruiting, Philogen S.p.A. | Recruiting --> Active, not recruiting

A 25-year-old woman with pre-existing Hashimoto's thyroiditis developed progressive bilateral nodular scleritis with anterior uveitis that proved completely refractory to high-dose corticosteroids, methotrexate, and conventional disease-modifying antirheumatic drugs, along with papilledema and granulomatous rosacea, suggesting systemic inflammation. Recognition of this molecular target enabled precision therapy with fostamatinib, a spleen tyrosine kinase (Syk) inhibitor, combined with adalimumab, a tumor necrosis factor-alpha (TNF-α) inhibitor, resulting in complete and sustained remission of all inflammatory manifestations over 18 months of follow-up. This case underscores the critical importance of maintaining high clinical suspicion for paraneoplastic autoimmune syndromes in patients with treatment-refractory inflammatory conditions, particularly when accompanied by atypical systemic or unexplained laboratory findings, and demonstrates that molecularly targeted precision medicine approaches can transform treatment outcomes in complex paraneoplastic rheumatic disorders.

The primary endpoint of the SELECT-SWITCH trial was met, with a higher percentage of patients with active RA who switched to upadacitinib after first TNFi failure achieving DAS28-CRP ≤3.2 at 12 weeks than those cycling to a second TNFi, adalimumab, with generally similar safety profiles.

P1, N=12, Not yet recruiting, University of Michigan Rogel Cancer Center

After eight years and treatment with lenalidomide with excellent clinical response, she developed progressive cytopenias and transformation to acute myeloid leukemia, myelodysplasia-related (AML-MR)...The patient was treated with combination azacitidine and venetoclax and an investigational immunotherapy within a clinical trial...Our findings expand the spectrum of dmin-associated oncogenic amplifications in myeloid neoplasms and highlight FLI1 and ETS1 as recurrent targets of 11q24-derived ecDNA amplification. Recognition of such rare events underscores the importance of integrative cytogenomic profiling for uncovering novel mechanisms of leukemic transformation and potential therapeutic targets.

P4, N=30, Not yet recruiting, Chia Tai Tianqing Pharmaceutical Group Co., Ltd.

P2, N=8, Active, not recruiting, University of Washington | Trial completion date: Apr 2026 --> Apr 2027

P=N/A, N=4970, Active, not recruiting, Janssen Biotech, Inc.

P=N/A, N=90, Recruiting, University of Glasgow

Advanced therapies-particularly TNFα inhibitors-appear effective and well tolerated for severe or refractory DCS. Earlier initiation of treatment may help modify the inflammatory disease course and potentially prevent irreversible scarring alopecia; however, this proposed benefit remains hypothesis-generating and warrants prospective validation.

CD19 expression may be diminished by exams using a tafasitamab-competitive-binding clone. This case highlights not only the concern of HBV reactivation, but also the diagnostic challenge due to CD19 epitope masking following tafasitamab therapy.