Consultant Physician & Rheumatologist, Pantai Hospital KL, @MedicineMsia @rheumatologymy @HackingHealthKL 🇲🇾
Kuala Lumpur, Malaysia
Joined May 2007
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Benjamin Cheah MD 🇲🇾 retweeted
First case report of BCMA-directed CAR-T therapy for severe, refractory antiphospholipid syndrome.
The patient had triple-positive APS with recurrent, life-threatening diffuse alveolar hemorrhage despite rituximab and high-dose GCs. BCMA CAR-T therapy resulted in a rapid clinical response, elimination of antiphospholipid antibodies, and sustained remission at 6 months
A&R
doi.org/10.1002/art.70322
ALT B-cell Maturation Antigen (BCMA)-CAR-T Therapy in a Patient with Triple Positive Antiphospholipid Syndrome and Recurrent Alveolar Bleeding. Graphical abstract made using BioRender
An important and self reflective article for all! kevinmd.com/2026/09/the-stru…
Benjamin Cheah MD 🇲🇾 retweeted
A serum #IgG4 cut off level of 135 mg/dl has been incorporated into the original Comprehensive Diagnostic criteria as well as the 2020 Revised Comprehensive Diagnostic criteria for IgG4-related disease (IgG4-RD). However, although elevated serum IgG4 levels are commonly observed in IgG4-RD and serve as a useful supportive marker, but they are not a gold standard for diagnosis due to variable performance (sensitivity 51-80%, specificity 60%).
In addition to traditional #biomarkers like serum IgG4 levels and characteristic histology, several novel indicators —including IgG2, serum soluble IL-2 receptor (sIL-2R), and CCL18— can help diagnose IgG4-RD more accurately and predict treatment response by reflecting inflammation and fibrosis. Ongoing research is focused on identifying specific autoantigens and exploring new potential biomarkers, such as various serological and histopathological immune cells (macrophages, mast cells, T and B cell subsets, and pathways like I-IFN/IL-33).
Due to the frequent multi-organ involvement in IgG4-RD, non-invasive PET-CT imaging is also valuable for improving diagnosis and differential diagnosis.
*Adapted from: Umehara H, Okazaki K, Kawa S, et al. The 2020 revised comprehensive diagnostic (RCD) criteria for IgG4-RD. Mod Rheumatol. 2021;31(3):529-533.
🔗doi.org/10.1080/14397595.202…
Benjamin Cheah MD 🇲🇾 retweeted
Idiopathic Inflammatory Myopathies made simple 🔥
Autoantibodies are not just diagnostic — they define the disease.
🧵 Key patterns you must know:
• MDA5 → Rapidly progressive ILD (high mortality)
• TIF1-γ → Malignancy (adult DM)
• HMGCR → Statin-associated necrotizing myopathy
• SRP → Severe myopathy + cardiac involvement
• Jo-1 → Classic antisynthetase syndrome
Clinical mapping = exam gold:
ILD dominant → PL-7, PL-12, MDA5
Cancer → TIF1-γ, NXP2
Good prognosis DM → Mi-2
⚠️ ANA can be negative (cytoplasmic staining)
Negative ANA ≠ No myositis
This is precision rheumatology in practice.
#Rheumatology #Myositis #Dermatomyositis #Pulmonology @DrAkhilX @IhabFathiSulima #MedTwitter #NEETPG #INI #MRCP
Benjamin Cheah MD 🇲🇾 retweeted
SMART study - Single vs. Split Dose Methotrexate in RA
Split dose weekly, oral methotrexate (MTX) was shown to be superior to single dose MTX in treating active rheumatoid arthritis (RA) patients.
buff.ly/AIPUFjK
Benjamin Cheah MD 🇲🇾 retweeted
Reproductive health guidelines
[Cuoghi Edens]
➡️TNFi safe in pregnancy & BF no need for “certolizumab switch” and risk flares
➡️RXB: Dose pre-conception or 1st trimester to minimise fetal exposure
➡️ Stop NSAIDS after 28 wks
➡️ NO Paracetamol link to autism/ADHD
#Rheumatology
Catching @XBaraliakos on his whirlwind tour of Asia talking biosimilars in axial SpA. @SandozGlobal
Benjamin Cheah MD 🇲🇾 retweeted
CAR-T cell therapy
▶️New concept of immune reset potentially leading to cure of autoimmune diseases
via Prof Schett #EULAR2025
Benjamin Cheah MD 🇲🇾 retweeted
CONGRESS | #EULAR2025 | PRESENTATION
Saira Sheikh, @UNC, presented results from the ongoing phase I/II RESET-SLE trial (NCT06121297) evaluating the safety and efficacy of rese-cel (resecabtagene autoleucel), a fully human, autologous 4-1BB, anti-CD19 CAR T-cell therapy, in non-renal #SLE and #lupus nephritis (N=8). As of June 2, 2025, rese-cel was well tolerated, with low grade CRS reported in 2 patients and ICANS in 1. DORIS was achieved in 3 of 4 patients with SLE, and the first patient with LN achieved CRR.
Follow our live feed for more updates: lupushub.com/medical-informa…
#RheumTwitter #MedEd #MedicalCongress
Benjamin Cheah MD 🇲🇾 retweeted
🔴 NEW EULAR recommendations for #SLE with #kidney involvment (2025)!
➡️ early biopsy
➡️ early combination
➡️ non immune treatment
#EULAR2025
Benjamin Cheah MD 🇲🇾 retweeted
Excited to present WIN #scleroderma #eular2025. This slide highlights the opportunities in drug development in SSc. Come and join on Saturday 6/14 at 9 AM CET.
The results appear revolutionary! Drug free in refractory cases! Wow! The side effects appear to be minimal despite needed lymphodepletion?
#EULAR2025
🧵[1/2] Dr Georg Schett follow up of 🚗 CAR-T cell therapy pilot cohort
⚡️Now 50 patients under treatment,
⚡️Longest follow up of nearly 5 years ➡️ 72 patients year
⚡️92% remission 96% off drugs 2 relapses
#EULAR2025 @eular_org
Benjamin Cheah MD 🇲🇾 retweeted
🚨 Mind-blowing insights from Georg Schett at #EULAR2025:
CAR-T in autoimmune diseases is no longer experimental — it’s revolutionizing care.
✅ Immune reset → drug-free remission
✅ Efficacy in highly-resistant AID
✅ Allogenic & “armed” #CAR_T moving fast into clinics
Benjamin Cheah MD 🇲🇾 retweeted
Biologics in Pregnancy Patients With Autoimmune Disease
A large cohort, claims data study shows that among pregnant women receiving biologic therapies for autoimmune conditions, 72% continued their biologics pregnancy, more so among inflammatory bowel disease (IBD) patients than those with rheumatoid arthritis (RA), psoriasis (PsO) or psoriatic arthritis (PsA).
buff.ly/3NB5pMn
Did the US just exploit the war in Ukraine for its own means through this minerals deal?
#Ukraine #UkraineWar
edition.cnn.com/2025/02/25/e…
Often a topic of discussion in rheumatologist consultations. “Does stress cause or worsens autoimmunity?” It is almost impossible to measure stress. I often would focus on stress management techniques as no one can truly remove stress.
medscape.com/viewarticle/str…
Benjamin Cheah MD 🇲🇾 retweeted
Treatment of rheumatologic complications (inflammatory arthritis, polymyalgia rheumatica and myositis/myalgia) from immune checkpoint inhibitors. Review by Cappelli LC et al
pubmed.ncbi.nlm.nih.gov/3318…
Benjamin Cheah MD 🇲🇾 retweeted
Late-onset Systemic Lupus Erythematosus
⏩Lo-SLE is a spectrum that behaves differently .
⏩ Though major organ involvement in the form of nephritis is less common, damage accrual over the years is greater.
link.springer.com/article/10…
