Issue 02: a few things worth knowing

Meredith Nolan (CEO, Founder of Constellate) and Jonathan S. Hausmann, MD

Welcome back for issue 2. Here are some developments from the past few weeks we think are worth your attention, in plain English, across the conditions our community lives with. No digging required. That is what we are here for.

“There’s never been a better time to be taking care of patients with autoimmune diseases (or, to be a patient, for that matter). We are learning how to combine medications to treat patients with refractory symptoms, how to target the root cause of many diseases, and how to arm a patient’s own immune system to attack the cells that cause disease. There are also new medications designed to treat rare diseases that have long been ignored. These various treatments have already improved the lives of many patients, and their impact is just starting to be felt among the broader patient community.”

From Dr. Hausmann's desk

How to make sense of new research

New findings are exciting, but most are early, or meant for specific situations. Nothing here is a recommendation to change your treatment. That decision belongs with you and your clinician. A simple way to weigh anything you read here:

1. Notice the stage. Approved means available now. In trials means promising, but not yet. Early means one to watch.
2. Ask if it is for people like you, your condition, your severity, your situation.
3. Bring the one item that looks relevant to your clinician and ask: “Is this worth considering for me?”

You do not need to become an expert. You just need enough to ask a good question.

New & emerging treatments

Dual biologic therapies may have a role in refractory autoimmune disease

For years, combining two biologic therapies to treat autoimmune disease has been avoided, out of a fear of increasing immunosuppression without improving results. Recent evidence suggests that for some select patients with severe disease that is not controlled by conventional treatment, dual biologic therapy may be beneficial.

The 2026 guidelines for axial spondyloarthritis in adults and children conditionally recommend dual biologic therapy for patients whose disease is still active despite a single biologic. It usually pairs two drugs that target different molecules, such as a TNF inhibitor combined with an IL-17 inhibitor, and can be especially useful when someone has more than one disease manifestation, for example axial spondyloarthritis with psoriasis or inflammatory bowel disease.

Similar approaches have shown promise in inflammatory bowel disease. For Crohn's and ulcerative colitis that no longer respond to a single medication, an early trial pairing a TNF inhibitor with an IL-23 inhibitor found the combination worked better than either drug alone, and more studies are now underway. It is still specialist territory and early, but it is a real move away from treating one drug at a time.

Why it matters: If your current treatment is not controlling your inflammatory disease, specialists are increasingly combining two biologic agents that target different molecules to improve control.

Evidence: 2026 treatment guideline (axial spondyloarthritis); Phase 2 proof-of-concept (IBD) · Source: American College of Gastroenterology (VEGA trial); 2026 ACR axial spondyloarthritis guideline

An MS treatment was approved for children for the first time

Ocrelizumab, one of the most effective MS therapies, is now FDA approved for children aged 10 and older with relapsing-remitting MS. Until now, kids with MS were treated with medicines only formally approved in adults. This gives families and pediatric neurologists an approved, highly effective option.

Why it matters: For younger patients and their families, an approved pediatric option changes the conversation with your care team.

Evidence: FDA approved (pediatric) · Source: NeurologyLive

Another condition that never had a treatment just got its first

For the first time ever, there is an FDA-approved treatment specifically for warm autoimmune hemolytic anemia, a condition where the immune system mistakenly attacks its own red blood cells. Up until now, people with this condition mainly relied on broad treatments like steroids. This new drug, nipocalimab, targets the specific harmful antibodies driving the disease instead. Even better, this same approach is already being tested for other antibody-driven conditions like lupus and Sjögren's disease, offering real hope for a wave of more targeted treatments.

Why it matters: The pace of firsts is picking up. If your condition has felt overlooked, that is starting to change.

Evidence: FDA approved (first in this disease) · Source: BioSpace

On the horizon

Lupus: a promising new drug called litifilimab, which targets specific immune cells (dendritic cells), is wrapping up a major clinical trial with results expected soon. Earlier Phase 2 results showed significant skin improvements for people with cutaneous lupus in just 16 weeks. (Clinical Trials Arena)

Rheumatoid arthritis: an “off-the-shelf” cell therapy (AlloNK) is heading into a late-stage trial. It uses healthy donor NK cells together with rituximab to deeply clear the B cells that drive disease, aiming for CAR-T-like results but far easier to give in a doctor's office. (Artiva)

Sjögren's disease: the first targeted treatment we flagged last issue (ianalumab) is awaiting an FDA decision, expected in the coming months. (Cleveland Clinic Journal of Medicine)

Save for your next clinic visit

One to bring to your care team: “Has anything changed in the treatment options for my condition that I should know about?” And if your current treatment is not working as well as it used to, that is worth naming directly, there may be more paths now than there were.

That is issue 02.