Matha Naidu.pptx
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A 57-year-old male patient presented with neck pain radiating to both upper limbs following a fall from a chair 4 months ago. On examination, the patient had increased tone in both upper and lower limbs with normal bulk and strength graded 4+/5 throughout. Reflexes were symmetrically brisk. Sensory examination was normal and cranial nerve examination was unremarkable. The impression was bilateral cervical radiculopathy with anterior cord compression due to trauma.
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There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
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- 1. Name- Matha Naidu Age- 57/M Mrd no- 1313379 Diagnosis – BI with AAD
- 2. A 57/M patient who is right handed by nature , -Neck pain radiating to both upper limbs - A/H/O trauma over neck due to fall from chair 4 months ago. - No radiation - No paresthesias - No H/o slippage of chappals - No fever, No bowel/bladder symptoms
- 3. MOTOR SYSTEM: Tone • Increased in both upper and lower limbs Bulk • Normal in both upper and lower limbs
- 4. O/E:patient conscious, Vitals stable GCS-E4V5M6 -CNS examination Higher mental function • normal
- 5. CRANIAL NERVE EXAMINATION • CN 1: B/L sense of smell normal • CN2: VA right –6/9 and left – 6/9, fundoscopy –normal disc CN 3,4,6- • All EOM full range, • No nystagmus • No ptosis • Pupils- B/L 3mm equal and reactive.
- 6. CN 5-intact CN 7-normal CN 8 • B/L AC>BC webers not lateralised CN 9, 10 • Uvula midline • Palatal movements normal ,no asymmetry • Gag reflex intact
- 7. CN 11 • Shoulder shrugging – Normal on both sides CN 12 • No fasciculations of tongue • no Tongue deviation
- 8. Power - right left Upper limb Shoulder- 4+/5 4+/5 Elbow- 4+/5 4+/5 Wrist- 4+/5 4+/5 Lower limb Hip- 4+/5 4+/5 Knee- 4+/5 4+/5 Ankle- 4+/5 4+/5 EHL- 4+/5 4+/5 -Hand grip - 90% 90% • Reflexes – • Superficial reflexes-present • DTR: BJ TJ S KJ AJ Right - 3+ 3+ 3+ 3+ 2+ Left - 3+ 3+ 3+ 3+ 2+ Plantars- both flexors
- 9. Sensory system- normal Cerebellar signs: no Tandem Gait : normal Meningeal signs: no