Publications
Find coverage of the latest original articles on Lupus, focusing on those with data on therapeutic interventions and those that have clinical impact.
Comparison of a voclosporin-based triple immunosuppressive therapy to high-dose glucocorticoid-based immunosuppressive therapy: A propensity analysis of the AURA-LV and AURORA 1 studies and ALMS
Lupus Science & Medicine 2024;11:e001319 DOI: 10.1136/lupus-2024-001319
Dall’Era et al. conducted a propensity analysis to compare voclosporin-based triple immunosuppressive therapy with high-dose GC-based regimens for active LN. Voclosporin showed fewer AEs, improved safety, and significantly reduced proteinuria over six months, suggesting a superior risk-benefit profile for patients with lupus nephritis.
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The 2024 APLAR consensus on the management of lupus nephritis
International Journal of Rheumatic Diseases; 28:e70021 DOI: 10.1111/1756-185X.70021
Mok et al. provided updated consensus recommendations from APLAR, emphasising evidence-based guidance for managing lupus nephritis in Asian populations. These recommendations consider ethnic, socioeconomic, and pharmacogenetic factors, focusing on treatment regimens, adjunctive therapies, and patient-specific approaches to optimise outcomes.
Association of lupus low disease activity state and remission with reduced organ damage and flare in systemic lupus erythematosus patients with high disease activity
Rheumatology 2024; Epub ahead of print DOI: 10.1093/rheumatology/keae631
Kandane-Rathnayake et al. demonstrated that achieving Lupus Low Disease Activity State (LLDAS) or remission in patients with high disease activity status (HDAS) significantly reduces the risk of organ damage accrual and flares. However, HDAS was found to be a poor prognostic indicator as fewer patients with HDAS attained and sustained LLDAS or remission when compared with non-HDAS patients.
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Efficacy and safety of sodium-glucose co-transporter 2 inhibitors for the primary prevention of cardiovascular, renal events and safety outcomes in patients with systemic lupus erythematosus and comorbid type 2 diabetes: A population-based target trial emulation
Arthritis Rheumatol 2024. Epub ahead of print DOI: 10.1002/art.43037
Ma et al. assessed the efficacy and safety of sodium-glucose co-transporter 2 inhibitors (SGLT2i) compared with dipeptidyl peptidase 4 inhibitors (DPP4i) in preventing cardiovascular and renal events in patients with both SLE and type 2 diabetes (T2D). SGLT2i use significantly reduced risks for acute kidney injury, chronic kidney disease, end-stage renal disease, and heart failure, though it increased genital infection risk.
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Effect of iberdomide on cutaneous manifestations in systemic lupus erythematosus: a randomized phase 2 clinical trial
JAAD. 2024. Epub ahead of print DOI: 10.1016/j.jaad.2024.09.074
Werth et al. demonstrated that iberdomide significantly improved cutaneous lupus erythematosus (CLE) outcomes, particularly in subacute and chronic CLE patients, by reducing Cutaneous Lupus Area and Severity Index Activity (CLASI-A) scores. The study showed continued efficacy through 24 weeks, with the 0.45 mg dose providing the greatest improvement in patients with severe baseline scores, and iberdomide was well-tolerated over 104 weeks.
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Attainment of EULAR/ERA-EDTA targets of therapy with current immunosuppressive regimens and adjustments in treatment: a multicentre, real-life observational study
RMD Open 2024;10:e004437 DOI: 10.1136/rmdopen-2024-004437
Pappa et al. explored the achievement of EULAR/ERA-EDTA targets in lupus nephritis patients receiving standard immunosuppressive therapy. Two-thirds of the cohort achieved target responses by 12 months, but 20% required therapy modifications due to suboptimal outcomes.
Safety, pharmacokinetics, biomarker response and efficacy of E6742: a dual antagonist of Toll-like receptors 7 and 8, in a first-in-patient, randomised, double-blind, phase I/II study in systemic lupus erythematosus
RMD Open 2024;10:e004701 DOI 10.1136/rmdopen-2024-004701
Tanaka et al. conducted a phase I/II study to evaluate the safety, pharmacokinetics, biomarker response, and efficacy of E6742, a dual antagonist of Toll-like receptors 7 and 8, in patients with systemic lupus erythematosus (SLE). The treatment demonstrated a favourable safety profile, with no serious adverse events, while effectively suppressing interferon gene signatures and showing promising preliminary efficacy.
Efficacy and safety of upadacitinib or elsubrutinib alone or in combination for systemic lupus erythematosus: A Phase 2 randomized controlled trial
Arthritis Rheumatol 2024 DOI: 10.1002/art.42926 Epub ahead of print
Daily oral upadacitinib 30 mg and ABBV-599 high dose (elsubrutinib 60 mg QD + upadacitinib 30 mg) were effective in multiple outcome measures including disease activity, flares, time to first flare, and joint counts.
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Urinary soluble CD163 is useful as "liquid biopsy" marker in lupus nephritis at both diagnosis and follow-up to predict impending flares
J Transl Autoimmun 2024;9:100244 DOI 10.1016/j.jtauto.2024.100244
Renaudineau, et al. show that the urinary sCD163/creatinurea ratio is a parameter than can be used in addition to anti-dsDNA antibodies, anti-C1q antibodies, C3 complement fraction, the protein excretion to creatinine ratio and the estimated glomerular filtration rate.
Immunosuppressives discontinuation after renal response in lupus nephritis: predictors of flares, time to withdrawal and long-term outcomes
Rheumatol 2024 DOI 10.1093/rheumatology/keae381 Epub ahead of print
This study by Panagiotopoulos, et al. showed that an early complete renal response achievement, persistent hydroxychloroquine use, and the maintenance of optimal low disease activity during follow-up in immunosuppressive (IS) tapering and discontinuation are fundamental in LN treatment. The authors also found that long-term renal outcomes are mainly associated with renal flares during IS tapering.