Publications
Find coverage of the latest original articles on Lupus, focusing on those with data on therapeutic interventions and those that have clinical impact.
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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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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Cenerimod, a sphingosine-1-phosphate receptor modulator, versus placebo in patients with moderate-to-severe systemic lupus erythematosus (CARE): an international, double-blind, randomised, placebo-controlled, phase 2 trial
Lancet Rheumatol. 2024. Epub ahead of print. DOI: 10.1016/S2665-9913(24)00246-7
Askanase et al. assessed the efficacy, safety, and tolerability of cenerimod in patients with moderate-to-severe SLE. While the primary endpoint of reducing mSLEDAI-2K scores at Month 6 was not achieved, cenerimod 4.0mg showed a significant reduction in disease activity versus placebo. Adverse events, including lymphopenia, were dose-dependent but manageable, and overall treatment was well tolerated.
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.
ANA-associated arthritis: clinical and biomarker characterization of a population for basket trials
Rheumatol 2024 2024;00:1–11 DOI 10.1093/rheumatology/keae269
Arnold et al. assessed musculoskeletal (MSK) inflammation in ANA-associated rheumatic diseases (RMDs) and redefined ANA-associated arthritis into two distinct multi-disease clusters based on disease activity, which may support a more targeted approach to treatment. The authors confirmed that MSK inflammation is a key feature across diagnoses and responded similarly to treatments.
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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.
Association of sustained lupus low disease activity state with improved outcomes in systemic lupus erythematosus: a multinational prospective cohort study
Lancet Rheumatol 2024:S2665-9913(24)00121-8 DOI 10.1016/S2665-9913(24)00121-8 Epub ahead of print
This study by Golder, et al. showed a significant protective association of lupus low disease activity state (LLDAS) and remission against damage accrual and flare. The authors also found a threshold of 3 months sustained LLDAS or remission, and that 3 months of sustained LLDAS are attainable in the setting of a 6–12-month clinical trial.