Literature Highlights - July 2024

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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Keywords:

Upadacitinib, Elsubrutinib, Efficacy, Safety, LLDAS
July 2024

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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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.

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June 2024

Combination of anti-SSA/Ro60 and anti-dsDNA serotype is predictive of belimumab renal response in patients with lupus nephritis

Lupus Sci Med. 2024 May 28;11(1) doi: 10.1136/lupus-2024-001156

The combination of anti-dsDNA and anti-SSA/Ro60 serotype may help to foretell the patient’s renal response to belimumab. Investigators here aimed to explore the effectiveness of belimumab on active LN, exploring predictors, including serological biomarkers, of renal response to belimumab in a real-world setting.

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Efficacy and safety of telitacicept therapy in systemic lupus erythematosus with hematological involvement

Clin Rheumatol. 2024 May 20 doi: 10.1007/s10067-024-06992-7. Epub ahead of print

This real-world combination of telitacicept and standard treatment demonstrated significant improvements in anaemia, as well as increased leukocyte and platelet levels in patients with SLE and haematological involvement. Here, investigators sought to evaluate the efficacy and safety of telitacicept in combination with standard treatment in SLE patients specifically with haematological involvement.

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May 2024

Belimumab Corticosteroid‑Sparing Treatment in Systemic Lupus Erythematosus: a Real‑Life Observational Study (BESST)

Rheumatol. Int. 2024 Apr 30:1–7 DOI: 10.1007/s00296-024-05589-2 https://pubmed.ncbi.nlm.nih.gov/38687385/

Belimumab confers an early and sustained corticosteroid-sparing effect after 3 months of treatment in SLE patients. This was demonstrated by a significant prednisone dose reduction that continued through months 6 and 12, and was sustained until month 24.

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April 2024

Cardiovascular risk factors and complications in patients with systemic lupus erythematosus with and without nephritis: A systematic review and meta-analysis

Lupus Sci Med 2024;11(1):e001152 DOI 10.1136/lupus-2024-001152

Patients with SLE and LN show increased risk of CV risk factors including diabetes mellitus, hypertension and hyperlipidaemia versus patients without nephritis.

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CD19 CAR T-Cell therapy in autoimmune disease - A case series with follow-up

N Engl J Med 2024;390(8):687–700 DOI 10.1056/NEJMoa2308917

In this case series by Müller, et al., eight patients who received a CD19 CAR T-cell infusion achieved Definition of Remission in SLE (DORIS) remission, Lupus Low Disease Activity State and a SLEDAI 2K score of 0 at 6 months post-infusion. Long-term follow-up through 24 months showed that SLE disease activity remained absent
in all eight patients.

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Smith-specific regulatory T cells halt the progression of lupus nephritis

Nat Commun. 2024 Feb 6;15(1):899 DOI: 10.1038/s41467-024-45056-x

Compared with polyclonal mock-transduced regulatory T cells (Tregs), Smith(Sm)-Tregs potently suppress Sm-specific pro-inflammatory responses in vitro and suppress disease progression in a humanised mouse model of lupus nephritis.

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