Publications
Find coverage of the latest original articles on Lupus, focusing on those with data on therapeutic interventions and those that have clinical impact.
April 2025
Unsupervised machine learning identifies distinct systemic lupus erythematosus patient endotypes with differential response to belimumab
Rheumatol (Oxford), 2025 DOI: 10.1093/rheumatology/keaf215. Epub ahead of print
Depascale et al. used unsupervised machine learning to identify three SLE endotypes based on B cell immunophenotyping and serological profiles. Belimumab was most effective in patients with transitional and naïve B cell enrichment (Cluster 2), where it significantly increased the likelihood of achieving sustained LLDAS and DORIS remission.
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March 2025
LLDAS and remission attainment with anifrolumab treatment in patients with systemic lupus erythematosus: results from the TULIP and long-term extension randomised controlled trials
Ann Rheum Dis. 2025:S0003-496700071-8. DOI: 10.1016/j.ard.2025.01.016. Epub ahead of print
Morand et al. conducted a post-hoc analysis of the phase III TULIP-1 and TULIP-2 trials and their long-term extension, including 369 patients with moderate to severe SLE, to evaluate the long-term impact of anifrolumab on attainment of LLDAS and DORIS-defined remission. The results demonstrated that anifrolumab significantly improved the likelihood, speed, and duration of LLDAS and DORIS remission versus placebo over 4 years, with benefits sustained throughout the treatment period.
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Belimumab efficacy in mucocutaneous lupus erythematosus: a large post-hoc analysis from five phase III clinical trials
Rheumatol, 2025. Epub ahead of print. DOI: 10.1093/rheumatology/keaf145
Grosso et al. conducted a post-hoc analysis of five phase III trials, including 3086 patients, to evaluate the efficacy of belimumab in improving mucocutaneous manifestations of SLE. The results demonstrated that belimumab significantly improved disease activity as measured by the mcBILAG and mcSLEDAI-2K indices compared with placebo and reduced flare rates in patients with high disease activity and serological positivity.
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Evolution and trajectory of B-cell targeted therapies in rheumatic diseases
Lancet Rheumatol, 2025. Epub ahead of print
Carter et al. review the clinical and mechanistic development of B-cell targeted therapies over the last two decades in autoimmune rheumatic diseases. B-cell depletion depth, repopulation dynamics, and immunogenicity determine long-term efficacy and inform the rationale for emerging
dual-targeted approaches, particularly in systemic lupus erythematosus where belimumab and rituximab combinations show potential to mitigate relapse driven by BAFF.
February 2025
Opportunities and limitations of B bell depletion approaches in SLE
Nature Review Rheumatol, 2025;21:111–126 DOI: 10.1038/s41584-024-01210-9
Stockfelt et al. reviewed the long-term efficacy and challenges of B cell depletion strategies in SLE. Rituximab, a CD20-targeting monoclonal antibody, has demonstrated efficacy in a subset of patients but remains limited by immunogenicity, residual B cells, and B-cell activating factor (BAFF)-mediated relapse. Newer strategies incorporating CAR T cells, bispecific T cell engagers, and combination therapies aim to enhance B cell depletion and optimise outcomes.
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Efficacy and safety of obinutuzumab in active lupus nephritis
NEJM, 2025. Epub ahead of print. DOI: 10.1056/NEJMoa2410965
Furie et al. demonstrated that obinutuzumab plus standard therapy significantly improved complete renal response at Wk76 compared with placebo. No unexpected safety signals were identified, though infections and COVID-19-related events were more frequent in the obinutuzumab group.
Belimumab versus telitacicept in sequential treatment after rituximab for refractory lupus nephritis: A real-world multicentre study
Lupus Science & Medicine, 2025;12:e001296 DOI:10.1136/lupus-2024-001296
Chen et al. demonstrated that sequential treatment with belimumab or telitacicept following rituximab (RTX) is a potential therapeutic approach for treating refractory LN. Major AEs included immunoglobin deficiency, respiratory tract infections and urinary tract infections, which are consistent with previous studies.
January 2025
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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December 2024
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.