Publications
Find coverage of the latest original articles on Lupus, focusing on those with data on therapeutic interventions and those that have clinical impact.
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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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.
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Efficacy and safety of sequential therapy with subcutaneous belimumab and one cycle of rituximab in patients with systemic lupus erythematosus: the phase 3, randomised, placebo-controlled BLISS-BELIEVE study
Ann Rheum Dis 2024;0:1–11 DOI 10.1136/ard-2024-225686.
Aranow et al. evaluated the efficacy and safety of combining subcutaneous belimumab with one cycle of rituximab in SLE. Sequential therapy did not show a statistically significant improvement in disease control over belimumab monotherapy, but did achieve nominally better reductions in disease activity markers.
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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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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.
Risk of flare and damage accrual after tapering glucocorticoids in modified serologically active clinically quiescent patients with systemic lupus erythematosus: A multinational observational cohort study
Ann Rheum Dis. 2024 Feb 29:ard-2023-225369 doi: 10.1136/ard-2023-225369 Epub ahead of print
Flare risk did not increase following glucocorticoid tapering in modified serologically active clinically quiescent patients with SLE. They also found that antimalarial use was associated with decreased flare risk.
Lupus low disease activity state and organ damage in relation to quality of life in systemic lupus erythematosus: A cohort study with up to 11 years of follow-up
Rheumatology 2024 DOI 10.1093/rheumatology/keae120 Epub ahead of print
Patients with a lupus low disease activity state (LLDAS) irrespective of organ damage were significantly more likely to have favourable health-related quality of life, pain, fatigue, and overall health experience.
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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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Burden of Systemic Lupus Erythematosus in Clinical Practice: Baseline Data from the SLE Prospective Observational Cohort Study (SPOCS) by Interferon Gene Signature
Lupus Sci Med. 2023; 10(2):e001032 DOI: 10.1136/lupus-2023-001032
This study from Arnaud et al described baseline characteristics of SLE patients grouped by disease activity and IFNGS category in the international SPOCS study. IFNGS-high patients were younger at SLE diagnosis, and a baseline SLEDAI-2K score ≥10 was associated with shorter disease duration, more frequent and more severe flares. IFNGS-low patients were more likely to exhibit musculoskeletal and CNS comorbidities than IFNGS-high patients. Continuation of the SPOCS study will allow investigation into how different baseline characteristics affect long-term outcomes in SLE patients.