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.
Keywords:
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.
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.
Keywords:
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.
EULAR Recommendations for the Management of Systemic Lupus Erythematosus: 2023 Update
Ann Rheum Dis 2023;83(1):15–29 DOI: 10.1136/ard-2023-224762
The objective of this international task force was to update the EULAR recommendations for the management of SLE. The Task Force agreed on 5 overarching principles and 13 recommendations, generating an overall framework for the approach to a patient with SLE. The updated recommendations provide consensus guidance on the management of SLE, combining evidence and expert opinion.
Keywords:
Impact of Low Disease Activity, Remission, and Complete Remission on Flares Following Tapering of Corticosteroids and Immunosuppressive Therapy in Patients with Systemic Lupus Erythematous: A Multinational Cohort Study
The Lancet Rheumatology, 2023, Volume 5, Issue 10, e584 - e593 DOI: https://doi.org/10.1016/S2665-9913(23)00209-6
In this study, tapering of corticosteroids or immunosuppressive therapy in patients in LLDAS, remission, or complete remission was associated with excess flares versus continuing with therapy. Tapering in complete remission was associated with lower odds of flares compared with tapering in LLDAS or remission. In addition, patients with longer sustained duration of LLDAS or remission at the time of tapering had lower odds of flare and longer time to flare versus those with a shorter duration of LLDAS or remission.
Safety and Efficacy of Long-term Voclosporin Treatment for Lupus Nephritis in the Phase 3 AURORA 2 Clinical Trial
Arthritis Rheumatol. 2023;76(1):59–67 DOI: 10.1002/art.42657
AURORA 2 demonstrated the safety and tolerability of continued administration of voclosporin over 3 years of treatment in patients with LN.
Keywords:
Lupus Low Disease Activity State and Remission and Risk of Mortality in Patients with Systemic Lupus Erythematosus: A Prospective, Multinational, Longitudinal Cohort Study
Lancet Rheumatol. 2022. Epub ahead of print. doi: 10.1016/S2665-9913(22)00304-6
Lupus low disease activity state (LLDAS) significantly reduced the risk of mortality in patients with SLE.
Keywords:
Trial of Anti-BDCA2 Antibody Litifilimab for Systemic Lupus Erythematosus
N Engl J Med. 2022;387(10):894–904 doi: 10.1056/NEJMoa2118025
Phase 2 study, in patients with systemic lupus erythematosus, shows that litifilimab is associated with a greater reduction from baseline in the number of swollen and tender joints than placebo, over a period of 24 weeks.