Ann Rheum Dis 2023; 2023-224762 DOI: 10.1136/ard-2023-224762 Epub ahead of print
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.
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.
Effect of Belimumab on Kidney-related Outcomes in Patients with Lupus Nephritis: Post Hoc Subgroup Analyses of the Phase 3 BLISS-LN Trial
Nephrol Dial Transplant. 2023 doi: 10.1093/ndt/gfad167 Epub ahead of print.
These data highlight the consistent benefit of belimumab versus placebo, combined with standard therapy, on kidney outcomes in both newly diagnosed and relapsed patients, and regardless of the use of GC pulses at induction.
Baricitinib for Systemic Lupus Erythematosus: a Double-blind, Randomised, Placebo-controlled, Phase 3 trial (SLE-BRAVE-II)
Lancet. 2023 doi: 10.1016/S0140-6736(22)02546-6
Negative results of SLE-BRAVE-II trial show that evidence for the efficacy of baricitinib in SLE is inconclusive.
A Randomized, Placebo-Controlled Phase III Extension Trial of the Long-Term Safety and Tolerability of Anifrolumab in Active Systemic Lupus Erythematosus
Arthritis Rheumatol. 2022. Epub ahead of print doi: 10.1002/art.42392
Long-term extension study shows an acceptable long-term safety profile of anifrolumab in SLE, in addition to sustained improvements in disease activity and reduction in glucocorticoid use.
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.
Phase 3, multicentre, randomised, placebo-controlled study evaluating the efficacy and safety of ustekinumab in patients with systemic lupus erythematosus
van Vollenhoven RF, et al. Ann Rheum Dis. 2022. Epub ahead of print. doi:10.1136/ard-2022-222858.
Phase 3 study evaluating the efficacy and safety of ustekinumab in patients with active SLE, despite receiving standard-of-care, does not achieve primary and key secondary endpoints.
Mechanism of action of baricitinib and identification of biomarkers and key immune pathways in patients with active systemic lupus erythematosus
Dörner T, et al. Ann Rheum Dis. 2022. Epub ahead of print. doi:10.1136/annrheumdis-2022-222335.
Phase II study results suggest that baricitinib 4 mg downregulates key cytokines that are upregulated in patients with SLE.
Concordance and discordance in SLE clinical trial outcome measures: analysis of three anifrolumab phase 2/3 trials
Ann Rheum Dis 2022;81:962–969 doi: 10.1136/annrheumdis-2021-221847
Bruce, et al. investigate the degree of concordance between BICLA and SRI-4 response across anifrolumab trials (TULIP-1, TULIP-2 and MUSE) in order to better understand drivers of discrepant systemic lupus erythematosus (SLE) trial results.
Anifrolumab efficacy and safety by type I interferon gene signature and clinical subgroups in patients with SLE: post hoc analysis of pooled data from two phase III trials
Ann Rheum Dis. 2022; 0:1–11. doi: 10.1136/annrheumdis-2021-221425
IFN-I signalling plays a key role in SLE pathogenesis, and anifrolumab has demonstrated inhibitory effects on IFN-I signalling in patients with SLE. Vital, et al. characterised efficacy and safety of anifrolumab in patients with moderate-to-severe SLE based on interferon gene signature, demographic and clinical subgroups using data pooled from the Phase III TULIP-1 and -2 trials.