Rheumatology Medical News about SLE, B-cell depletion, Biological therapies

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Treating lupus: From serendipity to sense, the rise of the new biologicals and other emerging therapies
Best Practice & Research: Clinical Rheumatology, 07/27/09

Sousa E et al. – This review article highlights the recent advances in systemic lupus erythematosus, (SLE) treatment that have evolved to target selective components of the immune system. B-cell depletion seems the most promising biological approach, but there is a need to optimize drug trial design. Some of the recent approaches in the treatment are as follows:

Rituximab: effective in refractory renal and non-renal lupus
Use of Belimumab and Atacicept is still awaited
Use of anti-TNF-α therapies has been limited by the risk of developing autoantibodies and lupus-like disease
Tocilizumab and MEDI-545 are in phase-I/II studies; phase-I trial is awaited with a human anti-IL-10
Anti-CD40 ligand Abs have either been associated with the development of thrombotic events or failed to demonstrate efficacy
Reducing the effect of pathogenic anti-DNA antibodies is an attractive approach, especially in renal lupus
Abetimus has shown some benefit, while Edratide failed to meet its primary endpoints
Drug trial designs and disease activity indexes need to be improved too

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