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Several new drugs and promising therapies, including CAR-T cell therapy, have ushered in a "renaissance" for lupus, according to Emily Littlejohn, DO, MPH, of the Cleveland Clinic, speaking at the symposium Basic and Clinical Immunology for the Busy Clinician. She described 2020 as the beginning of this renaissance, marked by the rapid approvals of belimumab (Benlysta), voclosporin (Lupkynis), and anifrolumab (Saphnelo), alongside the emergence of monoclonal antibodies and interferons as additional potential treatments for systemic lupus erythematosus. CAR-T cell therapy, already well established in oncology for conditions such as B-cell acute lymphoblastic leukemia and B-cell non-Hodgkin's lymphoma, has generated significant excitement in the autoimmune disease space. In a German study enrolling five patients with multi-organ involvement, all participants were able to achieve a state in which nephritis ceased, offering considerable hope for the therapy's potential in lupus. However, Littlejohn cautioned that the therapy carries a significant risk of cytokine release syndrome and ICANS, which remain serious concerns.
Alongside CAR-T cell therapy, several alternative treatments for systemic lupus erythematosus are currently in development, including litifilimab (BIIB059), interferon-kinoid, obinutuzumab (Gazyva), and iberdomide. Litifilimab was initially studied in 132 cutaneous lupus patients and met its primary endpoints with a meaningful decrease in skin CLASI score at week 16, while also demonstrating success in reducing the number of joints in active disease. Obinutuzumab has met its primary endpoint in patients with lupus nephritis, making it another promising candidate in the evolving treatment landscape. Interferon-kinoid, however, failed to meet endpoints in important trials, leaving its future uncertain. Together, these developments reflect a rapidly expanding armamentarium for lupus that offers new hope to patients who previously had limited options.
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About Dr. He Huang
Professional Position: Professor and Chancellor at Zhejiang University School of Medicine Associate Dean of Zhejiang University School of Medicine Director of Bone Marrow Transplantation Center at The First Affiliated Hospital, Zhejiang University School of Medicine Vice Director of the Institute of Hematology, Zhejiang University Education M.D. and Ph.D. f…
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