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Review
. 2023 Apr 29;12(9):3198.
doi: 10.3390/jcm12093198.

Targeted Therapy for SLE-What Works, What Doesn't, What's Next

Veronica Venturelli  1 , David Alan Isenberg  2
Affiliations
Review

Targeted Therapy for SLE-What Works, What Doesn't, What's Next

Veronica Venturelli et al. J Clin Med. .

Abstract

For many years, the failure of randomized controlled trials (RCTs) has prevented patients with systemic lupus erythematosus (SLE) from benefiting from biological drugs that have proved to be effective in other rheumatological diseases. Only two biologics are approved for SLE, however they can only be administered to a restricted proportion of patients. Recently, several phase II RCTs have evaluated the efficacy and safety of new biologics in extra-renal SLE and lupus nephritis. Six drug trials have reported encouraging results, with an improvement in multiple clinical and serological outcome measures. The possibility of combining B-cell depletion and anti-BLyS treatment has also been successfully explored.

Keywords: biological therapies; combination therapies; lupus nephritis; systemic lupus erythematosus; trials.

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Conflict of interest statement

D.A.I. has received honoraria from Amgen, Astra-Zeneca, UCB pharma, Vera Therapeutics, Merck Serono. These honoraria are passed onto a local arthritis charity. V.V. has declared no conflicts of interest.

Figures

Figure 1
Figure 1
Conventional lupus therapies. AZA: azathioprine. CNIs: calcineurin inhibitors. CYC: cyclophosphamide. GC: glucocorticoids. HCQ: hydroxychloroquine. IRR: incomplete renal response. MMF: mycophenolate mofetil. RTX: rituximab. SLE: systemic lupus erythematosus. SPF: sun protection factor.
Figure 2
Figure 2
Created with BioRender.com (accessed on 19 April 2023). Molecules and cells involved in the immunopathogenesis of SLE. The mechanism of the drugs discussed in the review is shown. APRIL: a proliferation-inducing ligand. BAFF: B-cell-activating factor. BAFFR: BAFF receptor. BCR: B-cell receptor. BDCA2: blood dendritic cell antigen 2. BTK: Bruton tyrosine protein kinase. CD40L: CD40 ligand. ICOS: inducible T-cell co-stimulator. ICOSL: ICOS ligand. IFNα: interferon α. IFNAR: type 1 interferon receptor. ILs: interleukins. JAK1: Janus kinase 1. pDC: plasmacytoid dendritic cell. TACI: Transmembrane Activator and Calcium-modulator and cyclophilin ligand Interaction. TLR: Toll-like receptor. TYK2: Tyrosine kinase 2.
See this image and copyright information in PMC

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