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Review
. 2024 Jan;16(1):15-20.
doi: 10.2217/imt-2023-0086. Epub 2023 Oct 25.

The development of litifilimab (BIIB 059) for cutaneous and systemic lupus erythematosus

Young Min Cho  1 , Richard Furie  1
Affiliations
Review

The development of litifilimab (BIIB 059) for cutaneous and systemic lupus erythematosus

Young Min Cho et al. Immunotherapy. 2024 Jan.

Abstract

This review describes the litifilimab (BIIB 059) development program to date for systemic lupus erythematosus (SLE) and cutaneous lupus erythematosus (CLE). Plasmacytoid dendritic cells (pDCs), major producers of type I interferons (IFN-I), play a key role in SLE pathogenesis. Litifilimab, a humanized monoclonal antibody, binds to BDCA2, a protein uniquely expressed on pDCs. The consequence of BDCA2 ligation is the inhibition of IFN-I as well as IFN-III, cytokine and chemokine production. Phase I and II LILAC trial parts A and B achieved primary end points in SLE and CLE patients, confirming the importance of pDCs and IFN-I in SLE and CLE. Litifilimab is currently being evaluated in phase III trials in both SLE and CLE.

Keywords: LILAC trial; anifrolumab; cutaneous lupus erythematosus; litifilimab; plasmacytoid denditric cell; systemic lupus erythematosus; therapeutic strategy; type I interferons.

Plain language summary

This review discusses a new medicine in development for systemic lupus erythematosus (SLE) and cutaneous lupus erythematosus (CLE). Known as litifilimab, it binds to a protein that is only found on a specific type of cell called a plasmacytoid dendritic cell (pDC). Although all people have pDCs, patients with SLE or CLE have large amounts of these cells in certain organs, such as their skin, kidneys and joints. Since pDCs make substances that promote inflammation and contribute to some of the manifestations of SLE and CLE, litifilimab was designed to prevent these cells from making such substances. One of the key substances made by pDCs whose synthesis is blocked by litifilimab is called interferon. The article describes how litifilimab works, discusses the studies performed to date and outlines the path forward to determine if litifilimab will ultimately be a drug that clinicians can use to treat patients with SLE or CLE.

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