Experimental Drug Promising in Lupus Treatment

Joint discomfort brought on by lupus may be relieved by an investigational medicine that has been demonstrated to alleviate rashes in patients with the disease.

Lupus is an autoimmune illness that affects up to 1.5 million people in the US and occurs when the body’s immune system mistakenly attacks its own blood vessels, joints, skin, brain, lungs, and kidneys.

According to a research trial, patients with lupus who took litifilimab experienced significantly less joint discomfort and edoema than those who took a placebo.

The new medication is a monoclonal antibody administered as a shot. These are synthetic compounds that target particular cell proteins. In this instance, the medication goes after blood dendritic cell antigen 2. (BDCA2). The plasmacytoid dendritic cells (PDCs) that produce type 1 interferons and other inflammatory chemicals also contain this protein.

The study’s lead author, Dr. Richard Furie, stated that there is “a lot of evidence that interferon is important in lupus.” He is a professor at the Feinstein Institutes for Medical Research in Manhasset, New York, and the chief of rheumatology at Northwell Health in New Hyde Park, New York.

The manufacture of type 1 interferon is stopped when the antibody binds to BDCA2 and the protein is internalised, he said. Litifilimab only puts the cell to sleep; it does not kill it.

Although the new medication appears to help reduce other inflammatory proteins linked to lupus, type 1 interferon is still its main target, according to Furie.

102 lupus patients with at least four sore and four swollen joints participated in the study and were given a 450 mg dose of litifilimab or a placebo for 24 weeks. Every four weeks, a dose of the medication is administered.

The researchers discovered that patients who received litifilimab experienced fewer swollen and sore joints than those who received a placebo.

The new medication not only reduced joint symptoms but also reduced skin rashes and had a “very robust” impact on a scale assessing all-around lupus symptoms and activity, according to Furie.

This medication is excellent for treating skin conditions, and based on the strong response, it is also effective against all forms of lupus, not just arthritis, the doctor stated. The new trial was supported by the pharmaceutical company Biogen.

The novel medication is now moving on to larger Phase 3 trials to evaluate its safety and efficacy. Furie hoped that it would then continue to advance toward the United States. approval from the Food and Drug Administration.

The future is promising, he declared. Lupus medication development is quite active, and results are already becoming apparent.

The New England Journal of Medicine published the findings in its issue on September 8. The same publication released encouraging results for the use of litifilimab in the treatment of cutaneous lupus in July.

The most recent findings were accompanied by an editorial written by Dr. Daniel Wallace, a rheumatologist and professor of medicine at Cedars-Sinai Medical Center in Los Angeles.

Wallace declared that the medication “shows promise for both systemic and cutaneous [skin] lupus.”

However, those who used the medication did had an increased risk of getting shingles.

Before starting this medication, patients would be urged to receive the shingles vaccine, according to Wallace. Additionally, this is advised for a different lupus medication that was authorised in August 2021 that targets interferon.

Before litifilimab is allowed, more research is required, he said.

The main issues that need to be looked into, according to Wallace, are how the medication affects individuals of colour, who were underrepresented in the study, and how it affects those with significant, organ-threatening diseases.

He pointed out that people from racial and ethnic minority groups are more likely to acquire severe lupus and that their rates of lupus are disproportionately higher.

Dr. Jill Buyon, a rheumatologist, is cautiously optimistic regarding the new medication and the current lupus therapy pipeline. She is in charge of running NYU Langone’s Lupus Center in New York City.

She added of litifilimab, “I am persuaded not only by the clinical findings but also by the mechanism, which is upstream of interferon signalling and more directly targeting the source.

According to Buyon, who is unrelated to the current research, it is still too early to determine which lupus patients might respond to the new medication the best.

The new medicine is fascinating because it’s very focused, seems to be pretty successful for arthritis, and comes on the heels of the cutaneous [skin] study, she said. “Arthritis is an unmet need in lupus, and we have not had a whole lot of success treating it.”

More lupus medications are unquestionably required as the ones currently available only function occasionally in some patients, according to Buyon.

Precision medicine, or matching medicines to individuals based on extremely specific aspects of their condition, is anticipated to play a significant role in the future of lupus treatment.

In order to employ precision medicine for the first time in lupus, she continued, “we are now searching for mechanisms that will be more and more specific.”

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