REVIEW - Biologics in the treatment of SLE

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Biologics in the Treatment of Systemic Lupus Erythematosus

From Current Opinion in Rheumatology

Aisha Lateef; Petria

Posted: 08/25/2010; Curr Opin Rheumatol. 2010;22(5):504-509.

Abstract

Purpose of review The pathogenesis of systemic lupus erythematosus

(SLE) involves aberrancy in multiple components of the immune system

including B cells, T cells, cytokines and growth factors. Therapeutic

agents targeting these mediators selectively have been tested for the

treatment of SLE. This review summarizes the recent advances in the

fast expanding field of these biological therapies.

Recent findings The two large phase 2/3 randomized placebo-controlled

trials of B-cell depletion, using anti-CD20 antibody, rituximab, in

SLE, reported unexpected negative results. On the contrary, two large

phase 3 trials of belimumab, the monoclonal antibody against

B-lymphocyte stimulator (BLyS), showed significant clinical benefit.

Response rates were 57.6 and 43.2% for 10 mg/kg belimumab, compared

with 43.6 and 33.8% for placebo in BLISS-52 and BLISS-76,

respectively. Studies of a co-stimulation blocker (abatacept), tumor

necrosis factor inhibitor (infliximab), and interleukin-6 inhibitor

(tocilizumab) were either negative (abatacept) or were associated with

high rates of adverse events. Studies of T cell and interferon

inhibition remain in the early development phase.

Summary Despite the enthusiasm in the field of biologic therapies, the

majority of these new modalities have fallen short of expectations for

various reasons. Only belimumab has recently met its primary outcome

in two phase 3 trials.

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Read the full article here:

http://www.medscape.com/viewarticle/726898

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