Systemic Lupus Erythematosus FocusRheum

SAN DIEGO—As part of a Nov. 14 session on lupus nephritis at ACR Convergence 2023, Simone Appenzeller, MD, PhD, shared perspectives on the importance of biopsy to inform its diagnosis, prognosis and treatment, with an emphasis on childhood disease. Prompt diagnosis and treatment of lupus nephritis is perhaps even more important for children than for…

Kidney involvement is a major cause of morbidity and mortality in systemic lupus erythematosus (SLE). Collectively termed lupus nephritis, SLE with kidney involvement comes in many subtypes. The current classification by the International Society of Nephrology/Renal Pathology Society (ISN/RPS), however, does not include lupus podocytopathy, which, through various clinical and epidemiologic studies, has recently been…

In 2022, an international group of researchers reported the seminal finding that a gain-of-function variant of a single-stranded ribonucleic acid (RNA) sensor, known as toll-like receptor 7 (TLR7), can cause human systemic lupus erythematosus (SLE).1 The paper in Nature showed that a newly described variant of TLR7, identified in a child with severe lupus, was…

Checking blood levels of commonly used disease-modifying anti-rheumatic drugs (DMARDs) has gained widespread attention in the rheumatology community, even resulting in a recent guidance document from EULAR for biologics.1 Although a highly useful tool, drug level measurement in rheumatology is not without challenges; many of our drugs violate the basic principles of pharmacology that we…

Patients with systemic lupus erythematosus (SLE) often face many concerns, fears and uncertainties that render “treatment decision making very difficult,” says Jasvinder Singh, MD, MPH, professor of medicine and epidemiology at the University of Alabama at Birmingham. Often these patients, who tend to be women from minority groups, “do not have access to easily understandable…

Through a project to reduce gaps and inequities in lupus care and treatment, ACR work groups have developed five quality measures focused on clinical and patient-reported outcomes and are integrating them into the RISE registry to support patient care and research.

AURORA 2, a double-blind, phase 3 study, evaluated the long-term safety, tolerability and efficacy of voclosporin compared to placebo in patients with lupus nephritis receiving an additional two years of treatment following completion of the one-year AURORA 1 study. Patients enrolled in AURORA 2 continued to receive the same treatment randomly assigned in AURORA 1, in combination with mycophenolate mofetil and low-dose glucocorticoids. Saxena et al. propose that the rapid renal response achieved with voclosporin treatment has long-term benefits, supported by stable kidney function over the three-year treatment period.

In a clinical trial, patients with active systemic lupus erythematosus (SLE) did not experience a reduction in disease activity with the addition of rezpegaldesleukin to their standard treatments. However, some patient populations did see improvements in their disease activity compared with the placebo-treated group.

A new disease model for lupus tackles issues with fatigue and other serious conditions that, although quite common among patients, get less attention because they fall outside classic symptoms associated with inflammation, a debilitating force behind systemic lupus erythematosus (SLE). The model features subtypes to cate­gorize two main groups of symptoms into type 1, typically…