[Biologicals and small molecules for systemic lupus erythematosus].

[Biologicals and small molecules for systemic lupus erythematosus].
Z Rheumatol. 2020 Mar 23;:
Authors: Aringer M, Leuchten N, Dörner T
Abstract
Targeted treatment is a rheumatologist's dream, which, with the advent of biologicals and more recently small molecules, has become true for rheumatoid arthritis and is about to translate into reality for systemic lupus erythematosus (SLE). Belimumab, the first biological approved for SLE, is now also available in a subcutaneous formulation. It is notable that this drug achieved the primary endpoint in four independent trials and demonstrated substantial reduction of organ damage accrual. The B cell depletion with antibodies against CD20 remains clinically relevant and of interest for future developments and the combination of both approaches (belimumab and anti-CD20) is an exciting idea. Blockade of the type I interferon receptor with anifrolumab was effective in a phase 3 trial and blocking interleukin-12 and interleukin-23 with ustekinumab is currently being tested in a phase 3 clinical trial. The old ideas of blocking tumor necrosis factor (TNF) and interleukin‑6 have also not yet been forgotten. More novel approaches comprise Janus kinase (Jak) inhibition with positive phase 2 data for baricitinib and soon inhibition of Bruton's tyrosine kinase (BTK) as well as proteasome inhibitors. The treatment of SLE could therefore soon become much more varied.
PMID: 32206866 [P...

Source: Zeitschrift fur Rheumatologie - March 22, 2020 Category: Rheumatology Authors: Aringer M, Leuchten N, Dörner T Tags: Z Rheumatol Source Type: research