Research Breakthrough Promises New Lupus Treatments

A study of patients with lupus has uncovered a root cause of the disease that may eventually lead to new treatments, researchers reported in a study published in Nature.

The immune disorder affects more than 1.5 million people in the US alone, and damages skin, joints, the kidneys, the brain and other organs.

Comparing blood samples from 19 patients suffering from lupus with healthy people, researchers found that the patients had an imbalance in immune-system cells called ‘T cells’. 

There was reduced production of T cells that aid in healing, and increased production of T cells that produce autoantibodies to attack healthy cells.

In the wake of the study, we take a look at lupus – at its effects and the available treatments. 

What is lupus?

Lupus is an autoimmune disease that causes the body's immune system to attack its own tissues and organs. This condition can affect various parts of the body, including skin, joints, kidneys, brain, heart and lungs. Diagnosis can be complex, as symptoms often mimic those of other ailments. Treatment options for lupus depend on the severity of symptoms and which organs are affected. 

The cause of lupus remains unknown, but researchers believe it involves a combination of genetic and environmental factors. Women are more likely to develop lupus than men, and it is more prevalent in certain ethnic groups.

Patients with lupus are advised to protect themselves from sun exposure, as ultraviolet light can trigger flares in some individuals.

How is lupus treated?

Medications include anti-inflammatory drugs, antimalarial drugs and immunosuppressants. 

Research has shown antimalarial drugs such as hydroxychloroquine and chloroquine can decrease the frequency and severity of lupus flare-ups. They work by modulating the immune system, which is overactive in lupus patients. This helps reduce inflammation and pain, particularly in the skin and joints.

These medications also help protect the heart, and are thought to lower the risk of blood clots in lupus patients. This is significant as individuals with lupus have an increased risk of cardiovascular complications.

Antimalarials are used in combination with immunosuppressants for more severe cases.

Immunosuppressants are used to treat lupus because the condition results in the body's immune system mistakenly attacking healthy tissue, causing inflammation and damage to organs including the kidneys, heart and lungs. 

Common immunosuppressants used in lupus treatment include methotrexate, azathioprine, mycophenolate mofetil, and cyclophosphamide. These can be administered orally or intravenously, depending on the specific drug and the patient's condition.

The use of immunosuppressants carries risks, as a suppressed immune system makes the patient more susceptible to infections. 

Companies that specialise in lupus medicines

Medications used to treat lupus include anti-inflammatory drugs, antimalarial drugs and immunosuppressants. The following are among the companies that produce treatments in these three categories.

• Immunosuppressants
  GlaxoSmithKline: Benlysta (based on belimumab)
  AstraZeneca: Saphnelo (anifrolumab-fnia)
  Aurinia Pharmaceuticals: Lupkynis (voclosporin)
  Roche: Rituxan (rituximab)
  Bristol Myers Squibb: Orencia (abatacept)
  Eli Lilly: Olumiant (baricitinib)
  Pfizer: Xeljanz (tofacitinib)
• Antimalarials
  Sanofi: Plaquenil (hydroxychloroquine)
• Anti-inflammatories
  Novartis: Ilaris (canakinumab)
  Janssen Pharmaceuticals: Remicade (infliximab)
  UCB: Cimzia (certolizumab pegol)