In an article published in TIME, experts revealed new advancements in the management and treatment of patients with lupus.
The experts explained that in 2021, a 20-year-old patient received chimeric antigen receptor (CAR) T-cell therapy to target their B cells; within 1 month, the patient’s symptoms had improved. Researchers validated the results in five additional patients, finding that when their B cells returned, they did not initially demonstrate harmful activity. Despite the positive findings, the experts stressed that CAR T-cell therapy currently costs about $400,000, making it inaccessible to many patients. Further, the treatment may cause severe and systemic toxicity, leading to infections and comas. The researchers underscored the need to analyze the 5-year effects of CAR T-cell therapy prior to its more widespread use in clinical settings.
In addition, the experts noted that other therapeutic options have become available for patients who have lupus with and without kidney involvement. The U.S. Food and Drug Administration (FDA) recently approved intravenous belimumab to target B cells, oral voclosporin to inhibit immune system overactivity caused by the protein calcineurin, and anifrolumab to target interferon alpha receptors. The experts revealed that the monoclonal antibodies obinutuzumab, obexelimab, and daratumumab have all demonstrated efficacy in clinical trials but have not yet been approved by the FDA. Researchers have also evaluated the effectiveness of urine protein detection to monitor disease activity and found that the practice may be inaccurate in about 30% of the cases. As a result, the researchers identified interleukin-16 as a more reliable marker of kidney health.
The experts concluded that future studies may need to focus on gene-expression profiling to better differentiate lupus subtypes, as well as personalized and combination therapies to more effectively treat patients with the disease.