Latest Discoveries in Lupus Research Highlighted at ACR’s 2023 Scientific Meeting

The American College of Rheumatology’s (ACR’s) 2023 annual meeting is well underway and significant advances as well as new discoveries in lupus research have taken center stage. The November 10-15 event has featured thousands of new studies and reaffirmed excitement and hope throughout the global lupus community.

The Lupus Foundation of America (LFA) presented original research on factors influencing time to diagnosis , a study on our lupus self-care app, findings from support offered by our health education specialists and increasing minority clinical trial participation. Additionally, the LFA also proudly supported many other important research studies which were covered by our Inside Lupus Research team. Below are some of this year’s meeting’s biggest research highlights.

Treatment News

Numerous advancements in therapeutics were reported, illustrating tremendous strides in the development of better treatments and outcomes for people with lupus.

Anifrolumab: In new research co-authored by the LFA’s Medical Director, Dr. Susan Manzi analyzed renal involvement in people with SLE and found people treated with anifrolumab (Saphnelo™) achieved renal improvement compared to those who received the placebo.

Azathioprine: Over time, cognition in people with lupus may improve when treatment is supplemented with the drug.

CAR-T Cell therapy: CD19 CAR-T cell therapy led to the disappearance of autoantibodies in people with SLE and vaccination responses remained stable in study participants, indicating safety and efficacy.

Dapirolizumab pegol: The biologic changes the body’s immune response, demonstrating impact after 2 weeks of use, compared to those treated with the placebo.

Deucravacitinib: For people with SLE, the investigational drug deucravacitinib was shown to be effective and well-tolerated in a phase 2 trial, eliciting a higher response rate compared to the placebo across multiple endpoints.

Ianalumab: In people with active lupus, the therapy reduces moderate and severe flare activity as well as laboratory markers of autoimmune activity.

Litifilimab: In a new Phase 2 LILAC study, the therapy met the primary endpoints for people with SLE or CLE, and further illustrates the drug’s ability to help regulate and reduce IFN biomarkers.

Obinutuzumab: After the drug’s last dose, B-cell recovery was evident and early sustained depletion of the therapy garners a greater clinical effect on renal response.

Upadacitinib: The SLEek phase 2 study further supports past research suggesting an association between the treatment’s clinical benefits and its effects on pathogenic B cells in people with lupus.

Voclosporin: When treated with a voclosporin-based regimen, Black people with lupus nephritis achieved higher rates of renal response that lasted over 3 years than those treated with MMF and glucocorticoids alone.

Disease Management

From ardently seeking resources to openly sharing information about their symptoms, people with lupus are actively contributing to the growing body of knowledge about the disease. And their contributions are providing greater understanding about challenges to diagnosis as well as best indicators for measuring treatment response.

Strategies to Embrace Living with Lupus Fearlessly (SELF): A Promising Digital Intervention for Lupus Self-Management, found strong interest in people with lupus to improve their disease self-management skills for better quality of life. Program participants reported increased self-management skills, decreased fatigue, better overall mental and physical health, and improved medication adherence and doctor/patient communication.

Inquiries to the LFA’s Health Education Specialists (HES) were examined in the study Meeting the Educational and Language Needs of the Lupus Community: A Snapshot of 2022 Lupus Inquiries. Overall, information about living and coping with lupus and available resources were the top two topics received by HES.

The study, Understanding the Burden of Cutaneous Lupus: A Subset Analysis from the 2022 World Lupus Federation Global Impact (WLFGI) Patient Survey, supported by the LFA provided a unique, global insight into lupus patient-reported burden of cutaneous lupus erythematosus (CLE) compared to systemic lupus erythematosus (SLE). The investigators found that skin-limited or CLE disease appears to carry as high a quality-of-life burden as SLE in several areas of disease impact, and that the presence of CLE among people with SLE is associated with higher quality of life burden, with particular impact on mental health (44%) and social interaction.

Factors Influencing Time to Diagnosis in U.S. Patients with Systemic Lupus Erythematosus utilized data from the LFA’s RAY® patient and caregiver registry and identified an average delay of more than six years between when a person first experiences symptoms to when they receive a lupus diagnosis, as well as many factors that seemingly influence time to diagnosis.

The study, Identifying Important Domains for Inclusion in a Novel Treatment Response Measure for Systemic Lupus Erythematosus (TRM-SLE): Results of a Modified Delphi Study, led by the LFA’s 2022 Evelyn V. Hess Award recipient, Eric Morand, MBBS, PhD, Monash University, shared 14 areas or domains deemed important to measure treatment response in SLE by both experts and patients. TRM-SLE is a new clinical outcome assessment for SLE randomized controlled trials and is supported by the LFA for representing and elevating the patient voice in clinical research.

Advanced Technology

To help predict neuropsychiatric lupus events, the study, Harnessing Machine Learning to Predict Neuropsychiatric Events in Systemic Lupus Erythematosus, integrated traditional risk factors into machine learning models and accurately predicted neuropsychiatric involvement with SLE, helping to anticipate neuropsychiatric flares.

Health Disparities

The inequalities in lupus disease management and outcomes along racial, ethnic and socioeconomic lines continue to be explored and discussed.

In peer-to-peer outreach, members of the LFA’s Lupus Research Action Network (LRAN) engaged in opportunities to discuss the importance of participation in lupus research. In the study, Lupus Research Action Network: Increasing Minority Clinical Trial Participation Through Peer Leaders, a community-based popular opinion leader model increased awareness of and commitment to diversity in lupus clinical trials among Black/African American people with lupus.

The study, Racial Disparities in Lupus Nephritis: A Nationwide Analysis, examines racial disparities in lupus nephritis and predictors of in-hospital death.

Therapeutic Hydroxychloroquine Blood Levels Are Cost Effective and May Reduce Health Disparities by Reducing Lupus Hospitalizations discovered routine hydroxychloroquine (HCQ) blood level monitoring reduces acute care utilization and health disparities, and is, thereby, a cost effective measure.

The study, Geographic and Demographic Representation in Industry-sponsored, US-based Clinical Trials of Systemic Lupus Erythematosus Therapies further underscores a known challenge throughout the field by revealing that while White, Hispanic and Asian Americans are adequately represented in US lupus clinical trials, Black and American Indian/Alaska Native participants are still underrepresented relative to the US population in lupus studies.

The Lupus Foundation of America is excited and remains committed to supporting and leading the lupus community toward a better understanding of lupus, management of the disease, better treatments and ultimately a cure. Continue to read the Lupus Foundation of America’s Inside Lupus Research articles for breaking news and important updates and see you at #ACR24!