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Promising drug against lupus

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Denise Mann HealthDay Reporter

(Health Day)

Thursday, Sept. 8, 2022 (HealthDay News) — An drug shown to treat rashes in lupus patients may also help lupus-related joint pain.

Affecting 1.5 million people in the United States, Lupus It is an autoimmune disease in which the body’s immune system misfires against its own joints, skin, brain, lungs, kidneys, and blood vessels.

Lupus patients who took ritifilimab showed a marked reduction in joint tenderness and swelling compared to those who took placebo (or a dummy drug). clinical trial Indicated.

New drugs given as injections monoclonal antibodyThese are artificial molecules that target specific proteins on cells. In this case, the drug targets a protein called blood dendritic cell antigen 2 (BDCA2). This protein is found in plasmacytoid dendritic cells (PDCs) that produce inflammatory molecules, including type 1 interferons.

“There is a lot of evidence that interferons are important in lupus,” said study author Dr. Richard Fury. He is director of the Department of Rheumatology at Northwell Health in Hyde Park, New York, and professor at the Feinstein Institute of Medicine in Manhasset, New York.

“Antibodies bind to BDCA2, the protein is taken up by the body, and the synthesis of type 1 interferon is blocked,” he explained. “Ritifilimab doesn’t kill cells, it just puts them to sleep.”

The new drug also appears to help cool other inflammatory proteins involved in lupus, but its primary effect is on type 1 interferons, Furie said.

In this study, 102 lupus patients with tenderness in at least four joints and swelling in four joints received 450 mg ritifilimab or placebo for 24 weeks. The drug is injected every 4 weeks.

Researchers found that patients who took ritifilimab had less joint swelling and tenderness than those who took placebo.

In addition to improving joint symptoms, the new drug also improved skin rashes and had a “very robust” effect on scales that measure global lupus symptoms and activity.

“This drug is very effective in skin conditions, and this strong response shows it’s good not only for arthritis, but also for systemic lupus. .

The new drug is now moving into larger Phase 3 trials to test its safety and efficacy. After that, Furie hopes it continues to move forward toward U.S. Food and Drug Administration approval.

“The future is bright,” he said. “Lupus drug development is booming, and we are finally seeing success.”

Dr. Daniel Wallace, a rheumatologist and professor of medicine at Cedars-Sinai Medical Center in Los Angeles, writes: editorial It accompanied the latest findings.

“This drug shows promise for both systemic and skin [skin] Lupus,” Wallace said.

People who took the drug had a higher risk of developing Herpes zosterbut.

“It is recommended that patients be vaccinated with the shingles vaccine beforehand. [starting this drug]said Wallace. It is also recommended for another interferon-targeted lupus drug approved in August 2021.

He said more research is needed before ritifilimab is approved.

“The main questions to be investigated are, first, how drugs work in people of color who are underrepresented in research, and second, how they affect patients with serious organ-threatening diseases. How does it work?

He said lupus disproportionately affects people from racial and ethnic minority groups who are also more likely to develop severe lupus.

Rheumatologist Dr Jill Bouillon is cautiously optimistic about new drugs and the current lupus drug pipeline. She is director of her NYU Langone Lupus Center in New York City.

“I’m inspired not only by the clinical data, but by the mechanisms that are upstream of interferon signaling and target the source more directly,” she said of ritofilimab.

It’s too early to know which people with lupus respond best to new drugs, said Buyon, who had nothing to do with the new research.

“Arthritis is an unmet need in lupus, and there hasn’t been much success in treating it,” she said.cutaneous [skin] study. “

Buyon says there is definitely a need for more lupus drugs because current drugs only work for some people.

The future of lupus treatment precision medicine Or tailoring treatments to people based on very specific characteristics of their disease.

“We are looking for more specific mechanisms so that precision medicine can be used for lupus for the first time,” she added.

Source: Richard Furie, MD, Professor, Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, NY, Chief, Division of Rheumatology, Northwell Health, New Hyde Park, NY, advisor, Lupus Clinical Investigators Network, Lupus Research Alliance’s Clinical affiliate Lupus Therapeutics. Daniel Wallace, MD, Rheumatologist, Professor, Medicine, Cedars-Sinai Medical Center, Los Angeles. Jill Buyon, MD, Rheumatologist, Director, NYU Langone Lupus Center, New York City. New England Journal of MedicineSeptember 8, 2022

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