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SLE Treatment Landscape: Abundance or Overload?

Janet Pope, MD, MPH, FRCPC

Imagine a world where the multiple drugs in Phase 2 and 3 trials actually get approved, and we get access to them? I know you may be thinking that I am overly optimistic, but there are so many drugs in development in lupus that we may have true difficulty choosing what to use.

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Do SGLT2 and GLP-1 therapies have a role in Lupus?

Maya Shumyatcher, MD,  , Arpitha Haranahalli Shivarudrappa, PhD , , Jennifer H. Anolik, MD, PhD

Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2i) and Glucagon-like peptide-1 receptor agonists (GLP1-RA) were initially developed as glucose-lowering agents for the treatment of Type 2 Diabetes. Since their introduction, they have been noted to have a myriad of other benefits, including cardiovascular and renal protective effects in patients both with and without diabetes. Here, we will review the evidence for SGLT2i and GLP1-RA in lupus.

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Belimumab in SLE with Mucocutaneous or Vasculitis Findings

Jack Cush, MD

A post hoc analysis of a belimumab (BEL) inn systemic lupus erythematosus (SLE) study showed lupus mucocutaneous and vasculitic manifestations improve with BEL and standard care.

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Dafna Gladman

50 Year Perspective on Lupus

Dafna Gladman, MD

An observational cohort study was started in Toronto by Dr. Murray Urowitz in 1970. The program was set up as a specialized clinic to provide care for patients with lupus, to study clinical laboratory correlations in the disease, and to better understand long-term outcomes of the disease. What have we learned from more than 50 years of follow-up of patients with lupus? Some of the important observations include the following.

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Contemporary lupus nephritis treatment

Janet Pope, MD, MPH, FRCPC

Outcomes in lupus nephritis are akin to the glass half full. Serial monotherapy is out, as the percentage who achieved a complete renal response was very low and some went to end stage kidney disease (ESKD). Solutions?

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2025 ACR Guideline for the Treatment of SLE

Jack Cush, MD

The ACR has released its 2025 Systemic Lupus Erythematosus (SLE) treatment guidelines and consensus-based good practice statements, applicable to children and adults with SLE. 

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pregnancy,embryo,fetal

IMPACT Study - Certolizumab Efficacy in APS Pregnancies

Jack Cush, MD

A pilot trial assessed the safety and value of tumour necrosis factor α inhibitor treatment with certolizumab in patients with high-risk pregnancies with antiphospholipid syndrome (APS).

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Hydroxychloroquine: Are Your Patients Taking It? Dr. Nathalie Costedoat-Chalumeau dives into monitoring HCQ levels and what they tell us about patient adherence. 💡Learn how to spot non-compliance early. 👉 Now live on RheumNow: https://t.co/KPjyCrMTBr #LupusCare https://t.co/vRASCc9kB0

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Dr. John Cush RheumNow ( View Tweet)
Using publicly available FAERS safety data, drug-induced photosensitivity (DIP) - among 17+ million safety reports, there 20,236 linked to DIP. The most common wereimmunosuppressants, monoclonal Abs, neoplastic agents, including adalimumab, adapalene, secukinumab, fingolimod https://t.co/QWg8FVvrZb
Dr. John Cush RheumNow ( View Tweet)
Contemporary lupus nephritis treatment The Lupus 2025 congress brought together world SLE thought leaders. Outcomes in lupus nephritis are akin to the glass half full. Serial monotherapy is out, as the percentage who achieved a complete renal response was very low and some https://t.co/4LVPeDn6r4
Dr. John Cush RheumNow ( View Tweet)
JAMA -- Full read review "Uveitis in Adults:" - affects adults 20 to 50 years - noninfectious anterior uveitis: corticosteroids 1st line Rx - posterior noninfectious uveitis: DMARDs 1st line Rx; Biologics 2nd line https://t.co/BJQkPtK2z2 https://t.co/9zAntZK66Q

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Dr. John Cush RheumNow ( View Tweet)
Early RA or undiff. arthritis (UA) shows initial hi-dose steroids have significantly better earlier outcomes, but lower doses have fewer early side effects. IMPROVED used high dose GC (60 mg/d tapered to 7.5 mg in 7wks). tREACH used lower dose GC (15 mg/d tapered in 10 wks to https://t.co/TkrGPb6EBZ
Dr. John Cush RheumNow ( View Tweet)
JAMA CME review of Immune Thrombotic Thrombocytopenic Purpura (iTTP) - thrombotic microangiopathy w/ hemolytic anemia (MAHA) & thrombocytopenia. iTTP incidence is 2-6 per million. Caused by Abs to ADAMTS13), w/ low ADAMTS13 activity vWF multimers bind platelets https://t.co/bvCexDPBmq
Dr. John Cush RheumNow ( View Tweet)
Emulation Trials in SLE: Real or Fake Dr. Janet Pope, Ontario, Canada, discusses emulation trials in systemic lupus erythematosus. https://t.co/wVmMfLVAuQ https://t.co/V4VGVncSE9

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Dr. John Cush RheumNow ( View Tweet)
IMPACT Study - Certolizumab Efficacy in APS Pregnancies A pilot trial assessed the safety and value of tumour necrosis factor α inhibitor treatment with certolizumab in patients with high-risk pregnancies with antiphospholipid syndrome (APS). Certolizumab (CZP) was shown to https://t.co/sbXW6vNX5y
Dr. John Cush RheumNow ( View Tweet)
Moving Targets in Lupus and Lupus Trials In the 1990s, developing lupus treatments became a priority, but success was elusive for 20 years. Belimumab was approved by showing only small differences from placebo in trials with 867 patients globally. Its efficacy was confirmed by https://t.co/TekxzTJjwC
Dr. John Cush RheumNow ( View Tweet)
Steroids in Lupus Nephritis: No Free Lunch https://t.co/yPQuZcnRLH https://t.co/V8GZoslSqV

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Dr. John Cush RheumNow ( View Tweet)
JAK inhibitors reduce inflammation while potentially exacerbating the propagation viral infections. They suppress transcription of IFN-stimulated genes in non-infected cells (usually triggered by type I IFNs produced by infected cells) Thus facilitating viral propagation https://t.co/BDzz8pHKxL
Dr. John Cush RheumNow ( View Tweet)
A retrospective VEXAS cohort study of 59 pts receiving 71 targeted Rx - 98%male, mean 71 yrs & 46% had myelodysplastic syndr. Treatments included tocilizumab(19), anakinra (13), azacitidine(13), baricitinib (11), & pred only (10). Best responses w/ azacitidine & tocilizumab https://t.co/fBdfrrZt1M
Dr. John Cush RheumNow ( View Tweet)
JAMA CME review of Immune Thrombotic Thrombocytopenic Purpura (iTTP) - thrombotic microangiopathy w/ hemolytic anemia (MAHA) & thrombocytopenia. iTTP incidence is 2-6 per million. Caused by Abs to ADAMTS13), w/ low ADAMTS13 activity vWF multimers bind platelets https://t.co/kwKXUciBd1
Dr. John Cush RheumNow ( View Tweet)
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