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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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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.
Article
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?
Article
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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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).
Dr. John Cush
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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
Dr. John Cush
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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
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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
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Steroids in Lupus Nephritis: No Free Lunch
https://t.co/yPQuZcnRLH https://t.co/V8GZoslSqV
Dr. John Cush
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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
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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
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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
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Hydroxychloroquine for Everyone
Nearly 25 years ago, while lecturing on best therapies for rheumatoid arthritis (RA), I loudly stated that hydroxychloroquine was “useless” and, deservedly, I was “boo-ed” off stage. My point then was that rheumatologists needed to be aggressive, https://t.co/qKnObzr5ib
Janet Pope
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Does ADDING an #immunesuppressive
To
#belimumab in #SLE give more benefit?
❎
NO
#RWE from Spain suggests no added improvement adding IS to Belimumab
Should you switch Rx then? 🤷♀️
@RheumNow #LUPUS2025 poster110
#ClinicalPearl https://t.co/C3ydArMx7x
Janet Pope
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Treat to target 🎯 #SLE #recommendations
Considerations are nuanced and Impt
Lowest clinical disease activity is goal
Try for remission
🎯 Get patients off #glucocorticoids
If not ⬇️low dose #prednisone
@RheumNow #LUPUS2025 https://t.co/HlBeh2FLxP
Dr. John Cush
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Lupus Unlocked: Pregnancy & SLE
📅 May 27, 2025
6:00 PM CT | 7:00 PM ET | 4PM PT
Join us for our final Lupus Unlocked webinar this month on pregnancy and SLE. In this webinar, panelists will discuss issues such as congenital heart block, lupus nephritis treatment, teratogenic https://t.co/gouTN7uzCo
Janet Pope
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IL2 low dose in #SLE
seems to + alter immune regulation
Multiple targets to explore in #lupus
Unravelling pathophysiology in SLE
CD40L
TLR7,8
#rapamycin type drugs
CAR-T w novel CARS
Etc
#LUPUS2025
@RheumNow https://t.co/jeycgg4ZhT
Janet Pope
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We are not (yet) in #SLE
Getting
👇
Correct drug
In right pt
At right time
At correct individual dose
Even more problematic is in a renal bx - 2 glomeruli beside each other have v different cytokine expressions
Unravelling #LUPUS2025
@RheumNow https://t.co/yGBvhFkPKY
Janet Pope
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Here’s who flares in #SLE
least to most
Persistently neg antiDNA
Persistently + antiDNA
conversion of neg to + antiDNA
So are we over ordering antibodies in 1st 2 groups 🤷♀️
Unravelling #LUPUS2025
@RheumNow https://t.co/1Feau7f199
Janet Pope
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controversy re
👇
Monitoring for +Ro pregnant re
#congenital #heart #block
87% Y
echo is possibly too late
No ideas if flourinated #steroids work
But many thing we should do something
Guidelines differ on recommendations
Would fetal home HR be better
#LUPUS2025 @RheumNow https://t.co/MY0oPjLnGs
