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Iberdomide Efficacy in Cutaneous Lupus

Iberdomide, a cereblon modulator that promotes degradation of transcription factors Ikaros and Aiolos, has been shown in a phase 2 trial to improve outcomes in subacute and chronic cutaneous lupus erythematosus (CLE).
 
This phase 2 study enrolled 165 CLE patients who were reandomized (2:2:1:2) to to 3 different doses iberdomide (0.45, 0.30 or 0.15 mg) or placebo (n=83) daily while on stable, background lupus medications. Primary outcomes were measured by the Cutaneous Lupus Area and Severity Index Activity (CLASI-A) score.
 
At entry the mean CLASI-A score was 6.9 (28% of patients had a score ≥8) and 56% had acute CLE, 29% chronic CLE, and 16% subacute CLE. Mean CLASI-A improvement in patients with baseline score ≥8 was:
  • 39.7% for iberdomide 0.45 mg 
  • 20.1% for placebo at week 4 (P=0.032)
  • Week 24 results showed continued improvement (66.7% vs 54.2%; P=0.295).
  • ≥50% CLASI-A reduction at week 24 was significant for those with SCLE (91.7% vs 52.9%, P=0.035) and CLE (62.1% vs 27.8%; P=0.029) when comparing iberdomide 0.45 mg versus placebo outcoms.  yet the overall population (55.6% vs 44.6%) with a baseline CLASI-A ≥8 was not significantly different (66.7% vs 50.0%).
 
Iberdomide showed beneficial effects when added to background lupus medications in patients with subacute and chronic CLE.

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Disclosures
The author has no conflicts of interest to disclose related to this subject