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Small-molecule Drugs to Treat Systemic Lupus Erythematosus

A metanalysis of randomized controlled trials (RCTs) on treatments of systemic lupus erythematosus (SLE), confirm the efficacy of several targeted small-molecule drugs. 

Newly developed therapies have become a hot topic in lupus therapeutics, with most of the attention going to infusible biologics. This network metanalysis included 13 studies and 3,622 patients taking 9 targeted small-molecule drugs for SLE. For most of these trials the primary outcome was SRI-4.

Results demonstrated that the Tyk2 inhibitor, deucravacitinib, was significantly superior to the JAK inhibitor, baricitinib (RR = 1.32, 95% CI (1.04, 1.68), P < 0.05).  By BICLA response, deucravacitinib significantly outperformed the placebo (RR = 1.55, 95% CI (1.20, 2.02), P < 0.05). 

Overall, the targeted small-molecule drugs did not shows more adverse events as compared to placebo. 

The dose and the course of treatment had little impact on the effect of targeted small-molecule drugs.

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease induced by immune system dysfunction, which may cause damage to multiple organs and systems [1]. The pathogenesis of SLE is very complicated, involving almost all parts of the immune system. Multiple genetic, epigenetic, environmental, and hormonal factors may lead to the loss of self-tolerance and disorders of adaptive and innate immune systems [2]. Therefore, the treatment of SLE is complex and challenging.


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