More than 3,000 scientific abstracts spanning the latest in lupus research were presented at the recent American College of Rheumatology (ACR) annual meeting in San Francisco, which brought together nearly 17,000 healthcare providers and researchers in the fields of rheumatology and immunology.
According to an article written by Anita Roach, MS, manager of The Lupus Foundation of America’s Research Program, that ran on lupus.org, the meeting covered several topics in research, such as children and teenagers with lupus, the effects of lupus in pregnant women, and the disease’s economic impact on patients. Two topics of particular interest concerned promising new therapies and the environmental dimensions of lupus development and progression.
At the meeting, ACR distributed awards of distinction to clinicians and scientists for exceptional work, with many members of the Lupus Foundation’s Medical-Scientific Advisory Council (MSAC) being recognized.
New Lupus Therapies
At the Novel Therapies in Lupus session, data from a multicenter, international Phase 2 trial of anifrolumab, a new monoclonal antibody therapy against type 1 interferon receptors, was presented. The trial’s primary goals were the evaluation of effectiveness and safety of anifrolumab, with results showing that its combination with standard care medications significantly reduced disease activity and improved symptoms in people with moderate to severe lupus (compared to a placebo control). The drug was considered safe and a phase 3 trial of anifrolumab is currently awaiting results, which could lead to a its approval and eventual commercial availability.
Results of an international, multi-center, phase 3 clinical trial of belimumab (the first FDA-approved medicine to treat lupus in over 50 years), were also discussed during the meeting. In this trial, the drug was administered subcutaneously, avoiding the more time-consuming intravenous infusion and allowing self-administration at home or at the patient’s convenience, with the potential to improve treatment. Patients who received belimumab through injection plus standard-of-care medications had significantly greater reductions in disease activity compared to the placebo group. Moreover, when compared to data from previous trials, belimumab delivered by injection was as effective at reducing disease activity as the intravenous method.
Environmental Triggers of Lupus
Epigenetics was the second most debated topic at the ACR meeting. Epigenetics is the study of factors that influence the way genes are activated (turned on) or silenced (turned off) when cells replicate. Factors affecting this process are sometimes external, like environmental triggers (such as UV light, pesticides, or hormones) and are thought to possibly contribute to the development of specific diseases. Epigenetics is seen as an important mechanism to study the risks of exposure to certain elements and has attracted research funding opportunities for several years.
During the Edmund L. Dubois, MD, Memorial Lectureship, a series of epigenetic discoveries by Amr Sawalha, chair of the MSAC Research Subcommittee, were honored. Also, findings that lupus immune cells accumulate more DNA damage upon exposure to environmental stress factors when compared to healthy immune cells, were presented. Other presentations included the identification of specific environmental factors that can be decisive in lupus development and progression, such as living near highways where the air is more polluted, a well-known trigger in several inflammatory conditions.
“A better understanding of how environmental exposures, epigenetics and genetics interact will provide insight into the risk and progression of lupus, as well as new therapeutic approaches for lupus. This is why the Foundation recently awarded an investigator research funding for the study of environmental triggers in lupus,” Roach concluded in her article.