How Lupus Should Be Viewed and Managed Today, According to The Medical Director of the Lupus Foundation of America

Ines Martins, PhD avatar

by Ines Martins, PhD |

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While biomedical research and development has come a long way in understanding lupus and how to manage it, experts believe they have barely made a dent in this autoimmune disease’s complexity and elusiveness. Many diseases stem from and degrade specific organs, which leads to tell-tale symptoms. Lupus, however, tends to be unpredictable and can affect the patient’s body in a manner or degree completely different from other lupus patients.

In fact, because this disease poses more questions than what today’s science can immediately answer, an emerging specialty of doctors has turned their focus and efforts on trying to debunk lupus and treating patients. Even though lupus can be unpredictable and difficult to identify, researchers were able to observe common overlapping symptoms, and further studies were able to pinpoint overlapping molecular disorders in the human immune system. This ultimately means there is no definitive means to diagnose lupus, and that not all treatments will be effective in all patients.

Joan T. Merrill, MD, the Medical Director for the Lupus Foundation of America, talks about these points on lupus in a commentary recently published in Nature Reviews Rheumatology, an internationally acclaimed scientific journal. Dr. Merrill urges researchers and healthcare providers alike to change the notion that lupus can be treated by specifically treating the organs affected by the disease. According to her, this approach tends to cause adverse effects and can be unnecessarily costly on the part of the patient because he/she may not respond well to the treatment. According to Dr. Merrill, “Not all patients who share a certain organ involvement are going to be optimally treated with the same medicine at the same dose.  Some may need a combination of treatments; others may not need so much.  A better understanding of those variables can be made, in part, by an improved classification of lupus. This would allow better results for more patients and avoid unnecessary toxic combination therapies for others. This is exactly where the field of lupus needs to go.  Thinking of lupus as a subset of arthritis isn’t going to get us there. The time has come for a more rational approach to selection of therapy than treating lupus by the organ”, she stated in a news release of the Lupus Foundation of America.

In a recent study presented during the European League Against Rheumatism (EULAR) Annual European Congress of Rheumatology, patients suffering from moderate-to-severe systemic lupus erythematosus (SLE) who have been treated with Benlysta have a low incidence of organ damage.

Researchers found that among the final 403 SLE patients, 343 (85.1% of the patients) had no change in SDI score between baseline and after the treatment, with only a mean SDI increase of 0.19. Of the 162 SLE patients who exhibited organ damage at baseline, 132 had no change in SDI score, with a mean change of 0.23. Of the remaining 241 SLE patients who did not have organ damage at baseline, 211 (87.6%) had no change in SDI score, with a mean change of 0.15.