COMMENTARY

EULAR 2010 Lupus Highlights From Allan Gibofsky, MD

Allan Gibofsky, MD

Disclosures

July 02, 2010

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Allan Gibofsky, MD: Hello, I'm Allan Gibofsky, Professor of Medicine and Public Health at Weill Medical College of Cornell University and Attending Rheumatologist at the Hospital for Special Surgery [in New York, NY]. I'm here at EULAR 2010 in Rome, Italy, and I'd like to comment very briefly on some of the abstracts and presentations that have been presented here that are of particular interest to those of us involved with the care of patients with systemic lupus erythematosus (SLE).

I think that there are several developments that we need to keep in mind and that we ought to be aware of that were presented here at this meeting. Great excitement is surrounding the newest data about, perhaps, the newest SLE therapy - that is anti-B-cell therapy, but in particular, anti-BLISS therapy. BLISS is a molecule that regulates B cells, and there has been great excitement about the fact that there has been efficacy shown in reducing lupus flares and, to some degree, lupus activity as well. In patients with lupus, this represents a significant advance because, quite honestly, we really don't have very many options for patients with advancing disease, let alone advanced disease. If acceptable, this entity would become the newest therapy that we've seen in lupus in several decades, so I think the interest surrounding this molecule is real and will almost certainly be sustained should it come to fruition and availability for our patients.

Other areas of interest involve the possibility that we might be able to predict either toxicity to therapy in lupus or, perhaps, efficacy of therapies in lupus. I'm referring particularly to some of the work of Dr. Peggy Crow and colleagues[1] at Hospital for Special Surgery, where they looked at interferon signatures in patients. Dr. Crow and her co-investigators have demonstrated clear differences in patients with active and inactive disease as compared to patients with other rheumatic diseases. The use of interferon signature patterns in combination with, perhaps, other biomarkers may very well lead to individualization of therapy in lupus and, for all we know, other diseases as well, where the need to individualize therapy is particularly important.

We've also seen and heard significant advances in the recognition, treatment, and chronic management of neuropsychiatric lupus, and the notion that neuropsychiatric lupus may itself be amenable to earlier diagnosis and earlier therapy.[2] The work of Betty Diamond and her colleagues is particularly exciting in this regard, and I think further work will demonstrate the lasting impact of this observation on our clinical armamentarium.

As was demonstrated by several groups here at EULAR, there is any number of advances that we could be discussing in terms of how changes in activity may predict outcome. And I think all we can say is that SLE remains, for us all, one of the most challenging conditions because of the protean clinical manifestations that we have to deal with. However, if the advances that we see here at this meeting and others stand this test of time, then I think we have the real possibility of offering significant hope to our patients with this disabling autoimmune disease.

Thank you.

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