Update on Clinical Trials in Systemic Lupus Erythematosus

Sonali Narain; Richard Furie


Curr Opin Rheumatol. 2016;28(5):477-487. 

In This Article

Targeting Plasma Cells

Proteasome Inhibitors

The effectiveness of proteasome inhibition is because of the drug's ability to cause apoptosis of plasma cells by blocking nuclear factor kappa B pathway activation. In a recent trial,[38] 12 patients with refractory SLE received bortezomib (1.3 mg/m2) and dexamethasone (20 mg). Although proteinuria was reduced in a subset of lupus nephritis patients (median 2.2–0.87 g/day at 3 months), treatment had to be discontinued in 58% of the study participants because of adverse events varying from infections to polyneuropathy. There is hope for next-generation proteasome inhibitors with greater tolerability. A trial is underway studying ixazomib, an oral proteasome inhibitor, in patients with lupus nephritis.