Update on Clinical Trials in Systemic Lupus Erythematosus

Sonali Narain; Richard Furie

Disclosures

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

In This Article

Targeting T Cells

The role of T cells in SLE pathogenesis has recently come to light.[39] Not only are they thought to be phenotypically and functionally altered in SLE, but also happen to play a crucial role in B-cell maturation, differentiation and proliferation as well as in inducing class switching and antibody production. T-cell therapies in SLE range from drugs that down regulate T cells and cytokine production to modifying T–B cell interactions. Key trials are illustrated in Table 2.

Laquinimod is an oral quinolone-3-carboxamide small molecule that has an immunomodulatory effect on T helper cells in favor of T helper 2 over TH1 leading to suppression of proinflammatory cytokines and upregulation of anti-inflammatory cytokines.[40] A phase II lupus nephritis study showed that the combination of laquinimod (0.5 versus 1 mg/day) and SoC marginally improved estimated Glomerular filtration rate from baseline and reduced proteinuria at 24 weeks, although the study was not powered to deduce statistically meaningful differences. Adverse events were not significantly increased in the treatment groups; however, one death (one of 15) secondary to pneumonia and sepsis occurred with laquinimod.[41]

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