Systemic lupus erythematosus (SLE) is a severe multisystem autoimmune disease that can cause injury in almost every body system. While considered a classic example of autoimmunity, it is still relatively poorly understood. Treatment with immunosuppressive agents is challenging, as many agents are relatively non-specific, and the underlying disease is characterized by unpredictable flares and remissions. This State of The Art Review provides a comprehensive current summary of systemic lupus erythematosus based on recent literature. In basic and translational science, this summary includes the current state of genetics, epigenetics, differences by ancestry, and updates about the molecular and immunological pathogenesis of systemic lupus erythematosus. In clinical science, the summary includes updates in diagnosis and classification, clinical features and subphenotypes, and current guidelines and strategies for treatment. The paper also provides a comprehensive review of the large number
Results from a small, independently funded, double-blind, active-comparator trial suggest that baricitinib could be beneficial in the treatment of lupus nephritis.
Baricitinib met the primary endpoint in one phase 3 study of patients with systemic lupus erythematosus, but failed to meet the same endpoint in a second trial aiming to repeat the results, according to data published in The Lancet.
Disease activity was reduced by treatment with either of the novel investigational agents in two separate early clinical trials, with further trials planned.