New Sjӧgren’s syndrome therapies may target BAFF receptors, CD40
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DESTIN, Fla. — Multiple potentially new therapies promise to improve the management of patients with Sjogren’s syndrome, according to a speaker at the 2023 Congress of Clinical Rheumatology meeting.
These advancements follow years of researchers struggling to repurpose existing drugs to fit the needs of patients with the disease.
“We have been trying to repurpose other drugs to fit Sjogren’s for a long time,” Sara S. McCoy, MDPhD, rhMSUS, of the University of Wisconsin School of Medicine, told attendees at the hybrid meeting. “We’ve been failing a lot in Sjogren’s, and that has been really discouraging.”
The first target McCoy identified is the anti-BAFF receptor.
“It is really, really important for the maturation of B cells and the immune process in general,” McCoy said.
One such BAFF receptor inhibitor and B-cell depletion agent currently under investigation is ianalumab (Novartis). In a randomized, controlled clinical trial, the drug improved EULAR Sjogren’s syndrome disease activity index (ESSDAI) scores and may improve salivary flow in patients, according to McCoy.
“There is improvement in ESSDAI from baseline in high-dose ianalumab,” she said.
The next target McCoy mentioned for future drug development is CD40.
“There are a lot of drugs in this space right now,” she said.
In a randomized clinical trial, iscalimab (Novartis), an anti-CD40 anitbody, improved ESSDAI when administered intravenously in patients with high ESSDAI scores. Dazodalibep (VIB4920, Horizon), a CD40 ligand antagonist, similarly improved ESSDAI scores in patients with high disease activity, McCoy said.
However, even with these potential therapies, physicians treating patients with Sjogren’s syndrome must first accurately diagnosis the disease and pay attention to disease activity scores.
“[ESSDAI] is actually not easy to do,” McCoy said. “But it is important to know, because all of our drugs right now are using this as a primary endpoint.”
The index is important to acknowledge, she added, because if a drug is evaluated on the grounds of the ESSDAI, those drugs may only prove efficacious in patients with high ESSDAI scores.
Above all, McCoy stressed the importance of achieving a timely and accurate diagnosis.
“I hope that I have really driven home the point that it is so essential to diagnose your patients with Sjogren’s upfront,” she said. “Because, let’s say they don’t have Sjogren’s, and these drugs come out; then they are never going to get them.”
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McCoy SS. Extra-mucosal manifestation, comorbidities and treatment of Sjogren’s disease. Presented at The Congress of Clinical Rheumatology East; May. 4-7, 2023; Destin, Florida (hybrid meeting).
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